For five years, Oliver Neely, 31, has nursed swollen, sore hands caused by repetitive use of a computer mouse at work and playing games at home during his teenage years. Despite seeking medical attention, his hand remains swollen.

But that’s not because the anti-inflammatories he was prescribed didn’t work. It is due to Oliver’s extreme aversion to taking medication. As a child and young adult, Oliver refused to take pills, whether prescription or over-the-counter, even if he was in excruciating pain or felt so bad that he needed to stay in bed.

Oliver suffers from pharmacophobia, as it is medically known: the extreme fear and distrust of medications.

At the opposite extreme is pharmacophilia, where people like to take medications when they don’t really need them.

Oliver, who lives in Folkestone, Kent, has been like this since he was a teenager.

Oliver Neely, 31, suffers from pharmacophobia, as it is medically known: extreme fear and distrust of medications.

While other kids his age were obsessed with their favorite soccer team, for example, he became obsessed with his health and ways to treat it. He worried about medications and what they contained, to the point that when he got an infection and was prescribed antibiotics, he would throw them away.

“I worried about medicines and drugs,” he says. ‘My fear is that I don’t know what these medications actually contain and if they would affect me negatively. I have suffered headaches, I ignored them; stomach pains, I ignored them; I get bugs, infections, and the usual cough and flu. But for many years I refused to take medication. I know it’s not the best for me, but I’m so afraid of the medication that I won’t risk it.’

Pharmacophobia can be triggered by several factors, explains Dr Becky Spelman, psychologist and founder of the Private Therapy Clinic in London. These include “negative past experiences with medications,” fear of side effects or addiction, or a general distrust of pharmaceuticals.

“People can have varying degrees of fear or aversion to medications, from mild discomfort to severe phobia,” he says.

It’s not uncommon for people to experience some level of apprehension when it comes to taking medications, suggests Dr. Spelman, which isn’t necessarily a bad thing, since all medications have potential side effects, so they should be taken with caution.

But pharmacophobia could help explain poor medication adherence, which is a major problem: It is believed that between 30 and 50 percent of patients do not take medication as directed. “Medication non-adherence is a complex conundrum and pharmacophobic beliefs will only be one contributing factor to the high rates seen in the general population,” says Dr Meg Arroll, psychologist and adviser to the British Psychological Society.

Other factors include poor communication between doctors and patients and a lack of trust in the healthcare system.

Pharmacophobia, as it is medically known, is the extreme fear and distrust of medications (file image)

“This is very problematic, as non-compliance with treatment can lead to a substantial worsening of an illness or condition, as well as increased healthcare costs with more doctor and hospital visits, as well as more necessary tests or treatments,” he says. Dr. Arroll.

However, for people with pharmacophobia, the fear of medications means that they will not take them even when it is truly best for them. Dimple Bhatia, a pharmacist from Tollesbury, Essex, says pharmacophobia is more likely “if the illness has not been fully explained to the patient, treatment has not been discussed and potential side effects have not been explored.”

Pharmacist and professor at the University of Reading, Gurinder Singh Purewal, adds: “Patients who fear medication feel judged and are afraid of being scolded.”

‘They often miss appointments. Some of the common examples I have dealt with are vaccines, statins and antidepressants.’

Oliver believes his fear may be due to his anxiety about taking liquid omega-3 capsules to help improve his concentration as a child. “I didn’t like the feeling of them going down my throat,” he recalls. “I was also never able to swallow paracetamol and had to take the soluble ones.”

Other triggers were then added. ‘When I became a teenager, I began to wonder what was in these medications. I would ask them to read the back of the package and then try to figure out what all the ingredients were.

“I started to worry about how they would affect my body and if they would interact with other things.”

As he grew up, Oliver remembers reading newspapers, watching television shows and learning about health. “I started to become more aware of my health and the control I could have over it,” he says.

‘I wanted to resolve the situation but I didn’t like the idea of taking medication. I never took it, not even paracetamol,” he says, even though his exasperated mother tried to comfort and reassure him.

There is growing concern that pharmacophobia is “on the rise,” explains Dr. Spelman. “This is partly attributed to social media, where misinformation and scaremongering about medicines is spread, and the growing influence of conspiracy theories, which exploit existing anxieties and promote distrust in pharmaceuticals, contributing to the development or reinforcement of pharmacophobia,” he says. .

Dr Henk Swanepoel, a neuropsychologist at the private Cygnet Health Care clinic in Bristol, adds that people with pharmacophobia “may also experience intense anxiety, in the form of panic attacks, for example.”

«It is often difficult for people to think about drugs or even see them in real life. This fear is irrational, but patients still cannot change behavior.’

Psychotherapy is the gold standard way to treat pharmacophobia (and other phobias).

On numerous occasions, Oliver visited his doctor because he suffered from anxiety and depression related to his pharmacophobia. He was prescribed antidepressant pills but he says he didn’t take them.

One option is exposure therapy, which involves gradually exposing individuals to their fear of medication, possibly through drug imagery, in a controlled environment, helping to “desensitize” them and overcome their phobia.

Cognitive behavioral therapy (CBT), a talk therapy in which negative thoughts and beliefs are challenged and replaced with more positive thought patterns, can also help, says Dr. Spelman.

Dr. Arroll advises people with pharmacophobia to talk to their doctor. “It may be helpful to see if there was a time in his history when he became afraid of taking medication, for example, if a tablet got stuck when he tried to swallow it during childhood and this produced a phobic association.” she says.

‘However, this is not the case for everyone, so it is often helpful to address the immediate response: breathing and relaxation exercises can help manage a fear response when taking medication.

“It may also be beneficial to take the first dose in a calming environment, such as a pharmacy. As with any phobia, the key is to break what we call the “fear avoidance pattern” to take care of your overall health.

However, as the years passed and his symptoms worsened, he reluctantly accepted prescriptions for more antidepressants. ‘He was terrifying for me: I was afraid they might hurt me. But he needed help and he had to try something.

In the first few weeks, Oliver almost gave up, so terrified was he of the side effects. ‘I felt all the initial things you feel when taking a new antidepressant for the first time, plus many more symptoms generated by my fear of what the medication could do to me. But after a while everything calmed down and overall I started to feel a lot less anxious.’

She also sought help from the charity Anxiety UK, the app Headspace (which focuses on mindfulness and meditation), as well as doctors and a therapist, and was slowly able to accept more medication.

‘I know that avoiding medication could one day harm my health and I have worked to find ways to overcome it. I still avoid medication when I can, but I’m more balanced now.’