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It has occured to me that while half the world is trying to stop people taking drugs (eg heroin or cocaine), the other half it trying to get people to take drugs (eg anti-retroviral medication for HIV must be taken consistently on a daily basis if it is going to work). By far the commonest reason (but
not the only reason) that people 'fail' HIV medication is that they don't take the tablets at the right times. So would there be an appropriate substance you could add to desirable drugs like anti-retrovirals such that people got withdrawal symptoms if they forgot to take them? It would have to be safe and not lead to high tolerance as people would then overdose on the anti-retrovirals but it would be like an in-built alarm clock telling a person when to take the meds and making them withdraw if they didn't. Obviously you would have to get informed consent from the patient and be able to supply the addictive substance alone should the anti-retrovirals need to be stopped but could it work????
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How would you do this, mix heroin in with the drug? |
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What was that old Hippocratic thing...? Oh, yeah: "First, do no harm." fishbone. |
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I suppose some drugs could be added to cigarettes. Tetracycline filters. Darvon longs. |
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First do no harm is a bit of a misnomer to be honest. If that was all you did you would never go to work or prescribe a drug. ALL treatments that work and many that don't cause harm ie side effects, it's a case of balancing risks and benefits. |
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I wasn't thinking of adding heroin. Something fairly safe but highly addictive like nicotiene would be OK except that people would quickly catch on that they could ease the cravings by smoking cigarettes, which would obviously be a really bad thing. I'm sure there are other candidate drugs. |
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I came in here with full intent to bone this idea to the fullest extent of the fish. I find myself scratching my head, though... in cases of transplant, one of the largest factors in failure / rejection / graft loss is non-compliance with the medication regimen. I have a neighbor who has lost two transplanted kidneys - and she's only 19. She just forgets to take her meds. |
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You'd want to do something that wouldn't create a desire to overdose, though. |
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This is a bit of a sledgehammer, surely. If
it's really that essential, and if the patient
is really that forgetful, then surely there's
an easier and more reliable way to remind
him? |
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This idea is terrible. Let me get this straight, you want to "hook" people on thier medications so they don't forget to take them??? Did you read over this at all before you posted it?
Assuming the majority of people remember to take thier medications, whether it be from development of a schedule or from self-preservation, you are proposing that we dope thier meds to keep the lazy/unorganized minority from killing themselves from an act of omission. Shall we fume the air with heroin so no one forgets to breathe? How many dehydration deaths could we avoid if we made water addictive? |
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My only regret is that I have but one bone to give. |
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