For five years, Oliver Neely, 31, has nursed swollen and painful hands caused by repeated use of a computer mouse at work and playing at home during his teenage years. Despite seeking medical advice, his hand remains swollen.
But that’s not because the anti-inflammatory drugs he was prescribed weren’t working. It stems from Oliver’s extreme aversion to taking medication. As a child and young adult, Oliver refused to take prescription or over-the-counter pills, even if he was in excruciating pain or felt so sick that he had to take them in bed.
Oliver suffers from pharmacophobia, as it is medically known: an extreme fear and distrust of drugs.
At the opposite extreme is pharmacophilia, where people like to take drugs when they don’t really need them.
Oliver, who lives in Folkestone, Kent, has been like this since he was a teenager.
Oliver Neely, 31, suffers from pharmacophobia, as it is medically known: an extreme fear and distrust of drugs.
While other boys his age were obsessed with their favorite football team, for example, he became obsessed with his health and treatments. He cared so much about the drugs and what they contained that when he got an infection and was prescribed antibiotics, he threw them away.
“I became preoccupied with drugs and medicine,” he says. “My fear is that I just don’t know what is really in these drugs and whether they will affect me negatively. I had headaches, I ignored them; stomach pains, he ignored them; got bugs, infections and the usual cough and flu. But for many years I refused to take medicine. “I know it’s not the best for me, but I’m so afraid of medication that I won’t take the risk.”
Pharmacophobia can be triggered by a variety of factors, explains Dr Becky Spellman, psychologist and founder of the Private Therapy Clinic in London. These include “negative past experiences with drugs,” fear of side effects or addiction, or a general distrust of pharmaceuticals.
“People can have varying degrees of fear or aversion to drugs, ranging from mild discomfort to severe phobia,” she says.
It’s not unusual for people to experience some level of fear when it comes to taking medication, Dr. Spellman suggests, which isn’t necessarily a bad thing, since all medications come with potential side effects, so they should be taken with caution.
But pharmacophobia may help explain poor medication adherence, a major problem, with between 30 and 50 percent of patients thought not to take their medication as directed. “Medication non-adherence is a complex puzzle and pharmacophobic beliefs will be just one contributing factor to the high rates seen in the general population,” says Dr Meg Arroll, psychologist and assessor for the British Psychological Society.
Other factors include poor communication between doctors and patients and distrust in the health care system.
Pharmacophobia, as it is medically known, is an extreme fear and distrust of drugs (stock image)
“This is very problematic, because nonadherence to treatment can lead to a significant worsening of the disease or condition, as well as increased health care costs with more doctor and hospital visits, plus more tests or treatments needed,” says Dr. Arrol.
However, for people with pharmacophobia, fear of drugs means they won’t take any even when it’s really in their best interest. Dimple Bhatia, a pharmacist in Tollesbury, Essex, says pharmacophobia is more likely “if the patient has not had the condition fully explained, treatment has not been discussed and potential side effects have not been explored”.
Pharmacist and lecturer at Reading University, Gurinder Singh Purwal, adds: “Patients with a fear of medication feel judged and are afraid to tell.
“They often miss meetings.” Some of the common examples I’ve dealt with are vaccines, statins and anti-depressants.’
Oliver believes his fear may have stemmed from anxiety about taking liquid omega-3 capsules to help improve his concentration as a child. “I didn’t like the feeling of them going down my throat,” he recalls. “Also, I could never swallow paracetamol and had to take the soluble ones.
Then other triggers are added to it. “When I hit my teenage years, I started to wonder what was in these drugs. I will have the package read back and then try to find out what all the ingredients are.
“I started to worry about how they would affect my body and if they would interact with other things.
As he got older, Oliver remembers reading newspapers and watching TV programs and learning about health. “I started to become more aware of my health and the control I could have over it,” he says.
“I wanted to deal with the situation, but I just didn’t like the idea of taking medication. I’ve never even taken paracetamol,” he says, even as his distraught mother tries to comfort and reassure him.
There is growing concern that pharmacophobia is “on the rise,” Dr. Spellman explains. “This is partly attributed to social media spreading misinformation and fear-mongering about medicines and the increasing influence of conspiracy theories, which exploit existing anxieties and promote mistrust of pharmaceuticals, contributing to the development or reinforcement of pharmacophobia,” she says.
Dr Hank Swanepool, a neuropsychologist at Cygnet Health Care private clinic in Bristol, adds that people with pharmacophobia “may also experience intense anxiety, for example in the form of panic attacks”.
“Often, people have a hard time thinking about or even seeing drugs in real life. This fear is irrational, but patients still cannot change their behavior.’
Talk therapy is the gold standard way of treating pharmacophobia (and other phobias).
On many occasions, Oliver visited his doctor because he suffered from anxiety and depression related to his pharmacophobia. He was prescribed anti-depressants, but he says he didn’t take them
One option is exposure therapy, which involves gradually exposing individuals to their fear of drugs, perhaps through images of drugs, in a controlled environment, helping them to “desensitize” and overcome their phobia.
Cognitive behavioral therapy (CBT), a talking therapy where negative thoughts and beliefs are challenged and replaced with more positive thought patterns, can also help, says Dr. Spellman.
Dr. Arrol advises people with pharmacophobia to talk to their doctor. “It can be helpful to see if there is a point in your history when you started to feel a sense of fear of taking medication, for example, if a pill got stuck when you tried to swallow it during childhood, and that caused a phobic association.” she said.
“However, this is not the case for everyone, and so it is often helpful to address the immediate response: breathing and relaxation exercises can help manage the fear response to medication.
“It can also be helpful to take your first dose in a calming environment, such as a chemist. As with any phobia, the key is to break what we call the “fear avoidance pattern” to take care of your overall health.
On many occasions, Oliver visited his doctor because he suffered from anxiety and depression related to his pharmacophobia. He was prescribed anti-depressants, but he says he didn’t take them.
However, as the years passed and his symptoms worsened, he reluctantly accepted prescriptions for more antidepressants. “It was terrible for me that I was afraid that they would harm me. But I needed help and I had to try something.’
In the first few weeks, Oliver almost gave up, so terrified were the side effects. “I felt all the initial things you get when first taking a new antidepressant, plus many more symptoms generated by my fear of what the drug could do to me. But after a while it settled down and I started to feel a lot less anxious in general.’
He also sought help from the charity Anxiety UK, the app Headspace (which focuses on mindfulness and meditation), as well as doctors and a therapist, and was slowly able to accept more medication.
“I know that avoiding medication could one day harm my health and I’ve been working to find ways to overcome that. I still avoid drugs when I can, but now I have more balance.”
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