Patient Experiences of Prescription Drug Dependence and Associated Treatment in England – A Qualitative Study.

Background - Medicines represent an important area of clinical therapy but several types including antidepressants, benzodiazepines, gabapentinoids, z-drugs and mostly recognisably opioids, have been associated with dependence and withdrawal symptoms. This represents both a clinical but also a public health concern and there have been recent attempts to limit prescribing, whilst providing more treatment and support. However, understanding of the lived experiences of those affected by prescription medicine dependence and withdrawal are still limited. This study aimed to explore experiences of those reporting dependence and withdrawal from such medications, contextualised within the theoretical frameworks of Parsons (1951) sick role and stigma.

Methods - A qualitative exploratory methodology was used. Thirteen semi-structured online interviews were undertaken between 2021-2023. These were with individuals residing in the UK who self-identified as being dependent on, or experiencing withdrawal from, the aforementioned prescription medicines using purposive sampling. This was analysed using Braun and Clarke’s six stage thematic analysis.

Findings – Patients using prescribed medicines continuously evaluate medicines in relation to their safety, efficacy and the wider social and personal implications of their use. Medicines were generally perceived to be safe and effective, with an overall positive perception of these drugs, particularly if therapeutic benefits were experienced. There was a perceived lack of information shared by prescribers regarding medicine risks. Non-pharmacological treatments such as psychosocial interventions were preferred, but these were limited in terms of availability due to perceived barriers such as waiting times. As a result, some individuals feeling “trapped” in their medication use.

Discussion and Conclusion - Experiences varied for individuals but perceptions of safety and risk were linked to whether side effects and positive effects were experienced or not. Individuals appeared to be relatively isolated and relationships with prescribers were often suboptimal which resulted in individualised attempts to address dependence and withdrawal. These findings suggest that more is needed in terms of training and education of prescribers in relation to these therapeutic groups and more support is also needed to manage those experiencing withdrawal and dependence.