Doping to live: Spain takes refuge in anxiolytics
In 2021, Spaniards will consume almost 159 million pills to treat the depression, anxiety and insomnia. A huge pile of colored tablets – psychotropics – which are substances that act directly on the central nervous system and are only sold with a prescription.
The stress of a pandemic explains, in part, that the number of psychoactive drugs sold last year exceed 16 million to those consumed in 2019, before the health crisis flooded everything. According to data from the consulting firm Iqvia, specialized in the pharmaceutical industry, the spike in consumption of these pills occurred in the months of lockdown and it fell when the population was able to go out into the streets freely again.
In the last two years, the pandemics, the rise has been sustained. Although the problem is long.
Psychologists, pharmacists and psychiatrists agree that the rise has to do with Ease of obtaining a prescription for this type of medication and contempt for psychotherapy. Spain –together with Croatia and Portugal– was already in the podium in the consumption of anxiolytics before 2020, according to the European Monitoring Center for Drugs and Addiction. In addition, it has the lowest ratio in Europe of public psychologists for every 100,000 inhabitants, according to the latest report by the Ombudsman. While the European average is 18, here it is 6. And in the absence of therapy, good are pills.
“The levels of self medication of the population are growing at breakneck speed. Also among health workers, who are often reluctant to go to a specialist. In some Spanish houses there are real pharmacies. The ease that people have to get a prescription is amazing and the casuistry, very diverse. It is the case that the person has a scheduled medication and can pick it up again from the pharmacy whenever they want. If the patient asks for it, the family doctor does not put too many hits to re-prescribe the drug. Those who are relatives of private doctors have authentic tacos of signed prescriptions in case they need something. Malpractice in this type of matter is more normal than we think, ”says Rafaela Santos, doctor in Neuroscience and psychiatrist.
The most prescribed psychoactive drugs in Spain are benzodiazepines, present in medicine cabinets under trade names such as Valium, Orfidal, Lexatin or Trankimazin. One of the most sought-after chemical formulas among drug addicts, who take it to calm their mood after abusing other drugs. If the imbalance has been punctual, -like the disorders that confinement could cause- they are substances that should be taken for short periods of time. If consumed uncontrollably, they can cause serious side effectssuch as hallucinations, delusions, or thoughts of suicide. Furthermore, they create a strong dependence.
“The pandemic has made us talk a lot about mental health, but perhaps the most correct thing would be to talk about pathologies associated with mood swings», explains Carlos Fernández Moriano, from the Directorate of Technical Services of the General Council of Pharmacists. This professional explains that, with the data in hand, it is important to bet on the pharmacovigilance so as not to create dependency problems. That is, prescribe controlled doses and ensure that withdrawal is done gradually. “Pharmacists must be alert to combat the so-called ‘withdrawal syndrome’ or the rebound insomnia that can manifest itself when the patient abruptly stops taking the pill”, argues Fernández.
“The side effects of psychotropic drugs are largely unknown, as well as the damage they can cause and even more so if they are combined with alcohol or interact with the active ingredients of other medications. This cocktail can be toxic. there should be a bigger regulation to control the prescriptions of this type of medication. It is not a problem for pharmacists”, says Dr. Santos.
In this sense, Antonio Cano, Professor of Psychology at the Complutense University of Madrid, says that if the person has resources, they can go to a private psychologist. But if you can’t afford it, see your GP. “The coronavirus crisis has created a healthcare saturation and many doctors prescribe and prescribe drugs to treat anxiety and depression even though they know that it is not the solution to the problem in all cases. If before they had three or four minutes to attend to each patient, now they have one. With these recipes addictions and dependence are generated. Five hypnotics cannot be prescribed for sleep. The pills are bread for today and hunger for tomorrow». In addition, Cano points out that the overdose of stress in healthcare has been such that the percentage of healthcare professionals that they have needed Psychological attention it has increased with the pandemic by 75 percent.
“When they turn to a psychiatrist, it is usually because there is already an addiction problem. In my consultation I have received many toilets with this problem. The body quickly gets used to consuming benzodiazepines. You notice that things do not affect you and you begin to integrate it into your routine. The day comes when if you don’t take it, you feel terrible. Then dependency begins, then addiction comes. It is quite usual that my work consists of help the patient to detoxify. You start by changing the active ingredient of the medicine and then gradually reducing the dose. They are true handicrafts”, says psychiatrist Rafaela Santos.
What is the most common profile of people who receive this type of treatment? According to studies carried out in several autonomous communities, it is normally women over 65 years. But the socioeconomic level also influences. “In the most deprived areas there is a greater consumption of psychotropic drugs. We cannot forget that the health crisis is also a social crisis,” says Fernández Moriano, from the College of Pharmacists.
This health professional also points out that although confinement spurred self-medication, we live in a world where social networks they are the main source of information for a not insignificant percentage of people. «We take hoaxes about diseases or untrue drug information as if we read them in the prospectus of a medicine, ”he says.
The effects of psychotropics are unknown, but so are the recommended doses. «In the consultation I meet patients who, from the outset, ask for a Valium to alleviate sleep problems, which is equivalent, more or less, to taking five Orfidales. They are drugs with very similar formulas, like first cousins, but do not contain the same amount of active ingredient. Some cause great relaxation, but the mood can drop so low that the person could fall into depression. The opposite can also happen: cause a degree of nervousness that takes the person to the emergency room, “says Santos.
The 2021 European Drug Report warns with concern about the growing and improper use of benzodiazepines. Among the causes, Europe points to low cost of these substances, in addition to mental health problems derived from the pandemic. In some countries have already taken measures to prevent the use of these pills from being maintained over time. The Netherlands, for example, removed benzodiazepines from the list of reimbursable drugs, so people had to pay for these pills out of pocket. But in Spanish medicine cabinets they still abound.