I’m so not addicted to statins

Copperfield discovers a bold new side-effect of statins: inspiring conspiracy theories more potent than the pills themselves

He comes in, chucks a pack of pills onto my table, and with the injured expression of the badly wronged, says: ‘I’m not taking these statins, they’re addictive.’

Here is what goes through my mind in the split second before I respond.

OMG, where to begin here, you think you’ve heard it all with statins, about how they make your muscles ache, your memory decline and your hair fall out, and how at age 78 this wouldn’t have happened without the statins, doctor, how the the body needs cholesterol so what we’re doing is unnatural, how you can stop taking them once your cholesterol is better, etc etc, but addictive????, that’s a new one on me and probably the most stupid thing I’ve heard all year, you might expect it from the ‘Make America Healthy Again’ Commission but not from someone on my list, true, they come out with some seriously weird shit but this is off the scale, OK, I acknowledge we do escalate doses but that’s evidence/target based, not because people are begging us to do it, it’s not like the statinised masses are banging our doors down in sweaty, trembly desperation because the dog’s eaten their prescription, or even that you just hear people say in passing, ‘Mmm, those statins, they’re so more-ish’, also, if statins are addictive, how come our main issue is that people keep stopping them, and unlike with, say, opioids, the person begging for them to be restarted is us GPs, and anyway, it’s not as though I really enjoy dishing out statins, it’s actually soul destroying spending large amounts of premium consulting time promoting a drug that I’m not that keen to prescribe to prevent something that probably won’t happen to someone who clearly doesn’t want them, and simple dose escalations are equally morale sapping given that the motivation is typically the fact that their LDL is 0.1mmol/L over target and the only real beneficiary from this intervention is my QOF score, but as it happens, this particular smoking diabetic hypertensive has a Qrisk of nearly 60% which means even I take it seriously, look, mate, you may not even make it to the end of this consultation, so I know I should come over all arsey GP and and, uh, explore his health beliefs by saying, oh, you believe statins are addictive, that’s interesting, tell me all about it, but it’s not and I don’t want you to, because I’ve been doing this job for years and if I’ve learned one thing it’s that with an opening gambit like this, the patient might as well be wearing a tin-foil hat and an ‘Ignore me, I’m a nutter’ T-shirt, so I’m not going to bother, because every attempt to rationalise in this situation is just another opportunity cost, in this case costing me the opportunity of a biscuit, so in fact I know exactly where to begin here, and it’s by saying

‘Yes, you’re absolutely right, let’s, er, wean you off them’.

I mean, it’s evolution, right?

Dr Tony Copperfield is a GP in Essex