Inspired by one of our favorite television shows, Allergy Myth Busters looks at a number of popularly held beliefs about allergy. But are these myths just urban legends or are they true?
Myth: I will become dependent on my asthma medications.
Background: Asthma is a chronic disease of the airways in the lungs. In asthmatics, these airways are inflamed and can swell, narrow, and produce mucous when triggered. Consequently, asthmatics can experience symptoms of shortness of breath, tightness, coughing, and wheezing. Asthma affects over 25 million Americans and can range from a mild intermittent problem to a daily life-threatening disease. Though there is no cure for asthma, it can be effectively controlled with proper management. Unfortunately, one of the greatest barriers to asthma control is a patient’s compliance with their inhalers as up to 60-70% of asthmatics do not take their inhalers as prescribed. Poor asthma control can subsequently have great consequences including emergency room visits, hospitalizations, and even death. Among the reported reasons for this noncompliance is the concern that one can become dependent on their inhalers.
Science: Asthma is primarily controlled by two types of inhalers. Bronchodilators (e.g. albuterol) are used as quick-relief or rescue medications, to quickly relax and open the airways, relieving the symptoms during an asthma flare- up. Inhaled steroids are used preventatively to control the underlying inflammation. The idea that one can become dependent on their asthma medication is likely the result of a few misunderstandings. First, the concern about dependency to medications is not unique to asthma patients as it is a true concern for many medicines in general. Given the vast differences in properties and mechanisms of action between medicines, they cannot be generalized as such. When steroid controller inhalers are used properly, symptoms should be minimized, and the need for a rescue inhaler should be rare. The sensation of dependency often comes when someone is not controlled and they need their rescue inhaler frequently. This leads to the feeling that they are becoming dependent on their rescue inhaler. The underlying issue is that asthma control can change due to a variety of factors and their increased rescue inhaler use is the result of that, which needs to be addressed by a your doctor. There is evidence that there are changes at the medication’s site of action with chronic overuse of a rescue inhaler, which promotes a tolerance to the medicine. This is more a secondary effect to the overuse, not the cause. Lastly, from a social science perspective, this idea is often seen in those that want to dissociate from the asthma identity, not accepting the fact that asthma is a chronic disease. Though there are reasons for the proliferation of this myth, there has never been any evidence to support the idea that one can become dependent on their asthma medicine.
Verdict: The myth that someone can become dependent on the asthma medication is busted.
Michael Alvares
Allergy Partners of Dallas-Fort Worth
512-349-9111