PATTERNS AND REASONS FOR ANALGESIC USE AMONG NORTHERN BORDER UNIVERSITY STUDENTS, SAUDI ARABIA

Mohamed M Abd El Mawgod^1,2*, Abdulaziz Mohammed Almalki³, Omar Mosab Alenzi³, Arwa Mosab Alenzi³ and Rahaf khalid Al obidan^3
*Correspondence: Mohamed M Abd El Mawgod, Department of Family and Community Medicine, College of Medicine, Northern Border University, Arar, Saudi Arabia, Tel: 00966501171525, Email:

Introduction

The global usage of analgesics has grown during the previous three decades. Prescription medication misuse has risen considerably.(Althemery et al., 2025) Irrational use of over-the-counter analgesics has negative health consequences, and steps must be taken to discourage it and improve the rational use of analgesics, which can be accomplished by raising individuals' awareness of rational medication use. (Khaled, 2025)

A study in Saudi Arabia found that 73% of the participants utilized analgesics, with headache being the most often given reason, and health professionals being the most common source of knowledge. (Elmorsy et al., 2024)

Analgesics are one of the most often used and misused drugs. Pain relievers such as paracetamol, aspirin, and non-steroidal anti-inflammatory medications are presently the primary methods of pain treatment. Unfortunately, these medications have serious side effects, especially when they are taken inappropriately and without regard for safety guidelines.(Siddig et al., 2020) University students frequently encounter special health hazards, such as stress, poor diet, inadequate sleep, drug abuse and mental health issues.(Mofatteh, 2020) Recognizing their behaviours and attitudes allows institutions to focus on possible risks and give resources to mitigate them effectively.(Kokabisaghi et al., 2024)

Analgesics are commonly used to treat a variety of medical ailments. However, inadequate information regarding proper usage and its side effects creates health problems.(Alwashali et al., 2024)

According to a Saudi Arabian study of university students, 23.2% obtained analgesics without a prescription, with headaches being the most common reason. (Alenzi, Bedaiwi, Hamayun, Alanazi, & Fawzy, 2024)

According to descriptive cross-sectional research conducted in Saudi Arabia, medical students consume analgesics at a rate of 92.7%.(Alharthi, Althomali, Alsufyani, Alsufyani, & Elnemr, 2019) Descriptive research conducted in Makkah, Saudi Arabia revealed that 45.8% and 27.5% of the respondents identified paracetamol as damaging to the kidney and liver, respectively. A Saudi Arabian study of females of reproductive age found that 76.2% used analgesics, with paracetamol being the most used drug. (Alali, Alhejji, & Younis, 2024)

Promoting awareness and offering educative initiatives for groups of students at high risk is necessary to encourage sensible medication use by emphasizing the importance of using medical services that are available on campus for free and discussing with health care specialists.(Alenzi et al., 2024)

Our study aimed to explore the pattern and knowledge of analgesic usage among university students at Northern Border University, and the awareness of analgesic side effects.

Subjects and Methods

Study setting and design: A quantitative cross-sectional survey was undertaken among university students at Northern Border University from 1 December 2023 to 30 April 2024

Tool of the study: A self-administered structured questionnaire was developed following a thorough literature review to recognize the assessment of the knowledge and practices around analgesic usage. Four closely related publications were used in the tool development.(Al Masoudi, Al Dweik, & Al- Dweik, 2023; Asiri et al., 2020; Mahmoud, Raghad, Sultan, & Aljuhani, 2020; Siddig et al., 2020)

The tool included four sections. The first section included the participants' sociodemographic information, such as age, gender, college name, residence, and GPA. The second part involved questions about the patterns of analgesic use among the investigated participants, the third part examined the participants' awareness of analgesic side effects, and the last section assessed the source of information and analgesic accessibility among analgesic users.

Pilot study: To assess the tool's limitations and constraints, a pilot study was employed with 20 participants using the same criteria, settings, and data collection methodologies. Piloting participants found the instrument's items clear, complete, and relevant to the purpose. The time required to accomplish it ranged from 5 to 8 minutes.

Content validity: The tool was examined for content validity by three qualified experts. The distribution of the experts was as follows: Two family medicine consultants, and one community medicine staff at Northern Border University.

Sampling method: A convenience sampling approach via Google Forms was employed for recruiting participants from four colleges at Northern Border University, two theoretical (Business, and Education), and two scientific (Engineering, Science) colleges.

Sample size: The sample size was estimated using Epi Info software version 7.2.4.0 with the following parameters: 50% expected use, 0.05 margin of error, and 95% confidence level. Based on the inputs provided, the predicted sample size is 376. Using a 10% non-response rate (about 38), the total sample size is 414, then the sample had been completed at 420.

Inclusion criteria: University students from the selected colleges, both male and female, are ready to be involved.

Exclusion criteria: University students who are not affiliated with recognized colleges, and those who declined to participate.

Ethical clearance: The current research was accepted and approved by the local bioethical committee at Northern Border University (HAP-09-A-043) on November 28, 2023, with decision no. (102-23-H).

Results

The socioeconomic characteristics of the research participants are shown in Table 1. In all, 420 people were involved in the research; their mean age was 21.4±4.2 years, they were mostly from urban areas, over one-third were between the ages of 18 and 20, and slightly over half were female. Around two-thirds of their GPA ranged between 4-5; business college students made up slightly over 30%, science students slightly over 25%, engineering students roughly 25%, and education students less than 20%. Concerning the distribution of college students, less than 25% belong to the third year, and less than 15% come from the fifth.

Age: Mean±SD=21.4±2

Table 2 displays the study subjects' patterns of analgesic use. Most participants (75%; 315) who used analgesics did so regularly (93%; 293). The most widely used analgesic (67.9%; 214%) is paracetamol, which is more frequently taken during exams (65.8%; 179). The primary reason for using analgesics was headache (50.5%; 159). About one-third proposed raising the dose, and slightly more than fifty percent said they would see a physician or pharmacist if there was no improvement. About half of analgesic users sleep six to eight hours a day, fewer than forty percent use their phones for four to six hours a day, and less than twenty percent are smokers.

*No (315)

Table 3 demonstrates participants’ knowledge of analgesic side effects. A significant proportion knew that increasing analgesic doses have renal (82.6%; 374); gastric (74.5; 313); adverse effects; and (70.8%; 297) concurred that analgesics have contraindications.

Table 4 lists the analgesic users' information sources and analgesic accessibility. In terms of information sources, physicians were most often stated (31.1%; 98), then pharmacists (29.8%; 94), parents (15.4%; 49), personal knowledge (18.1; 57), and friends (1.6%; 6). The majority (71.7; 226) said they obtained their analgesics from the pharmacy, whereas less than half of users indicated they would consult a physician if they experienced analgesic side effects.

Discussion

Regarding analgesic use, the study reveals that three-quarters of the participants use analgesics regularly or occasionally. Paracetamol is the most often used analgesic, and headache is the most reported reason, slightly more than fifty percent claimed to seek advice from a physician or pharmacist if there is no improvement.

Align with research done among Taif University students in Saudi Arabia, indicated that paracetamol was the most often used analgesic (77.3%), generally used on necessity (95.7%), and 70.9% consulted physicians or pharmacists if there were no changes. (Siddig et al., 2020) El ghazaly et al. reported that 89.6% of medical students in Qassim province utilized nonopioid analgesics, with headaches being the most common cause (66.8%). (Elghazaly et al., 2023), Comparable research done among medical students at King Abdulaziz University in Jeddah, Saudi Arabia, indicated that analgesics were the most often used medication (55.4%).(Ibrahim, Alamoudi, Baamer, & Al-Raddadi, 2015), According to a Saudi Arabian study of university students, 23.2% received analgesics without a prescription, with headaches accounting for the majority of cases (59%).(Alenzi et al., 2024) In Jordan, Al Masoudi et al. in comparable research revealed that 31.3% of the students utilized analgesic medicines over the preceding month from data collection.(Al Masoudi et al., 2023).

Community-based research in northern Saudi Arabia reported that 78.7% of participants utilized analgesic drugs as prescribed, with paracetamol most often used (50%).(Elmorsy et al., 2024) A study done among the adult population in Taif Saudi Arabia, indicated that 65.1% were using analgesics, mostly for pain relief(30.9%) and headache(19.1%), and 9.7% claimed they took it regularly.(Asiri et al., 2020) In a survey among the adult population in the Qassim region, Saudi Arabia Al-Abbasi et al. mentioned that 74.75% used analgesics without prescription, with paracetamol the most frequently used 43.5%. (Al-Abbasi & Sekhar, 2020), A survey of the general population in Hail, Saudi Arabia indicated that paracetamol was the most often used medication (71%), 21.6% used more than one analgesic, headache was the most frequent reason(33.3%), and 41.1% sought advice from physicians or pharmacists. (Mahmoud et al., 2020) Community-based research in Jordon found that more than one-third (37.1%) of the participants used analgesics, with paracetamol being the most widely used, headache being the second most 2nd prevalent reason, and thirty percent getting advice from a physician or pharmacist. (Alkilani et al., 2019), Community-based research in Albania indicated that paracetamol was the most frequently utilized analgesic medication (36.1%). (Roshi et al., 2017) Furthermore, a Croatian study found that headache is the most prevalent analgesic commonly used among dental medicine students. (Šimunović, Špiljak, Bašić, & Šutej, 2024)

An Iranian community-based survey reported that more than one of the respondents mentioned received analgesic usage guidance from a physician or pharmacist(56.7%) (Amirimoghadam et al., 2017), A Malaysian communitybased study found that more than one-fifth of participants agreed to take many analgesic drugs at the same time if there is no response for pain alleviation, and slightly less than 20% agreed to raise the analgesic dose for pain relief. (Paramalingam et al., 2021)

Concerning participants' perception of analgesic side effects, most of them reported renal and gastric side effects. In agreement with a comparable study done at Taif University in Saudi Arabia revealed that 47.2% of the participants were aware that paracetamol causes adverse effects. (Siddig et al., 2020),

Mahmoud et al., in Hail, Saudi Arabia showed that 45% and 31.5% of respondents noted stomach and renal adverse effects for analgesic use. (Mahmoud et al., 2020) also, in the same region, Altahini et al. discovered that 50% and more than 75% of subjects were aware of analgesic gastrointestinal and renal side effects. (Altahini et al., 2024), A study of university students in Hafr Albatin, Saudi Arabia, found that more than half of them had a strong understanding of analgesics' uses, and the majority of them claimed that analgesic medicines induce liver impairment. (Ismail et al., 2024), a Jordanian survey among university students indicated that 88.9% and 77.8% recognized that analgesics had a detrimental impact on the kidney and the stomach respectively. (Al Masoudi et al., 2023)

Descriptive research done in the Makkah region, Saudi Arabia, indicated that 45.8% and 27.5% of the subjects recognized paracetamol as harmful to the kidney and liver, respectively.(Alwashali et al., 2024) According to a Malaysia community-based survey, around 40% of respondents mentioned that analgesic has hepatic and kidney side effects, and approximately one-third (30.9%) agreed that frequent analgesic usage is associated with significant serious consequences.(Paramalingam et al., 2021) Furthermore, in Albania, Roshi et al. found that 31.2% and 27.1% of the participants reported that analgesics have gastric and renal side effects.(Roshi et al., 2017)

Regarding participants' information sources of analgesic use, physicians were the most often reported information sources, followed by pharmacists, parents, and personal knowledge. The majority indicated that they get analgesics from their community pharmacy, and fewer than half said they see a doctor if there are any side effects. In line with a similar study among Taif University students, in Saudi Arabia, Siddig et al. found that the most prevalent information source for analgesic usage is a pharmacist or physician (68.1%). (Siddig et al., 2020) In Qassim province, Saudi Arabia, half of the participants were aware of analgesic usage, with the pharmacist being the most prevalent and trusted source of knowledge (51.5%). (Elghazaly et al., 2023), in the same area, Al-Abbasi1 et al., in Qassim region, Saudi Arabia reported that they depend on their personal experience for analgesic use. (Al-Abbasi & Sekhar, 2020)

According to Mahmoud et al., research among the public in Saudi Arabia found that physicians (49.5%) and pharmacists (29%) were the most frequent sources of information on analgesic use.(Mahmoud et al., 2020) additionally, El morsy et al. reported that health professionals are the primary source of information(50%). (Elmorsy et al., 2024)

In Jordan, physicians and pharmacists were the sources of information for 21% and 57.4% of participants, respectively. (Altahini et al., 2024) In Libya, 38.5% of university students cited pharmacists as a source of self-medication with analgesics. (Omar et al., 2024)

Limitations

The descriptive nature of the study failed to identify the cause-effect relationship. The results didn’t reflect all university students at Northern Border University. Another limitation was that it depended on self-reporting, which was prone to recall bias.

Conclusion

The study demonstrated that most of the studied students at Northern Border University used analgesics regularly. The most widely cited analgesic was paracetamol, and headache was the most often mentioned reason. Fortunately, many respondents were aware of the analgesic side effects, and physicians were reported as the most common source of information. We advocate conducting a health education campaign on analgesic uses.

Conflict of interest

Nil

Funding

None

Author Contributions:

Mohamed M. Abd El Mawgod. The research's principal investigator. Conceptualization, Abdulaziz Mohammed Almalki, Omar Mosab Alenzi, Arwa Mosab Alenzi, and Rahaf Khalid Al Obidan collected and coded data. Mohamed M. Abd El Mawgod. Data input, cleansing, and analysis. Abdulaziz Mohammed Almalki, Omar Mosab Alenzi, and Arwa Mosab Alenzi wrote the original draft. The final version of the work was reviewed and approved by all authors.

References

Al-Abbasi, S. M., & Sekhar, K. C. (2020). PREVALENCE OF ANALGESIC USE AMONG GENERAL POPULATION IN BURAIDAH CITY, AL QASSIM PROVINCE. World Journal of Pharmaceutical Research, 9(6), 2346-2359.

Al Masoudi, W., Al Dweik, R., & Al-Dweik, G. (2023). Knowledge and practices regarding the use of non-steroidal anti-inflammatory drugs among university students in Jordan. The Open Public Health Journal, 16(1).

Alali, F. M., Alhejji, W. A., & Younis, N. S. (2024). Recognizing the usage of analgesics among Saudi women with primary dysmenorrhea. Signa Vitae, 20(3), 7-16.

Alenzi, E. O., Bedaiwi, S. K. A., Hamayun, R., Alanazi, A. S. T., & Fawzy, M. S. (2024). Key modifiable risk factors for self-medication among university students: An observational study. Explor Res Clin Soc Pharm, 15, 100483.

Alharthi, N. A., Althomali, M. M., Alsufyani, A. H., Alsufyani, A. A., & Elnemr, G. M. H. (2019). Prevalence of self-medication with analgesics among medical students of Taif University. International Journal of Medicine in Developing Countries, 3(12), 1122-1127.

Alkilani, A. Z., Alkalbani, R., Jaber, D., Hamed, R., Hamad, I., Abumansour, H., & Abu Assab, M. (2019). Knowledge, attitude, practice and satisfaction of patients using analgesic patches in Jordan. Tropical Journal of Pharmaceutical Research, 18(8), 1745-1753.

Altahini, A. T., Aburas, W., Aljarwan, S. F., Alsuwayagh, S. A., Alqahtani, N. F., Alquwaiay, S., & Anwar, S. (2024). Charting the Knowledge and Patterns of Non-Steroidal Anti-Inflammatory Drugs Usage in Hail Population, Saudi Arabia: Insights into the Adverse Effect Profile. Pharmacy (Basel), 12(1), 9.

Althemery, A. U., Alsubaie, M., Alharbi, H., Alqahtani, A., Alsubaie, G., & Alotaibi, A. (2025). Patterns of Opioid and NSAID Use in Saudi Arabia from 2010 to 2020. Journal of Psychoactive Drugs, 1-6.

Alwashali, D. N., Abumansour, R. T., Alansari, A. H., Alotaibi, T. A., Zaki, A. A., Fatani, Z. A., . . . Ageel, M. (2024). The Assessment of Knowledge, Attitude, and Practice of Paracetamol and Ibuprofen Administration Among Saudi Parents in the Makkah Region. Cureus Journal of Medical Science, 16(8), e67123.

Amirimoghadam, P., Zihayat, B., Dabaghzadeh, F., Kiani, K., Ebrahimi, J., Ghazanfari, M., & Arjmand, S. (2017). Evaluation and awareness of over the counter use of non-steroidal anti-inflammatory drugs. Journal of Applied Pharmaceutical Science, 7(3), 154-159.

Asiri, O. A., Alzahrani, A. A., Alshehri, K. M., Althomali, O. W., Alameen, A. A. I., & Serwah, M. A. (2020). Prevalence of non-steroidal anti-inflammatory drugs usage and assessment of knowledge related to its complications among Saudi population; a cross-sectional study. International Journal of Medicine in Developing Countries, 4(2), 296-296.

Elghazaly, A., Alsahali, S., Farooqui, M., Ibrahim, N., Alshammari, M., Almutairi, A., . . . Almutairi, W. (2023). A Cross-Sectional Study to Investigate the Prevalence of Self-Medication of Non-Opioid Analgesics Among Medical Students at Qassim University, Saudi Arabia. Patient Prefer Adherence, 17, 1371-1379.

Elmorsy, E., Alruwaili, S. M. M., Alsayer, R. I. A., Alanazi, N. K. J., Alshammari, K. H. S., & Albalawi, D. A. A. (2024). Pattern of analgesics' use and side effects among Saudis in Arar, Saudi Arabia. Annals of Clinical and Analytical Medicine, 15(1), 28-32.

Ibrahim, N. K., Alamoudi, B. M., Baamer, W. O., & Al-Raddadi, R. M. (2015). Self-medication with analgesics among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia. Pak J Med Sci, 31(1), 14-18.

Ismail, E. H. M., Dabaan, A. K., Almutairi, G., Alhumidan, F. A., Sami, M. A. P., Aldhafeeri, G. M., . . . AlFurayh, M. A. (2024). Knowledge, Awareness, and Attitudes Regarding Self-Medication With Non-opioid Analgesics Among Students in Hafar Al-Batin, Saudi Arabia: A Cross-Sectional Study. Cureus, 16(11), e73512.

Khaled, A. (2025). Assessment and Evaluation of Consumer Awareness and Self‐Medication Use Practices Towards Over the Counter (OTC) Analgesics. A Cross‐Sectional Study in Abha‐Saudi Arabia. Journal of Evaluation in Clinical Practice, 31(1), e14298.

Kokabisaghi, F., Emadi, M. S. M., Tajik, A., Sharifi, F., Houshmand, E., & Varmaghani, M. (2024). The prevalence and causes of self-medication among medical university students in Iran during COVID-19 outbreak and its implications for public health and health systems: A cross-sectional study. Health Sci Rep, 7(3), e1983.

Mahmoud, M. R., Raghad, E., Sultan, B., & Aljuhani, N. (2020). Awareness about misuse of analgesics and anti-inflammatories and their complications on liver, heart and kidney among Saudi Arabia population. Adv. Biores, 11 (2 ), 98-105.

Mofatteh, M. (2020). Risk factors associated with stress, anxiety, and depression among university undergraduate students. AIMS public health, 8(1), 36.

Omar, H., Omar, A., Elderbi, M., Omar, M., Faraj, M., & Abdulhamid, A. (2024). Analgesic Self-Medication among Medical Students in Omar Al-Mukhtar University. AlQalam Journal of Medical and Applied Sciences, 15801587-15801587.

Paramalingam, P., James, R., Zahari, N., Sethuraman, N., Jalil, A., & Rani, N. (2021). Knowledge Attitude and Perception (KAP) of Patients towards Analgesics Use: A Cross-Sectional Study in Outpatient Pharmacy Settings [J]. Bioinformation, 20(7), 11-20.

Roshi, D., Toçi, E., Burazeri, G., Schröder-Bäck, P., Malaj, L., & Brand, H. (2017). Users’ knowledge about adverse effects of non-steroidal anti-inflammatory drugs in Tirana, Albania. Materia socio-medica, 29(2), 138.

Siddig, A. I., Alqahtani, A. M., AlShalawi, A., Turkistani, M., Binbaz, S., & Altowairqi, A. (2020). Awareness of analgesics complications in Saudi Arabia: a cross-sectional study. Future Journal of Pharmaceutical Sciences, 6(1), 1-6.

Šimunović, L., Špiljak, B., Bašić, K., & Šutej, I. (2024). Self-medication, self-assessment and knowledge of dental medicine students about analgesics. Journal of Clinical and Experimental Dentistry, 16(8), e967.