8.7 Stopping medication

A Family Guide to Concurrent Disorders - Part III: Treatment

People are often ambivalent about staying on their medications. Reasons for the ambivalence include:

• unpleasant side-effects
• feeling well and no longer seeing the need to take medications
• messages from peers (e.g., 12-step peers) that you should be able to cope without any substances, including prescribed ones
• concerns about interactions with alcohol or other substances.

Families should encourage their relatives to talk about problems with medications—with the hope that they will fully explore what could happen if they suddenly decide to stop taking a medication. For clients who choose not to take their medication:

• Acknowledge they have a right to choose not to use any medication.
• Stress that they owe it to themselves to make sure their decision is well thought out. (It is an important decision about their personal health and they need to discuss it with their doctor.)
• Ask their reason for choosing not to take the medication.
• Don't accept “I just don't like pills.” Tell them you are sure they wouldn't make such an important decision without having a reason.
• Offer as examples reasons others might choose not to take medication. For instance, they:
  • don't believe they ever needed it (i.e., they were never mentally ill)
  • don't believe they need it anymore (i.e., they are cured)
  • don't like the side-effects
  • fear the medication will harm them
  • struggle with objections or ridicule of friends and family members
  • feel taking medication means they're not personally in control.

Medication is often an important part of a treatment plan for concurrent disorders, but finding the most effective medication, or combination of medications, can be a long, frustrating process. You can help by learning about the benefits and risks of the medications that your relative is taking, and by talking with your relative and the treatment team about how the medication is working, and the nature and severity of side-effects. Make sure the medication and dosage are reviewed regularly. If you are not satisfied, you and your relative can ask for a second opinion.

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