Are Asthma Medications Addictive?
Many patients fear they will become addicted to their asthma medications and be unable to stop their use. This may partly be due to dependence on medication for the relief of symptoms and attacks. This fear of addiction may explain why some patients do not take their medications.
There is no evidence of the development of addiction to asthma medications. When good control of asthma is achieved, it is often possible to reduce or discontinue medication that is no longer needed. However, good control must come first since withdrawal of medication may result in increased frequency of attacks.
Adrenal Insufficiency
In the case of systemic corticosteroids, the management of reduction and withdrawal of these agents must be closely supervised in view of possible adrenal insufficiency. Patients with severe asthma may become “steroid dependent” for control of their disease, but that does not represent an addiction to medication.
Are There Delay Effects of Asthma Medications?
Patients may be concerned whether long-term use of asthma drugs will have serious adverse effects, another reason why patients may reduce or eliminate medications on their own.
Long-term use in adults of the B-agonists, theophylline, cromolyn sodium, and inhaled corticosteroids have not shown any evidence of delayed adverse effects. In children, inhaled corticosteroids may have adverse effects on growth and bone development. These agents may still be necessary, however, when the risk of severe, uncontrolled asthma out-weighs the possible detrimental effects on bone growth. Nedocromil and ipratropium bromide are still relatively new and long-term experience with these agents is forthcoming. At this time there is no evidence of possible delayed adverse effects of these agents.
Oral Corticosteroids
In both children and adults, long-term effects of the oral corticosteroids must be anticipated. These effects are outlined above and must be weighed against the dangers of uncontrolled asthma. Once systemic steroids are required there should be frequent review of their necessity with the goal of reducing dosage or withdrawal if possible. Alternate-day administration should always be considered if patients must remain on oral corticosteroids.
