Image: gaelx – CC BY-SA 2.0
There’s an odd cognitive dissonance when it comes to dependence upon medications, amongst clinicians and public alike.
When it comes to pharmaceuticals, some people will say “I’d hate to be dependent upon anything.” Righty-ho, I’ll just be a tick – nipping outside to cut off your water supply. In fact, bear with me – I’ve got some canisters of nitrogen in the car. We can rig those up to purge all the oxygen from the room. You’re okay with that, right?
If people have atrial fibrillation we give them blood thinners to reduce the possibility of stroke. We give insulin to diabetics so that they don’t get brain damage and die. Immunosuppressive drugs are prescribed long term if someone has lupus. Although it’s never lupus.
But when it comes to psychiatric drugs, dependency is often seen as a Very Bad Thing©. I think this may have started with the advent of Prozac, when they came with every McDonalds Happy Meal for a while. When this over-prescribing was rightly recognised, there seems to have begun a kick-back against psychiatric drugs in general.
In having conversations with people in the know, I’ve been warned that pregabalin can cause ‘discontinuation syndrome’. Said information was given to me as friendly advice – which is very much appreciated – but my immediate reaction was simply that unless I start to suffer unmanageable side-effects, I see no reason to discontinue it anyway.
Another person, who works in a rehab centre no less, described pregabalin as a Highly Addictive Drug©. When it’s prescribed for the reasons I’m on it, all my research indicates that this is simply untrue.
Any psychoactive drug has abuse potential – I used to care for someone who was always trying to get more PRN haloperidol, and why anyone would want to abuse that particular antipsychotic is pretty hard to fathom when you read up on it. I can also imagine that if someone’s been prescribed pregabalin for neuropathic pain, there’s a risk that they want to continue with it even when the pain’s gone – and it’s fair to say that counts as ‘abuse’. But to call it a Highly Addictive Drug© is getting things out of perspective a wee tad when you consider other substances. I’ve heard that crack can be a bit moreish for instance.
But it did give me cause to ponder what exactly we mean by ‘addictive’. When pregabalin’s prescribed for Generalised Anxiety Disorder, then the fact that someone doesn’t want to stop taking it just means it’s doing its job, surely. Take the pregabalin away, and all the symptoms of my GAD come rushing back, like a swarm of malevolent sprites intent on dragging me underwater again. And given that, of course I’m damn well going to be agitated and want to recontinue.
If stopping it didn’t result in me feeling mentally worse, then why the hell would I be taking it in the first place? Without the pregabalin I wouldn’t be growing chillies, and I wouldn’t be writing this blog. I’m rather keen on this new experience of the world, breathing the reality around me instead of the ceaseless sense of looming catastrophe that was inside my head before. On my current low regimen I still get that feeling between doses – I can’t bear the thought of returning to it 24/7. If you want to say that it’s addictive because of that then fine, go ahead. I say that it means it works.
This phenomenon doesn’t appear so much for the types of conditions I mentioned previously, conditions that show up on a scan or a blood test. No one worries about the fact that people have to take their medication for those conditions. But for invisible illnesses, there’s a pervading sentiment that we shouldn’t be reliant on them.
Like I said – cognitive dissonance.