Pharmacophobia (drug phobia): symptoms, causes and treatment

Fear of drugs can be life-threatening for the person suffering from this phobia.

We all know a case of someone who does not like to take drugs. People who do not go to the Paracetamol when they have a headache, who are reluctant to use Antibiotics even if they have a throat infection. We also know or have heard of people who refuse to vaccinate themselves or their children (sometimes with dramatic consequences).

In almost all these cases we are dealing with a personal choice, based on the beliefs of these people. But there are people who avoid taking drugs not because of ideology, but because of the presence of a high level of anxiety and discomfort in the form of phobia. We are speaking about the pharmacophobia.

What is pharmacophobia?

Pharmacophobia is one of the many specific phobias that exist, characterized by the presence of an irrational and uncontrollable fear towards the consumption and application of any type of drug. an irrational and uncontrollable fear towards the consumption and application of any type of drug.. Exposure to such stimulus involves a very high level of anxiety for the subject, generating different physiological symptoms and the need to avoid approaching both drugs and any situation in which they may appear with him. The subject himself usually recognizes that his reaction is excessive, but he needs to flee and avoid exposure or, in cases where it is essential, he will endure it with a very high level of discomfort.

Although the symptoms may vary from case to case, in general, the following symptoms are usual tachycardia, hyperventilation, cold and profuse sweating, tremors and gastrointestinal discomfort. which can lead to nausea and vomiting at the mere thought of seeing a drug or being prescribed medication. Fainting and even the appearance of anxiety crises are also probable.

This phobia involves a fear of drugs as a whole, and the avoidance of oral medication, injections, vaccines or other routes of administration such as inhalation or aspiration may occur. Likewise, when a drug is taken, fear of it may cause the subject to induce vomiting in order to expel it. Although the fear is specific to the medication, it can sometimes lead to avoidance of contexts can lead to the avoidance of contexts in which they are frequent, such as hospitals, for example, or the reduction or avoidance of the use of drugs.or the reduction or avoidance of contact with people who need to take them, such as the elderly and chronically ill. This is why it is an important limitation, in addition to having a series of serious consequences.

A phobia with deadly potential

Most specific phobias can generate a series of variable repercussions in the life of the person who suffers from them. These consequences are based on the behaviors that the subjects carry out or the situations or stimuli that they avoid, and can limit their lives to a lesser or greater extent. But generally, except for those phobias referring to especially prevalent stimuli, it is one of the types of psychological problems that generates the least interference.

In this case, the consequences can be much more serious, directly affecting the patient's health and survival and, in extreme cases, can even and may in extreme cases lead to disability or even death of the patient. The fear and avoidance of drugs can have serious repercussions in patients who need them, as in the case of coagulation problems, heart disease, respiratory problems, type 1 diabetes mellitus (insulin-dependent), HIV....

This fact makes the treatment of this type of phobia essential, especially in the population with chronic diseases and/or with the potential to kill.

The causes of this phobia

The reasons that can generate this type of phobia are multiple, and there is no proven etiology.

A possible explanation is found in conditioning through traumatic consequences.There is a fear of feeling harm or suffering or of being intoxicated. This is linked to the experience of professional malpractice or profound pain or discomfort associated with some previous treatment in the patient's life, which has been generalized to all drug-related stimulation.

Someone who has come close to choking trying to swallow a pill, or a high level of suffering/discomfort when consuming a substance or after an injection (for example, after the administration of chemotherapy) could develop this phobia.

How to treat pharmacophobia?

The treatment of the pharmacophobia is something necessary and may be urgent, depending on the patient's state of health. Fortunately, phobias are the group of disorders that usually have the best prognosis and the best therapeutic success.

In order to treat pharmacophobia, as with other phobias, the treatment of choice is the following exposure therapy or systematic desensitization.. In vivo exposure is especially recommended, although imaginary exposure can be used as a preliminary step.

During this therapy a hierarchy of items will be elaborated between patient and practitioner. (some examples could be seeing a pill, manipulating it, taking it, going to a pharmacy or hospital, seeing another person take some type of drug...), structuring the situation to a large extent (presence or not of other people, place, number of drugs involved...) ordered according to the level of anxiety they cause the patient, in order to gradually expose him/her to these situations. The subject must remain in each item until the level of anxiety drops or is imperceptible in at least two consecutive attempts before being able to move on to the next one.

It has also been observed to be effective work on the cognitions and emotions linked to pharmacology, investigating what a drug means for the subject and working and restructuring possible dysfunctional beliefs about it.investigating what a drug means for the subject and working on and restructuring possible dysfunctional beliefs in this regard.

Although in the treatment of phobias sometimes drugs are used to lower the level of anxiety (such as benzodiazepines) and to make a possible exposure more bearable in extreme cases, in the present case such treatment would be the phobic stimulus itself, something that will make its application very difficult. Thus, it will be hardly feasible to provide tranquilizing drugs, not being an optimal therapeutic option, at least initially. Nevertheless, this could be used to condition a response contrary to that of the phobia, and could be considered as a possible element to be included in an exposure hierarchy.

The use of relaxation techniques can also be effective in reducing the discomfort and anxiety associated with this phobia, such as diaphragmatic breathing or Jacobson's progressive muscle relaxation.

Bibliographic references:

• Bulbena, A., Guimón, J. and Berrios, G. (1993). Measurement in Psychiatry. Barcelona: Salvat.
• Jaspers, K. (1946/1993). Psicopatología General. Mexico: FCE.
• Lemos, S. (2000): Psicopatología general. Madrid: Síntesis.