Pharmacophobia (phobia of drugs): symptoms and treatment

We all know a case of someone who does not like to take drugs. People who do not go to 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 facing a personal choice, based on the beliefs of said people. But there are people who avoid drug use not because of ideology, but because of the presence of a high level of anxiety and discomfort in the form of a phobia. We are talking about pharmacophobia.

• Related article: "Types of Phobias: Exploring Fear Disorders"

What is pharmacophobia?

It is known by the name of pharmacophobia to one of the multiple specific phobias that exist, which is characterized by the presence of an irrational and uncontrollable fear towards the consumption and application of any type of drug. Exposure to this stimulus supposes a very high level of anxiety for the subject, generating different symptoms. physiological and the need to avoid approaching both drugs and any situation in which they may appear with the. 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 depending on the case, it is generally common appearance of 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 attacks are also likely.

This phobia supposes a fear of all the drugs, being able to appear the avoidance both of taking oral medication such as injections, vaccines or other routes of administration such as inhalation or aspirate. Likewise, before the consumption of a drug, the fear of it can cause the subject to vomit in order to expel it. Although the fear is specific to the medication, sometimes it can lead to the avoidance of contexts in which these are frequent, such as hospitals, or reducing or avoiding contact with people who need to take them, such as the elderly and chronically ill. That is why it is an important limitation, as well as being able to have a series of serious consequences.

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A potentially deadly phobia

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, being able to limit their life to a lesser or greater extent. But generally, except for those phobias related to especially prevalent stimuli, it is one of the types of psychological problems that generates less interference.

In the case at hand, the consequences could be much more serious, directly affecting the health and survival of the patient and can in extreme cases lead to disability or even death of the patient. And it is that fear and avoidance of drugs can have serious repercussions in patients who need them, such as in 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, with the fear of feeling harm or suffering or of being intoxicated. This is linked to the experience of professional malpractice or deep pain or discomfort associated with some previous treatment in the patient's life, which have been generalized to all stimulation linked to drugs.

Someone who has nearly choked trying to swallow a pill, or a high level of distress/discomfort from the consumption of any substance or after an injection (for example, before the administration of chemotherapy) could develop this phobia.

How to treat pharmacophobia?

Treatment of pharmacophobia is necessary and that it may have a certain urgency, depending on the state of health of the patient. Fortunately, phobias are the group of disorders that usually have the best prognosis and the greatest therapeutic success.

In order to treat pharmacophobia, as with other phobias, the treatment of choice undergoes exposure therapy or systematic desensitization. Exposure in vivo is especially recommended, although exposure in imagination can be used as a previous step.

During this therapy, A hierarchy of items will be developed between the patient and the professional. (Some examples could be seeing a pill, handling it, taking it, going to a pharmacy or hospital, seeing another person take some type of drug...), largely structuring the situation (presence or not of other people, place, number of drugs involved...) ordered according to the level of anxiety that they cause the patient, to subsequently and gradually expose themselves to said situations. The subject must remain on each item until the anxiety level drops or is imperceptible on at least two consecutive attempts before being able to move on to the next.

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

Although in the treatment of phobias, medications are sometimes used to lower the level of anxiety (such as benzodiazepines) and make a possible more bearable exposure in extreme cases, in the case at hand such treatment would itself be the phobic stimulus, something that will greatly hinder its application. Thus, the supply of tranquilizing drugs will hardly be viable, not being an optimal therapeutic option, at least initially. Despite this, 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 It can also be effective for reducing the discomfort and anxiety associated with this phobia, an example of which is 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). General Psychopathology. Mexico: FCE.
• Lemos, S. (2000): General psychopathology. Madrid: Synthesis.