INFORMED Choice

Below this article is a list of other articles that explore what choice looks like at this point and what it might look like in the future as well.

I’m doing a repost from a couple of years ago. I thought of this old post of mine the other day when I read We need drugs by Elliot Goldberg at Mad in America. That article takes on a different aspect of what I’m talking about below. They’re good companion pieces in my opinion. In the end we must find a way to Goldberg’s prescription:

In order to get back to an environment where we can manage the pent up emotions caused by decades of escapism and self-medication we must once again embrace the loss and grief that rampant depression designates.

Until the healers/therapists/social workers/psychiatrists in our society can do that for themselves those who seek help in the broken mental health and psychiatric systems won’t be finding out how to do that for themselves.

I say all the below having been gravely harmed by prescribed psychiatric drugs. I am drug free today but I am not free from the harm the drugs wrought in my life. I am very motivated to help people find options that they might not feel forced to take drugs. Feeling forced, is not really a choice at all, is it? Until the time we have a sane infrastructure of care, we must be both pragmatic and compassionate about the reality on the ground today, while working to change it at quickly as possible that fewer people will be harmed.

Pro-information and pro-choice when it comes to drugs and medications

I posted about the New York Times article the other day in which two doctors in answering the question, “Are sleeping pills addictive?” are slaughtered by the commenters who know the truth, yes indeed sleeping pills can cause addiction. While the doctors respond by saying sleeping pills are safe, the readers told stories of addiction and disability. Also, in the fray were people who felt that sleeping pills had saved their lives. And others who clearly had used the drugs and had no horrible outcome or felt they’d been saved by them.

The truth is not everybody becomes addicted. Others that do become addicted have varying degrees of difficulty freeing themselves when they choose to. And some of us end up bedridden and sick for years. Big spectrum of outcomes. Yes.

For example in my mid-twenties I came off of Xanax after using it daily for 2 or 3 years. It was painless and uneventful. That fact led me to think that perhaps I wouldn’t have issues in the future and I did not hesitate to resume use of benzodiazepines later. This is another thing people generally do not know. For some stopping and starting leads to a “kindling” effect which can make future attempts to quit more difficult. In addition, I’ve seen folks on the benzo boards have a hell of a time when only having taken something like Xanax a matter of a couple of weeks or months. So time on the drug is not even always indicative nor is age though some generalities can be made about both factors.

Below I share a comment of someone who has worked in addiction medicine. The comment struck me as the voice of reason in that thread. It was broadly ignored by the other commenters. This person has observed many people and has emerged with a view similar to my own though his bias is most likely leaning in a different direction. I do feel that we should always look to solutions other than neurotoxic drugs. That we should move in a direction where people feel less compelled to take a pharmaceutical solution and that they have access to the necessary resources so that they might be able to meaningfully make another choice.

I am adamantly pro-choice. I do not assume that because psychiatric drugs are the iatrogenic cause of my chronic illness and disability, that anyone else should come to final conclusions about their own use of medications. I understand that people who feel that similar drugs have saved them may have very good reasons to believe such. I understand that life is incredibly complex and in the end we are all just trying to survive. Sometimes a solution to aid in survival when there is no other viable option is a good choice.

Most people who end up on drugs that harm did not have viable options or they were not told of them if they did have them which amounts to a similar circumstance in their personal understanding of their own experience. Of course we don’t have an infrastructure of care that offer options and that is where policy making and legislation and education have to come in. For now though many people simply have very few options, but worse, if they do have access to options or alternatives they are not told and so they may make choices that are harmful when it wasn’t necessary.

People are also routinely not told that psychiatric drugs of all kinds are indeed addictive and/or physically damaging, which disallows people to understand they may want to make another choice or they may want to take a medication only during an acute or crisis phase to limit harm. I know lots of people who take meds on a PRN basis now, in crisis only. And that includes meds that are not routinely prescribed that way. Most of these people do very well. And most everyone else is not told this is an option and are instead told they need many dangerous drugs for the rest of their lives.

The fact is there are more choices than simply drugs or no drugs. That is a hard thing for people who think in black and white to grasp.

If we are told that these drugs have the risks and dangers that they have when we are offered them then we can approach their use with much greater caution. As it stands now many don’t understand that caution is warranted. This is why the doctors who respond to the question “Are sleeping pills addictive?” are out and out criminal. That many people don’t get addicted is true. But if our doctors assure us these drugs are safe with no caveats about the large number of users who are devastated by addiction or illness after taking them, then we have not been able to make an informed choice.

Being that life is difficult and we are all different it may be appropriate for some people to choose meds after knowing the risks. The problem is most people do not know the risks. This goes for all psychiatric drugs with all the dangerous risks involved…addiction is only one of them. With other psych meds it may also be addiction and dependence but it’s often all sorts of life shortening physical problems such as diabetes, weight gain, heart disease etc. Sleeping pills also shorten life span. Much more info on this class of drugs on my Benzo Info page. At this juncture informed consent is our responsibility because our medical professionals don’t provide us with this information!

I liked this persons comments in response to the New York Times piece. It is one that respect our differences. His bias may be in a different direction than mine, but still we largely agree.

I have worked in addiction medicine for many years, I get it. One of the things that people leave out in these kinds of dicussions is the fact that all of us are neuro-chemicial organisms – every one of our cells is a chemical factory that reacts and responds to our internal and external environment. We are humans. Are we similar to each other? Yes. Are we identical? No. We all have neural pathways and chemical responses that are individually unique to us.

Problems emerge when we begin to think that everyone should or does behave or react the same way, or that solutions are the same for everyone. We know a lot about the neurochemistry of the brain, but in actuality what we know is only a fraction of what there is to know. Much of what we “know” is inferred – which means we “know” it indirectly. Some might say that we are making it up, and in some ways that is true.

The point is that every person with any kind of sleep disturbance is different, and what works for me may not work for you. Does everyone who has insomnia need prescription medication? No. Will everyone respond to natural methods? No. Will some people need to be on sleep medication long term? Yes. Does everyone who takes sleep medication become addicted? No. Do some people have reactions or become addicted? Obviously yes. Do we need to use good judgement when treating this disorder? Of course. Do we need more research and more education? That’s a no-brainer.

Thankfully I have never had a problem with sleep. But in the course of many years I have seen the negative effects that chronic insomia (much like chronic pain) can have on the quality of life for individuals. When we try to put everyone in the same box, we risk losing our compassion for the people that don’t fit in the box. As they say, unless you have walked in someone else’s moccasins, you can’t really know what it is like for them. For me, I would rather have a hundred different possilbilities for remedies that might work, than only one that doesn’t work.

Discernment about our individuality and the vast array of human experience and context helps us be in the moment so that we might respond to both our needs and that of others most effectively. We all need different things at different times. Some of us have far more resources, both internally and externally than others. Economics and education have a lot to do with what any given individual has access to. This much change, no doubt. I certainly hope that a day comes when there are many options offered to all regardless of individual resources and that those options will allow most people to avoid potentially dangerous drugs most of the time. We don’t live in the future though and we have to be present and compassionate to the reality of today. Sometimes drugs are unavoidable. Today. Someday that may be true much less frequently. We need to make that happen while understanding the reality of the moment.

Some thoughts on stopping psychiatric medications — things to think about before deciding if you should discontinue your medications