RFK Said Antidepressants Are Harder to Quit than Heroin. It’s Just Not True.
During his Senate confirmation hearing to serve as Health and Human Services Secretary, Robert F. Kennedy, Jr. suggested antidepressant drugs may be as addictive as heroin. Research doesn’t support his claim. “I know people, including members of my family, who’ve had a much worse time getting off of SSRIs than they have getting off of heroin,” Kennedy said in the hearing.
But as a mental health and addiction counselor who specializes in opioid addiction, I find that claim to be nonsense. It is also dangerous to stigmatize people who are successfully managing their depression with SSRIs.
In contrast, research has shown SSRI use to be safe and effective. Keith Humphreys, who studies addiction at Stanford University said, “In my 35 years in the addiction field, I’ve met only two or three people who thought they were addicted to antidepressants versus thousands who were addicted to heroin and other opioids.” I agree with Humphreys. In my 35 years in this field, I have never met anyone who was addicted to an antidepressant.
As an aside, I wonder if he is confusing antidepressants with benzodiazepines. Withdrawal from severe benzodiazepine dependence, on drugs such as Xanax, can be dangerous, and even fatal without medical supervision. But that’s a column for another time.
Antidepressant medications are not addictive, but they do cause dependency. They have the potential to cause withdrawal symptoms when use is suddenly reduced or stopped.
It is important to distinguish the difference between being dependent and being addicted. Dependence is when the body physically relies on a substance. Many medications cause physical dependence but not addiction. When people withdraw from these medications, they do not crave them, and once tapered, they do not compulsively seek more. Addiction can occur without physical dependence. For example, cocaine can cause addiction without dependence. People addicted to heroin will suffer physical withdrawal symptoms (e.g., vomiting, diarrhea, sweating).
That said, it is uncomfortable for people who abruptly discontinue their antidepressant medication. There’s a name for it: antidepressant discontinuation syndrome (ADS). Around 1 in 5 people experience ADS when stopping their medication suddenly. Symptoms include anxiety, mood changes, lethargy, irritability, insomnia, flu-like symptoms with nausea, and others.
The severity of withdrawal symptoms varies with the type of drug (some drugs have no effects associated with their abrupt discontinuation and some do), the length of use, dosage level, and the speed at which you discontinue the antidepressant. And different people have different reactions to drugs.
When other treatments, such as talking therapy, have not helped, antidepressant medication may be called for. If you need it, use it, regardless of RFK’s opinion.