I love having thought experiments and exercises. They help to keep my mind function critically and entertained when I am alone (which is quite often, due to withdrawal). Bear in mind, these are my personal thoughts. Treat them as rubbish and bullshit. If they make sense, please share this.
A search on pubmed of the term “Topical Steroid Addiction” returns 5 links, all of which provide non-definitive information on TSA.
I needed to ask “Why? Why so little, if none, researched on this topic?”
One need to understand how research is being conducted in academia. Funding is essential in starting research in a particular field. It depends on the field of research being conducted. Hot research topics with the greatest potential of future utility (and profits) are generally well funded. Topics of low interest have to survive with minimal funding, sometimes even self-funded. The source of funding is also important. University grants, grants from companies with vested interests in the outcomes of the research (yes big pharma, I’m pointing at you), self funding and etc.
So to backtrack to our question: Why so little research on TSA?
We need to dig deeper and ask ourselves more:
1) What is the utility for the outcome of this research?
Ans: Great news for the people. People will be more aware of the dangers of TS, so much so that they MAY NOT even use TS at all, given the severe consequences of TS and potential addiction factor. People will start to look for alternative treatments for their skin conditions.
Not so great news for the companies selling topical steroids. It is a big industry with high sales volume. They tend to lose most.
Not so great news for clinicians and dermatologists. They may be sued for clinical malpractice for over prescription of TS. They lose business, due to lack of returning chronic skin customers. Not so profitable now eh?
2) Where is the funding coming from if this research is undertaken?
Ans: Definitely not from the big pharma companies. Probably from university grants. Mostly self-funded grants. The scale of the funding from self/university grants when compared to major pharma companies is too small and limited to expect sustained research in this area.
3) Even if there is funding, what can we expect?
Ans: research may not even make it pass the peer-review phase. Even if they are scientifically well-research, other conflicting forces such as self-interests of pharma companies/dermatologists can come into play, forcing these research to be bunked. Ever wondered why so many dermatologists rejected the notion of topical steroid addiction and withdrawal when many of us try to engage with them with this information? There is simply just too much to lose, too little to gain. This is politics, get real.
3) What happens if such research do come to light?
Ans: Pharma coys get sued. Doctors get sued. People lose confidence in doctors and their institutions. Big stakes.
In light of this, your meagre personal life does not matter when compared to what these institution stands to lose.
As a person who always tries to see reality as it is, this is basically what is happening currently, and will continue to be the status quo in the future. Unless this issue reaches a critical mass and someone does a fantastic expose of the entire pharma industry, nothing will happen. I do hope one day class action suits will follow. I hope this would be achieved in my lifetime. I hope I’m doing my part. I hope if in the future my kids ask me, “Dad, what have you done in light of all these atrocities?”, I want to tell them I have done what I can given my capabilities.
It is easy for me to be idealistic and positive on the future, naively believing that more research in this area will bring about positive effects to skin sufferers. In an ideal scientific community free from external forces of lobbying and vested interests, research like these could potentially result in newer innovations of treatment of eczema or conditions that previously required the use of TS. I’ll give my money gladly to any company who can innovate and produce a drug which is non-invasive and non-addictive without any of the withdrawal symptoms experienced.
This is the ideal situation in an ideal world. Anyone can write this and have this similar opinion. Not anyone can envision reality as it is and understand that forces beyond science and logic are in play, and they affect our lives more significantly than we think they do.