We all know a case of someone who doesn’t like to take drugs. People who don’t go to Paracetamol when they have a headache, who resist using antibiotics even when 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 faced 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 talking about pharmacophobia .

What is pharmacophobia?

One of the many specific phobias that exist is known as pharmacophobia, which is characterized by the presence of an irrational and uncontrollable fear of the consumption and application of any type of drug . Exposure to this stimulus implies 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 symptoms may vary from case to case, it is generally common to have tachycardia, hyperventilation, cold and profuse sweating, tremors and gastrointestinal discomfort that can lead to nausea and vomiting at the mere idea of seeing a drug or being prescribed medication. Fainting and even anxiety attacks are also likely.

This phobia is a fear of all drugs, and may include avoidance of both oral medication and injections, vaccines or other routes of administration such as inhaled or aspirated. Likewise, when a drug is consumed, the fear of it can make the subject vomit in order to expel it. Although the fear is specific to medication, sometimes it can lead to the avoidance of contexts in which these are frequent, such as hospitals , or the reduction or avoidance of contact with people who need to take them, such as the elderly and chronically ill. For this reason, it is an important limitation, in addition to having a series of serious consequences.

A phobia with deadly potential

Most specific phobias can have a variable impact on the life of the person suffering from them. These consequences are based on the behaviours that the subjects carry out or the situations or stimuli that they avoid, and can limit their life to a lesser or greater extent. But generally, except for those phobias referring to especially prevalent stimuli, this is one of the types of psychological problems that generates the least interference.

In the case in question, the consequences can be much more serious, directly affecting the health and survival of the patient and in extreme cases may even result in the incapacity or even death of the patient. This is because fear and avoidance of drugs can have serious repercussions on patients who need them, such 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 aetiology.

One possible explanation is found in conditioning through traumatic consequences , where there is a fear of feeling hurt 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 drowning while trying to swallow a pill, or a high level of suffering/maladness from substance use or injection (e.g., from chemotherapy) may develop this phobia.

How to treat pharmacophobia?

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

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

During this therapy, a hierarchy of items will be drawn up between patient and professional (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…), largely structuring the situation (presence or not of other people, place, number of drugs involved…) ordered according to the level of anxiety they cause the patient, and then gradually exposing themselves to these situations. The subject must remain in each item until the level of anxiety decreases or is imperceptible in at least two consecutive attempts before being able to move on to the next one.

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

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

The use of relaxation techniques can also be effective in reducing the discomfort and anxiety associated with this phobia, an example being 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: Síntesis.