Recently I attended a group education class on psychotropic medications. Knowing the presenter, and feeling a bit cheeky, I went up to the whiteboard before the scheduled start and wrote this:
- Take the right dose at the right time
- If you have questions, ask your doctor or nurse
When the presenter arrived, I piped up: “Do we really need to spend an hour talking about this? Surely those two points sum it all up?”
She just smiled wisely and commenced the session.
You see, she knew something I didn’t – that quite a few people don’t follow their doctors’ instructions when it comes to medications.
“Well, duh,” you might say. “How could you be so naive?”
OK, I’m naive. But it seems a bit silly to me to pay good money to someone who’s studied medicines, their interactions and the way they influence a range of people for years and years, and then ignore what they had to say. OK, I typed “silly” but what I meant was “mindachingly stupid”.
Turns out I was the stupid one.
Nearly every other person in the room had a story of misusing medications: “deciding to halve their medication because they didn’t like the side effects” (so talk to your doctor!), mixing prescribed medications with illicit drugs (yeah that’s going to end well), swapping medications with friends (best I not comment here), even coming off medications “because they felt a lot better” – which seems reasonable, unless you accept that perhaps your medications have something to do with your improved mood in the first place. Hmm, what a strange concept.
Then people started getting stuck into one of my favourite prescribed drugs, alprazolam (commonly known as xanax). Let me clarify that sentence: I am not addicted to alprazolam, but I do find it a very effective medicine in helping control and stay on top of my anxiety disorder. I use it as a PRN medication (in other words, when I need to, not as a scheduled dose) and, when I’m well, I generally only use it premenstrually to alleviate the worsening of my anxiety symptoms. I have been taking alprazolam since 2006 and, when well, can go a couple of months without taking a tablet. When unwell, I do take more, but within the boundaries set by my psychiatrist. Perhaps that’s why it remains an effective anxiolytic for me.
Others around the table had horror stories of people becoming addicted to alprazolam and having great difficulty coming off it. (Perhaps because the education session was taking place in an institution, illicit use and trade of alprazolam wasn’t discussed, even though it has been identified as an issue in the city where I live.) I still believe that if it is used correctly, alprazolam is a safe, fast-acting and effective anxiolytic, but I asked why people were giving it such a bad rap . They cited the celebrity deaths associated with this drug in recent years. “Yes,” I argued, “but look at Point One: those people weren’t taking the right dose at the right time.”
So, please, educate me. Am I simply a naive goody-goody two shoes who doesn’t want to hear bad things about a drug I’ve found useful, or is alprazolam really an evil scourge which should be wiped from our pharmacy shelves? Seriously, I’d be interested to hear your thoughts.
- State’s prescription drugs alarm (theage.com.au)