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Placebo Effect Narratives and Chronic Benzodiazepines Use in Uruguay
Thu, August 31, 4:00 to 5:30pm, Sheraton Boston, Floor: 3, Gardner BAbstract
This paper analyzes narratives of public health professionals of Uruguay on the long term use of benzodiazepines in patients with insomnia and the effect, of its extended use further than indicated.
In Uruguay, benzodiazepines are frequently prescribed at the first level of health attention by general practitioners, psychiatrists, family doctors, cardiologist and other specialist doctors. The data presented are part of the results of a qualitative research carried out on the role of the so-called “benzodiazepine controversy” in the clinical practice of medicine, psychiatry and psychology in the Uruguayan public health sector. 35 in-depth interviews were conducted to general practitioners, family doctors, psychiatrists and psychologists; 2 discussion groups; and 10 interviews to sanitary authorities.
Professionals interviewed commented on patient resistance to their intention of withdrawing a medication, use of which does not correspond for chronic problems. Some narratives on the placebo effect for insomnia after years of use of a medication that would be indicated for not more than six weeks are analyzed.
Narratives about placebo effects related to the chronic use of benzodiazepines emerge. These narratives depict the patients will to continue on benzodiazepines as irrational and senseless but at the same time explain how benzodiazepines work for chronic insomniacs.
We discuss that these arguments contrast with the placebo notion of clinical trials that is used to distinguish the difference of taking a drug or not taking it. Paradoxically, in health professionals accounts placebo effect turns out to be a reason to take medicines, not to withdraw from them. About these paradoxes we want to contribute to the discussion about placebo and nocebo effects in biomedicine.