How to assess

Assessing mental dependence on a medication can be a bit nuanced because medications are typically prescribed to address a specific medical condition. Therefore, one must differentiate between appropriate use, where the medication is alleviating symptoms of a medical condition, and psychological dependence, where the person believes they need the medication for reasons beyond its intended therapeutic effects.

Here’s a framework for assessing if someone has become mentally dependent on a medication:

• 1) Clarify the reason for the medication: Begin by understanding why the person was prescribed the medication and if they still need it for that condition.
• 2) Examine the subjective feelings towards the medication: If someone expresses beliefs like “I can’t function without this medication,” or “I need this medication to feel normal,” even when the underlying condition it was prescribed for is under control, it may indicate a psychological dependence.
• 3) Changes in behavior: Look for behaviors such as:
  • Hoarding the medication.
  • Becoming anxious or distressed when doses are missed or when the medication isn’t readily available.
  • Expressing a reluctance to try alternative treatments or taper off the medication.
• 4) Using the medication outside of prescribed parameters: This could include using the medication more frequently than prescribed, using higher doses, or using it in situations where it isn’t needed.
• 5) Resistance to changes in the prescription: An individual might become extremely anxious or upset when a doctor suggests reducing the dosage or switching to another medication.
• 6) Feedback from loved ones: Family or close friends might notice that the person seems overly reliant on the medication or expresses excessive fear or concern about being without it.
• 7) Continued use despite negative consequences: This includes continuing to use the medication even if it’s causing side effects, problems in personal relationships, or other issues in their life.
• 8) Frequent discussions or preoccupations with the medication: They may frequently talk about the medication, express concerns about running out, or seem preoccupied with the next dose.
• 9) Seeking the medication from multiple sources: They might try to get the same medication from different doctors or pharmacies or turn to unauthorized sources.
• 10) Avoiding or downplaying discussions about the medication: On the flip side, they may avoid talking about their medication use or downplay how much they rely on it when asked.