Drug addiction?

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Photo by taiyofj : Flickr click image

There have been many discussions on over reliance/ dependence on medication over the years. Personally, I do think that both public and professionals rely too much on pill popping. I certainly feel a degree of sympathy for GP’s who have a few minutes to decide on someone’s illness and treatment plan. The prescription of a drug is likely to work so this becomes a ‘default’ option (and my apologies to any GP’s reading this.  I am aware that this is very simplistic but it does illustrate a point that is true for all professionals. And patients…well, when I see a health professional I will admit to feeling comforted by popping a pill. After all, a pill means that my illness is treatable doesn’t it?

 

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Medicine (photo KB35 on Flickr : Click image)

But hang on. If this deeply held belief that pills cure illness is flawed, then what is even more flawed is the idea that medication even treats mental illness. Lets look at depression. Depression involves the lowered state of serotonin and so all anti-depressants work by increasing levels of this neurotransmitter through one means or another. But aren’t we missing the point? By increasing serotonin levels all we are doing is dealing with the symptoms of an illness, not the illness itself. Schizophrenia treatment is exactly the same but here it is reducing the elevated dopamine.

My point – we are not dealing with illness eradication, rather we focus exclusively on symptom suppression. But this is the nature of mental health problems. It would be foolish to think that a little tablet taken twice a day will be a panacea for all our ills – unfortunately though, this is exactly what people think.

7 thoughts on “Drug addiction?

  1. Unfortunately no. The issue that I was trying to highlight was that we place so much faith in medication to cure us but in reality, the medication masks the symptoms whilst it is the human body that actually deals with the illness.

    To be honest, I wish I did have something better.

  2. There is much that can be done to treat disorders such as depression or schizophrenia without over-reliance on medication. In the case of schizophrenia, work on interpretation and perception of sensory experience produces massive improvements in people’s lives.

    Working on helping people to learn to control their own mood directly has a huge impact upon depression.

    Conversely, prescribing medications produce what psychologists call ‘safety behaviours’ and creates a belief that the person cannot cope without the meds. This makes it much less likely that they will do the work needed for recovery because the prescription itself suggests that there is no hope.

  3. I think you are right Tony, people do think pills are the cure to all ills. Because this is what we are led to believe, not only in MH but physical also. I have often been asked by some mh staff, “What do carers expect” as if MH cares are any different than them.

    We expect what we have been led to believe, if you pop a pill it sorts the problem out. Just like pain killers or anti biotics.

    Antipsychotics can suppress the symptoms in some as with antidepressants both have addictive properties and both have withdrawal symptoms. I can see where Stuart is coming from with his perspective the prescription itself suggest there is no hope. But he knows the prescription only mask the symptoms, the patient doesn’t and neither do the relatives. They have to learn the hard way, this is hidden from both patient and relatives just like the more severe side effects are.

    I remember the day I discovered the more serious side effects of Clozaril. My first thought was I shouldn’t tell my son, followed very quickly by guilt. To let him take this medication without knowing what it might do to him, was for me like conning him into taking something that could cause him severe harm and if he died as a result, because I was aware I would feel I played a hand in his death.

    What I didn’t know at the time was he could have suffered a fatal heart attack or stroke within the first few weeks. Nobody tells you this and I wonder if he had a physical illness would the risks be witheld as they are with MH patients.

  4. I’ve popped over from Mental Nurse.

    I’m conflicted about this. Mental illness is so awful that I don’t want to begrudge anyone anything that helps abate that awfulness. The pills are tremendously overprescribed, often to people who aren’t mentally ill, but are perhaps just a bit sad or stressed. But should that matter? If the pill helps, who am I to say that they aren’t “sick enough”? Perhaps the crux may have to be the danger of these pills, determining whether the potential benefit is worth the risks.

    Your description of the flawed concept of the helpfulness of medication, though damning, doesn’t even get entirely at the flaws. We only decided that depression is caused by decreased levels of serotonin because we gave some people some chemicals that seemed to alleviate depression a bit, then noticed that those chemicals also happened to increase serotonin levels. We could be completely wrong about serotonin, which could also be why psychotropic drugs are so hit-or-miss.

  5. Indeed.

    It’s interesting that after over half a century of expensive research the dopamine hypothesis of schizophrenia is still just that – a hypothesis. Personally I’ve yet to see any evidence that schizophrenia is an organic brain disease that isn’t either mirrored in the general (non-psychotic) population or the result of antipsychotics themselves.

    Not that I think drugs have no place in psychiatry – it’s only 2009 and we simply don’t know enough yet to dispense with them. I do think though that it’s about time we stopped pretending that we’re treating an organic brain disease when really all we’re doing is tranquilising.

    There is a role for tranquilisation given the state of our current knowledge, especially in the acute phase of psychosis, but there’s also a role for other interventions such as CBT and my own specialty of Psychosocial Interventions. In fact I think that the only route to widespread recovery is via medication reduction and the increase of psychological and social assistance.

    Cheers,

    Stuart

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