Pharmacophobia as as Obstacle to Good Care Part I

I recently had an experience that got me thinking about one of the major obstacles that we face here in the Pacific Northwest in helping patients get well and that is pharmacophobia.  I say that it is most prominent in the Pacific Northwest, because I’ve worked in other parts of the U.S. and it is rare. I have also done a lot of medical work in the developing world and there, even in places like remote Tibet, there is no fear of medications but a great appreciation for the benefit that they bring to relieve them of their suffering.

The first experience happened three weeks ago.  I noticed that over the span of two days I had four patients follow up that had something in common.  When each of the four came to see me, they were suffering horribly from severe daily headaches and had been for many years.  On those particular follow up appointments they each were all doing remarkable well.  The most noteworthy thing was how easy it was to help them get them from suffering horribly to doing great in the span of a couple of months.

The other thing these three patients had in common is that they know far more about medications than the typical patient. Two were pharmacists, one a doctorate in pharmacology and one a physician. The major reason that it was so easy to help them was their great wealth of knowledge about medications.

It is a current fad in our society that all natural is good and processed is bad. This fad is nowhere more pronounced than here in the Pacific Northwest. I am a student of philosophy and would love to start a long dialog about how the writings of the eighteen centuries philosophers, such as Jean Jacque Rousseau, David Hume and the like, started us down this philosophical path. But, that would be confusing and beyond the scope of a short article.

We now live in a society where it is very popular to believe that all things that come directly from nature are good for you and all things that are processed are inherently bad for you. This belief system is not based on research, science, or real dangers but on philosophical idealism and pop culture. The term here, processed, sounds disgusting and is loaded with emotion and connotations but it simply means humans have worked with it.  All medications come from nature, but they have been processed to make them more effective and safer.  Processing these doesn’t make them more dangerous or unethical.

The irrational fear of medications is called Pharmacophobia.  It is irrational because it is not based on truth but on popular hype.  This hype usually has some devious motivation such as selling books, supplements or treatments that have no supporting research.

There is not a new patient that I see that I don’t first ask, “Have your tried non-pharmacological treatments such as supplements, acupuncture, massage therapy, chiropractic or naturopathic approaches?”  Virtually all have by the time that they come here and with no or minimal help.  I really do think that Complementary and Alternative (CAM) practitioners bring something valuable to the table and I appreciate their work. In a perfect world where insurance companies would pay us and we had the resources to expand, I would love to have a massage therapist and/or acupuncturist on staff.

Almost no one wants to be on prescription medications and we totally respect that. The non-drug approaches should always be tried first or in addition to medications. However, the reality is, headache disorders are real.  Many (such as migraine) are caused by complex genetic mutations (we know this factually and it is not just a theory) and many require medications to achieve optimal health.

I will come back in Part II and continue this discussion by looking at some of the mis-information that is being endorsed by a few in the CAM industry and to give some honest guidelines to help the patient to decide what is best for them.

J. Michael Jones, MPAS-C