We are all familiar with prescription drugs. We don’t feel so good, and we go and see the doctor. The doctor writes a prescription. We take the medication and the theory is that we get better. We implicitly trust the whole process.
It seems nowadays it is almost impossible to read a newspaper without reading about the damage certain prescription drugs are causing in individuals, families and communities. There have never been so many headlines about the misuse of prescription medication. In America, the word Epidemic is used to describe the current situation with opioids – these are being prescribed initially for pain management. This well documented issue is not just restricted to America, it a worldwide phenomenon. One opioid, Tramadol, has become the most misused medication in Egypt.
Here at the Kusnacht Practice we have seen an increase in the use of Lyrica – an anti-epileptic also used for nerve pain or anxiety. Particular in Arabian countries. It gives a feeling of euphoria. Lyrica was cited on 38 death certificates in the UK in 2014. I have seen clients taking up to ten times the recommended dose. Lagaflex is another medication misused in the Middle East. This is a muscle relaxant used to treat pain and injury. It produces effects similar to barbiturates and has been noted as a medication often abused alongside opioids as it increases the potency of those substances.
The use of benzodiazepines such as Xanax or Valium (there are many others) has been well documented for many years. I have seen clients that have been taking benzodiazepines for years. Ask anybody that works in the field of addiction and they will tell you the horror stories of patients trying to withdraw from this medication. Benzodiazepines are regularly described by clients as being the most difficult drug to stop.
So why are we facing such a global issue with the misuse of prescribed medication? Often, we are all looking for a short-term fix to change how we feel. Talking therapies may help in times of depression or anxiety but this may be either against cultural norms or too expensive or just simply not quick enough to alleviate discomfort. Of course, in terms of pain management talking therapies will not be a solution.
Poor follow up or monitoring of medication regimes can contribute to the issue – this could be because of time constraints, lack of knowledge of contra-indications, maybe it is easier to give the patient what they want. Especially if it is a private patient. I mentioned trust earlier – we trust our doctors have our best interests at heart without considering it is impossible for a doctor to be an expert in everything. Plus, it is easy to operate under the misapprehension that prescription drugs are safe and less addictive because we have a legitimate health concern and are being prescribed a perfectly legal, and recommended, solution.
Another important question is when does use become misuse. If you are taking doses above that which are recommended for sure that is misuse, or if you are taking medication for non-medical reasons. Perhaps you are taking somebody else’s medication or you begin to seek more medication from the doctor because you like the euphoric feeling from the drug. Seeking more medication may mean you are exaggerating symptoms and manipulating medical officials. It could be that you have slipped into any of these patterns by simply not being given enough education around the medication you have been prescribed.
There is a lot of articles and commentary on the cause of the problems we are facing globally with prescribed medication. From our perspective at the Kusnacht Practice we need to focus on the solution for the individual that presents with a desire to stop. This would start with a carefully managed detox from the medication. At the same time, we can begin to focus on the underlying medical diagnosis that prompted the need for medication in the first place. In some cases, the detoxification from prescribed medication is even more complex than illicit drugs and can be a much longer process. We work hard to make sure this process is comfortable and safe through the application of a holistic approach and high levels of medical supervision.
Author: Dean Gustar – Head of Clinical Operations, The Kusnacht Practice