Sharing moments Menopause Young adults Bye bye Hotel Mum How you feel at home Semester abroad Language course abroad or work as an au pair? Be prepared for military training Grassrooted Pack smarter, travel better Make an impression Contraception Vegan diet Bye bye Hotel Mum – hello shared flat Big trip, small budget Finanzielle Vorsorge Planning a family Tracking fertility The right time? How men can help Fertility and diet Medical check-up What you need to know about ovulation What to do if you don’t conceive straight away Three electronic fertility and cycle trackers in comparison Planning a family and partnership Pregnancy Examinations during pregnancy Diet and nutrition Is my pregnancy progressing normally? Tips for daily life Important points for travel and holidays Is my pregnancy progressing normally? What items do I need for my baby? Where and how do I want to give birth? What do I need to pack for the hospital? How should I prepare my home for my child? Is my pregnancy progressing normally? How can I best prepare for my baby? How can I best prepare for the birth? Nutrition Parent-child relationship Preparing for breastfeeding | Sanitas Magazine Insurance Stretch marks Sleep Rupture of membranes Baby blues High-risk pregnancy Braxton Hicks & false labour Formalitites Morning sickness Family rooms Signs of a premature birth Our baby Bathing baby – what you need to know How babies hear Infant first-aid kit Baby care Is my baby developing normally? Month-to-month overview of baby development Is my baby developing normally? Baby’s development: Months 3 and 4 Baby care Breastfeeding When does a baby start eating? Weight Baby growth spurts Toys Sun protection for baby skin Teething Milk teeth: what to do in case of accident Baby’s development: Months 5 and 6 Pelvic floor exercises after birth Babyschlaf Celebrating and enjoyment Christmas and New Year’s Eve with a twist A philosophical take on pleasure Pleasure can also be found in the soup kitchen in Zurich Tips for a peaceful and stress-free Christmas Living better with cardiac insufficiency Alejandro Iglesias Hana Disch Patrizio Orlando Vaccinations and travel first-aid kit Hay fever In pursuit of happiness Seven tips for a happier daily life Kids in lockdown Online addiction Women's hearts Decisions Decision-making tips Report from the hospital Donating a kidney Life decisions Emigrating to South America Geocaching Sexuality Erectile dysfunction Young people and sexuality Queer pastor Drag queen Paprika Sexually transmitted infections What does LGBTQIA+ stand for? Gender medicine HPV Families of transgender people Medically assisted suicide Types of dementia Be active Active during pregnancy Sport and exercise during pregnancy Antenatal exercise classes Standing properly Healthy eating Green smoothies Vitamin D Good eggs, bad eggs Diet plan Healthy fats Feed your muscles How much sugar should we eat a day? How much fat should we eat a day? Lactose intolerance Healthy diet, strong immune system Low Carb E-numbers and other additives in food Personalised diet Vegan meat substitutes Healthy heart Interview with Christophe Wyss Heart-friendly sports How the mind affects the heart Taking blood pressure correctly High blood pressure: what you need to know Healthy teeth Home remedies: relief for sore gums A dentist explains Brushing up on brushing Changing habits Interview Stortpsychologie 10-step guide to changing habits Try, try, try again Fitnessmotivation Running coaching Running ABC Race in Sarnen Factors affecting condition Weekly planner Running shoes Strengthening exercises Running nutrition Complementary sport Warm-up Stretching Functional clothing Fitness tracker Shopping – sportswear Running tips for women Relaxation technique Recovery New lease of life thanks to Sanitas running coaching Sport after childbirth Postnatal exercise Taking the strain off your shoulders Kangatraining Workout while walking Expert tips Stress and relaxation Moving air Fight stress with yoga What is stress Learn how to relax Dealing with stress What is burnout? “The first step was to create boundaries” Juggling family and a career Reduce stress Stressor factors The most beautiful Swiss saunas Sweating in the sauna Breathing exercises for relaxation The right rest & recovery: debunking myths Mindfulness Sleep Constant availability: chronic stress Trend sports Fitness boxing Slackline Bouldering Fascia training Stand Up Paddling Keeping fit efficiently Swing with a smile! Vertical workout Hiking Altitude sickness Seven stroller-friendly hikes Needed: a hiking-friendly pushchair There goes the other sole! Tips on hiking with a baby Mountain lakes Winter walks Planning a family: Fertility and exercise Stair climbing Pumptrack Kids’ back Back exercises Sitting properly at work Forest fun Playing for life Promoting health and fitness Motivation Sledging Curling glossary What do you get if you cross a kite with snow? Snowshoeing Preventing falls Inline skating Swimming Swimming Wings for Life Stretching Bike tips Stretching exercises for cyclists koerper-und-kaelte Healthy teeth thanks to dental hygiene and preventive care Putting wishes into practice Tips for healthy teeth Hometraining Investigating teeth-related myths 10 tips to ease anxiety Hand care How our body regenerates The best abdominal exercises in five minutes Keeping fit on holiday Swim training aids Wie viel Sport ist gesund Gathering mushrooms – the right way | Sanitas Magazine Check-ups Five-minute stretching routine Gehirntraining Rückenschmerzen Licht Yogastile Ayurveda-Morgenroutine Tips for doing sport outside in winter Cross-country skiing for beginners Home remedies against dandruff Home remedies Home remedies for bladder infections Home remedies for a sore throat Home remedies for migraines Home remedies against excessive sweating Home remedies for a sun allergy Healthy feet, healthy back core exercises for mountain bikers Symptoms Check Sport after Corona HIIT: quick and efficient exercises Sore muscles: debunking myths Debunking swimming myths strength training for young people Exercise videos Whole-body workout Fascia training Lack of exercise Sun protection Strong mind How to be mentally strong Mental strength Psychosomatics Resilience Tips against feeling down Sleep hygiene and mental well-being Depression Panic attacks Prescription drug addiction ADHD: Symptoms in children and adults Mental illness: help for friends and family Living with autism Pressure to perform Alcoholism Blood: myths and facts Hormones Complementary medicine: the most common treatments Complementary medicine Training in line with your menstrual cycle Living together today Digital life Online addiction Digital temptation Children and digital media Smartphone neck Digital responsibility and solidarity Our brains love habit Change my habits? You’re joking! Planning a family: Difficulties trying to have a baby Planning a family: Myth vs fact Solidarity study Newcomers Living together tomorrow Digital nomads Giesserei multi-generation house The blind film director Help instead of rent Working on the move Medical practices of the future Our skin – layer by layer Generational discussion: wishes for life Hausarzt und Corona Safe return to work Corona crisis: singing together Corona crisis: Working in intensive care Corona crisis: working in a nursing home Rest and recovery: learning from children Corona crisis: voluntary work for the needy Second opinion Relationships and children Three questions that keep us awake at night Outing The nature of lying Vorsorge Finding sound health-related information online Impfstoffe entwickeln Tipps für Jugendliche in der Corona-Krise Becoming parents Diagnose: Kind im Haus Long Covid Take it easy in your free time YouTuber Aditotoro on the coronavirus pandemic Minimalism for a happy life Thanks to corona: more time for family Back to life after a paragliding accident Decluttering: the answer to chaos Living and loving with autism Synaesthesia Talking to doctors Non-verbal communication Is there really a serial killer gene? Developments for the future App check Aqualert SRC blood donor Codecheck Forest Freedom Freeletics Moment Three sleep apps reviewed PeakFinder Findery Six fitness apps reviewed Internet use High-tech trousers Prostheses Hospital of the future New skin for burns victims Online-Therapien How drugs are developed Generics A vision of the future: How we will live in 30 years Onward Overcoming erectile dysfunction Family medicine practices of the future Personalised medicine A voice for Clara Sanitas newsletter
Dossier: Strong mind

One pill leads to another – addicted to prescription drugs

When you feel you can’t cope without medication: addiction is harmful to health and impacts on your quality of life. You also have to be careful with some prescription drugs. Drug addiction can catch you unawares: What are the first signs and how can you stop it?

Text: Julie Freudiger; photo: iStock

Addiction has many faces. It’s not only drugs, alcohol and tobacco that can be addictive, but also prescription medicines, and it often creeps in and goes unnoticed, because medicines are readily available and considered unproblematic. According to estimates, around 400,000 people in Switzerland take medication every day with a potential risk of addiction. That is alarming. Above all, sleeping pills and sedatives from the group of benzodiazepines, also called “benzos” or Z drugs, and strong pain medication containing opioids put patients at risk of developing an addiction if they are not taken properly.

Dependence on benzodiazepines is third only to nicotine and alcohol dependence in Switzerland. Medication used to treat attention deficit hyperactivity disorder, for example ritalin, can also be addictive and should only be used to treat ADHD. The same applies to cough medicines with the active ingredients codeine or dextromethorphan, which are deliberately overdosed and abused.

Addiction is an illness that can be prevented and, above all, cured.

At what point is a person addicted? 

Of course, not all medicines are addictive, even if they are used over a longer period of time. Although many medicines, such as antidepressants, may lead to physical dependence, this is a long way from addiction. The body or mind gets used to the effect and reacts if intake is stopped abruptly. 

So, what is addiction? “An addiction is a medically diagnosable disease, it has nothing to do with lack of willpower,” explains Domenic Schnoz, head of the Zurich Centre for the Prevention of Substance Abuse (ZFPS) “Addiction is an illness that can be prevented and, above all, cured.” For a diagnosis of addiction, at least three of the following six symptoms must have been indicated within the last twelve months: 

  • Strong desire or wish to take the medication.
  • Developed a tolerance to the medication, i.e. when the dose or frequency of intake has to be increased to achieve the same effect.
  • Physical effects of withdrawal as soon as you stop taking the medication or reduce the dose.
  • Little control over the timing and frequency of consumption.
  • Neglect other activities in favour of consumption, obtaining the substance or recovering from consumption.
  • Clearly visible harm as a result of taking the medication. 

However, only a professional can actually diagnose addiction, because the common perception of addiction is often different to the medical diagnosis, explains Schnoz. “Being an addict doesn’t necessarily mean suffering shakes in the morning and immediately grasping for a glass of wine.” 

Patients also have a responsibility. They have to ask questions, gather information and consider alternatives.

How prescription drug addiction develops

A person is most at risk of developing an addiction if they take prescription medicines without a medical prescription or if they don’t follow the doctor’s instructions – they either increase the dosage, take it for longer than recommended or without medical necessity. Prescription drug abuse can be life-threatening, especially if taken with alcohol or other substances.

Even if doctors monitor the intake of medication, addiction can occur, although the risk is much lower. Low-dose dependence, for example, is difficult to detect because the dose has never been increased and the withdrawal symptoms are similar to the original symptoms. A patient may therefore experience restlessness and anxiety again after stopping the sleeping pills and sedatives. What then look like symptoms are actually withdrawal symptoms. 

In order to prevent drug dependence, everyone involved has to play a part. “The doctor has to be careful when prescribing medicines and provide support while the patient is taking the medication. But patients also have a responsibility: They have to ask questions, gather information and consider alternatives,” says addiction expert Schnoz. In case of doubt, they should seek a second opinion. First and foremost: Prescription medicines may only be prescribed by the doctor providing treatment and must be coordinated with any other medicines the patient may be taking.

Alternatives and withdrawal

If you suspect that you or a friend or relative of yours is addicted to prescription drugs, you should seek professional help. Going cold turkey on your own isn’t a good idea. First, it’s almost impossible to do on willpower alone and, second, it can have serious and life-threatening repercussions. The type of therapy depends on personal prerequisites and preferences. Options include withdrawal supported by your family doctor at home, outpatient treatment in an appropriate facility or an inpatient stay in a clinic. 

Medication can be an important part of treatment, but it is not the solution to every problem. Sleeping pills and sedatives in particular are usually intended for use in crises and not for long-term use. However, Schnoz points out that alternatives to drug treatment are not one-size-fits-all solutions.

“You have to find out what works for you, be it behavioural therapy, physiotherapy or alternative medicine For example, when it comes to pain management, there are cases where behavioural therapy can be more effective than medication.” Getting more exercise day-to-day, adjusting your lifestyle, sitting less and buying a new mattress are all ways that may help to reduce pain. And sleeping pills and sedatives tend to relieve the symptoms, but they don’t tackle the root of the problem and aren’t really a permanent solution. It is important to address the problem at all levels and to ensure that patients are offered long-term support.

When your nose is running, it can seriously affect your quality of life. Many people turn to nasal sprays for relief. But there’s a catch: Your nose quickly gets used to the effect of the spray and it can cause rebound congestion.

After the effect has worn off, the nasal mucous membranes swell even more than before. This can cause chronic congestion, the mucous membranes dry out and become cracked, often leading to frequent nose bleeds. In the worst case scenario, it can result in a condition called atrophic rhinitis or ozaena, with the dryness of the nasal mucosa leading to the build-up of bacteria that cause a foul smell. As the patient’s sense of smell is damaged, the smell is usually first noticed by other people.

Alternatives include sprays with sea salt solutions or essential oils, and nasal douches. If you’ve already got used to using nasal sprays, your nose will need a “detox”. 

  • Stop straight away: Going cold turkey takes an awful lot of willpower and the risk of relapse is high.
  • Gradual reduction: Once you’ve used half the nasal spray, fill it up with a saline solution. When the bottle is half empty again, fill it up once more with the saline solution. Continue in this way until the bottle only contains saline solution.
  • 1-nostril therapy: get one nostril used to doing without the spray, then start on the other one. 

If your symptoms are severe, you should contact your doctor for advice.