Self-medication

Self-medication is the use of drugs, including alcohol, or self-soothing forms of behavior, to treat a perceived or real malady. Self-medication is often referred to in the context of a person self-medicating, in order to alleviate their own distress or pain.

In some countries, use of controlled drugs for self-medication is illegal without a prescription.

Overview

Some mental illness sufferers attempt to correct their illnesses by use of certain drugs. Depression, for example, is notorious for being a trigger of alcohol, tobacco, cannabis, or other mind-altering drug use. While this may provide immediate relief of some symptoms such as anxiety, it may evoke and/or exacerbate some symptoms of several kinds of mental illnesses that are already latently present, and may lead to addiction/dependence, among other side effects of long-term use of the drug.

The theory that drug dependence or addiction results from self-medication for the distress caused by a pre-existing condition was introduced in 1974 by David F. Duncan and Edward J. Khantzian in independent publications. This theory has come to be known as the self-medication hypothesis.

For example, sufferers of post-traumatic stress disorder are prone to self-medication, as well as many individuals without this diagnosis whom have suffered from (mental) trauma.

Occasionally an individual will attempt self-medication for physical illnesses. For example, it is believed that Kurt Cobain's use of heroin partially stemmed from a painful stomach condition.

The current phenomenon in many Western societies of the widespread usage of vitamins, herbs, and other over-the-counter "supplements"--usually without the advice, supervision, or even knowledge of any licensed health professional--is another possible example of self-medication.

Some observers of health behavior and medical affairs have speculated that this trend may arise from the desire of laymen to feel more in control of their own health--rather than relying on the traditional medical establishment, whose motives are sometimes seen as suspect. The extraordinary increases in the cost of traditional health care in recent decades--doctors, hospitals, prescriptions, etc.-- causes some individuals to desperately try to find more affordable alternatives to treat or prevent their own afflictions.

Chronic exposure to organic solvents in the work environment can produce a range of adverse neuropsychiatric effects. Occupational exposure to organic solvents can lead to alcoholism with higher numbers of painters for example suffering from alcoholism. It is possible that a small number of alcoholics are self medicating the toxic effects of organic solvents albeit with another toxic substance alcohol.^[1]

Benzodiazepines/alcohol and anxiety

Self medicating especially where benzodiazepines or alcohol are concerned often make matters worse. Approximately half of patients attending mental health services for conditions including anxiety disorders such as panic disorder or social phobia are the result of alcohol or benzodiazepine dependence. Sometimes anxiety pre-existed alcohol or benzodiazepine dependence but the alcohol or benzodiazepine dependence act to keep the anxiety disorders going and often progressively making them worse. However, some people who are addicted to alcohol or benzodiazepines, when it is explained to them they have a choice between ongoing ill mental health or quitting and recovering from their symptoms, decide on quitting alcohol and or their benzodiazepines. It was noted that every individual has an individual sensitivity level to alcohol or sedative hypnotic drugs and what one person can tolerate without ill health another will suffer very ill health and that even moderate drinking can cause rebound anxiety syndromes and sleep disorders. A person who is suffering the toxic effects of alcohol will not benefit from other therapies or medications as they do not address the root cause of the symptoms.^[2]

See also

• Dual diagnosis
• Psychological trauma
• Deinstitutionalisation

References

• Achalu, ED (2002).The self-medication hypothesis: a review of the two major theories and the research evidence. SMH: Recent Developments on the Self-Medication Hypothesis, 1(10), id1. [1]
• Blenkinsopp A, Bradley C (1996). Over the counter drugs: the future for self medication. British Medical Journal, 312, 835.
• Duncan DF (1974a). Reinforcement of drug abuse: Implications for prevention. Clinical Toxicology Bulletin, 4(2), 69.
• Duncan DF (1974b). Drug abuse as a coping mechanism. American Journal of Psychiatry, 131(6), 724.
• Duncan DF (1975).The acquisition, maintenance and treatment of polydrug dependence: A public health model. Journal of Psychedelic Drugs, 7(2), 201.
• Frances RJ (1997). The wrath of grapes versus the self-medication hypothesis. Harvard Review of Psychiatry, 4(5), 287.
• Hughes CM, McElnay JC, Fleming GF (2001). Benefits and risks of self medication. Drug Safety, 24, 1027
• Khantzian EJ (1985). The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. American Journal of Psychiatry, 142(11), 1259.
• Khantzian EJ (1990) Self-regulation and self-medication factors in alcoholism and the addictions. similarities and differences. Recent Developments in Alcoholism, 8, 255.
• Khantzian EJ (1997). The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231.
• Khantzian, EJ, Mack JE, Schatzberg AF (1974). Heroin use as an attempt to cope: clinical observations. American Journal of Psychiatry, 131(2), 160.
• Wazaify M, Shields E, Hughes CM, McElnay JC (2005). Societal perspectives on over-the-counter (OTC) medicines. Family Practice, 22: 170.

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