"I don't want to depend on it"

Of the concerns people report about their medicines, this is one of the two big ones, and the researchers who measured it found that over a third of patients with long-term conditions held it strongly. The word underneath is dependence, and it carries a smell from somewhere else. Dependence is what happens with alcohol, with nicotine, with the tablets people can't come off. Taking something every day for years sounds like the start of that, and stopping sounds like the way to prove you're not.

But the word is doing two jobs. Dependence in the sense that matters, the sense book 11 in this series is about, means the substance has changed what your body expects, so that stopping produces craving and the substance itself has become the problem. Needing a medicine is different. Someone with an underactive thyroid depends on levothyroxine the way someone short-sighted depends on their glasses. The glasses haven't done anything to the eyes. Taking them off doesn't prove independence, it proves the eyes were short-sighted all along, and the same is true of most of the silent and holding ones.

There's a real version of the worry and it deserves a straight answer. Some medicines do produce withdrawal symptoms when stopped, and antidepressants are the clearest case, which is why chapter 10 gives them their own chapter and why the NHS says to reduce them gradually with a doctor. That's a reason for a planned stop, not a quiet one. The one thing the dependence worry argues for is the thing the habit skips, which is a conversation about whether the medicine is still the right one and how a change would be done.

I'd put it this way. The person who takes the tablet every day and reviews it once a year with the prescriber is less dependent on it, in every sense that matters, than the person who takes it on and off and never asks. The first one has a decision. The second has a drawer.