Psychotropic Medication and Addiction: What You Can Do

Where larger accountability is unavailable, it becomes up to the patient to self-advocate.

Benzodiazepines pills
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When singer Noah Cyrus first took Xanax, she was just 18 and hoping to bond with her then-boyfriend. But Cyrus quickly entered what she describes as a "dark pit" of being addicted to the substance. Her story is unfortunately yet another file in the growing story of psychotropic medication-based addiction.

In the United States, the larger class of drugs to which Xanax belongs, benzodiazepines, has ballooned from 8 million users in 1996 (registration required) to an estimated 92 million benzodiazepine prescriptions in 2019. That growth has led some experts to assert that benzodiazepines are the next drug epidemic to come after opioids. Yet the crisis of medication abuse and addiction goes far beyond opioids and benzodiazepines, extending even into substances readily available over the counter, and significantly more attention is needed on the improper use of medications within the mental health arena.

How We Got Into This Drug Mess

Between Prozac opening the floodgates in 1987 and the mental health industry's biomedical model — which asserts "that mental disorders are brain diseases and emphasizes pharmacological treatment to target presumed biological abnormalities" — becoming widespread and accepted, we began to see prescription rates skyrocket. Now we know that the chemical imbalance theory was largely false, but the damage had already been done.

A more holistic view of care became less important, to the degree that the World Health Organization acknowledges that broader sociocultural elements (e.g., access to safe housing, education and work) are largely ignored in mental health treatments.

As people seek help for mental health concerns, they are often receiving psychotropic medications without being evaluated by a mental health professional or learning about other treatment options. According to research, "Psychiatric medications are among the most heavily advertised prescriptions in the United States. [...] Psychiatric drugs comprised three of the five most advertised classes of medication and were among the first drugs to attain 'blockbuster' status. [...] Data from 2014–2015 indicate that psychiatric medications comprise 20% of the 10 most advertised drugs and 10% of the 100 top-selling drugs."

Where We Are Now

A 2021 report from the Florida Department of Law Enforcement showed that, although fentanyl caused the most deaths in Florida (where I live), coroners are finding psychotropic drugs, such as alprazolam (Xanax), in the systems of deceased individuals, as well. The number of people who died with more than one prescription medication in their system went up 5% to 4,740.

Nationally, between 2000 and 2012, the number of people taking five or more medications went from 8.2% to 15%. Many of these individuals are medicating in this extreme way to manage the side effects of a single drug. But some doctors might overprescribe to line their own pockets. An analysis from ProPublica revealed that doctors who get payments linked to specific medications tend to prescribe more of those substances.

To make things worse, doctors are not always aware of all of the side effects or risks associated with the substances they prescribe. The education doctors get often still comes directly from pharmaceutical companies. For example, in 2007, the FDA proposed that antidepressant makers "update the existing black box warning on their products' labeling to include warnings about increased risks of suicidal thinking and behavior." Yet many doctors aren't aware that antidepressants can increase the risk of suicide, violence and homicide at all ages — and according to the CDC, antidepressant usage continues to increase. In 2020, the antidepressant drug market exceeded $13.5 billion.

Even if watchdogs and the public were to get control over the pharmaceutical industry, the biomedical model still has to be dealt with. Research has failed to prove that the model can be applied consistently. In fact, a review of a class of antidepressants suggested that as much as 75% of the perceived benefits were a placebo effect.

More recently, an analysis of research found no support at all for the hypothesis that low serotonin levels or activity cause depression. The analysis sent shockwaves through the medical community as it contradicted decades of professional thought and protocol.

As a result of these types of studies, some professionals are asserting that some mental disorders might not be chemical-based disorders at all. They claim that conditions like ADHD and depression might be responses to adversity instead.

Safety and Health Depend on Your Own Self-Accountability

Many medications people take today can do enormous good when prescribed and used appropriately. But systems and beliefs in place, such as the degree of power pharmaceutical companies have, make this difficult to reach. They've resulted in a situation in which the people meant to help patients might not be equipped to do so and, in the worst circumstances, even contribute to harm.

Left in this situation where larger accountability is unavailable, it becomes up to the patient to self-advocate. This includes a willingness to ask basic questions, such as what the side effects of a medication are, and even to question the models care is built on. In the end, the "right" treatment isn't necessarily the fastest or most profitable. It is the one that sees each person as a distinct human being, tailored to the individual's needs.

Consider asking about other, more holistic options, like nutrition and exercise. According to the John W. Brick Mental Health Foundation's 2022 Move Your Mental Health Report, which advocates for an integrated mind-body-spirit approach, "89% of all published peer-reviewed research between 1990 and 2022 found a positive, statistically significant relationship between exercise/physical activity and mental health." It may seem simple, but often the most workable solutions are.

For anyone already struggling with addiction to psychotropic medications, there are grassroots community efforts, like The Withdrawal Project, that offer information and assistance. And never underestimate the power of simply reaching out to a trusted family member or friend for support (or being that trusted family member or friend to someone in need).

By each taking full responsibility for our own well-being, looking for answers beyond what we're told and approaching mental health holistically, we can realize the improvements we seek—not just in our own health but in the industry as a whole.

The information provided here is not intended as medical advice, diagnosis or treatment. You should consult with a qualified healthcare provider for advice concerning your specific situation.

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