Misuse of medications is a serious problem in developing countries where drug sales are not regulated. This study assessed drug knowledge and use in a rural Ghanaian town. We surveyed health care workers and a community population sample regarding knowledge and use of available drugs. Although drugs were used by a large percentage of the population, only a small percentage correctly described their recommended use. Doctors and medical assistants were knowledgeable in the correct use of drugs, while chemists were poorly informed. However, the majority of the non-health care worker (NHCW) population bought drugs from chemists without a prescription. We conclude that in this rural setting, chemists contributed to drug misuse by providing misinformation about drugs and selling drugs according to popular demand. Educational programs for chemists and the population regarding drug use and regulation of drug sales by chemists will be critical to drug reform in Ghana.