Anxiety About Taking Medication: Why It Happens & How to Cope

Medication anxiety is the terrifying feeling that the rescue boat sent to save you might actually be the thing that sinks you. Simply trying to “power through it” ignores the real issue: a powerful, protective part of your brain screaming that you are in danger. This guide offers a practical plan—not to eliminate your fear overnight, but to help you find solid ground and make this decision with confidence.

Key takeaways

  • Feeling scared about starting a new medication is a normal and common protective response.
  • This fear often comes from worry about side effects, losing control, or past negative experiences.
  • Creating a step-by-step plan for your first dose can significantly reduce anticipatory anxiety.
  • Open communication with your doctor is the most powerful way to manage your concerns.
  • The goal is not to erase fear, but to manage it so you can make a clear choice.

Understanding anxiety about medication (pharmacophobia)

Anxiety about taking medication feels like being handed a fire extinguisher that you’re afraid is filled with gasoline. You know you need help, but your brain is screaming that the solution itself is the most immediate danger. This isn’t just “being nervous”—it’s a visceral, protective response that can feel completely overwhelming.

Clinically, this experience is often called pharmacophobia: a significant fear related to taking prescribed medicine. While it is not a formal psychiatric diagnosis, it’s the internal conflict that leads you to leave a prescription unfilled or stare at a pill in your hand, unable to swallow. When this fear takes over, it can stand in the way of getting the help you need.

This fear doesn’t come from nowhere. It’s rooted in legitimate and understandable human concerns.

Why it’s normal to feel scared

Feeling anxious about taking a new medication is not a personal failing. It’s a deeply human response to uncertainty. You are being asked to put a substance into your body and trust that it will help, even though you can’t be certain how you will feel.

Your fear isn’t a sign of weakness; it’s your body’s way of trying to protect you from the unknown. This feeling is especially common if you have a history of negative medical experiences or already live with an anxiety disorder. Acknowledging this fear as a normal, protective instinct is the first step toward managing it.

Differentiating between medication anxiety, health anxiety, and OCD

While these conditions can feel similar, knowing which one fits best can help you find the right support. Here’s how this fear of medication differs from other related anxieties:

  • Medication anxiety: The core worry is about the medicine itself—its side effects, its effect on your personality, or the risk of dependency. This can look like spending hours researching a drug’s rarest side effects or avoiding picking up a prescription altogether.
  • Health anxiety: This is a broader fear about having or getting a serious illness. A fear of medication might be part of this, but the anxiety exists even without a prescription. This might show up as interpreting a normal headache as a sign of a brain tumor.
  • Obsessive-Compulsive Disorder (OCD): This involves a cycle of intrusive thoughts (obsessions) and behaviors (compulsions). While this can involve medication, the pattern is more ritualistic, like needing to check the pill bottle exactly seven times before you can take it to neutralize a fear of being poisoned.

Understanding these differences is important because the right therapy can help you target the cycle of fear you’re trapped in.

Common causes of medication anxiety

This fear is not random; it grows from specific, understandable roots. Recognizing where your anxiety comes from is the first step to untangling it, moving the problem from a vague sense of dread into a set of concrete challenges you can actually address.

Fear of side effects or allergic reactions

This is often the biggest hurdle. It’s the 2 a.m. scroll through online forums, past the ninety-nine success stories, to find the one post that confirms your worst fear.

You’re not just reading a list of potential symptoms; you’re imagining each one happening in your own body.

The uncertainty can feel like a high-stakes gamble, because it’s true that no two people react to a medication in the same way. The cost of a bad reaction feels much more immediate and real than the potential for future relief.

Worry about personality changes or losing control

The fear that a pill could change who you are is profound. It’s the chilling worry that it will erase the very things that make you you—your sharp wit, your deep feelings, your creative spark—leaving a muted, gray version in your place.

This isn’t vanity; it’s a deep-seated need for autonomy. The goal is to feel more like yourself, not less, and the fear is that the medication will get that backward. It’s a worry so powerful it’s a primary reason people avoid their prescriptions.

Previous negative experiences with medication

If you’ve been burned before, it’s natural to be afraid of the fire. A single bad experience—a severe side effect, a terrifying allergic reaction, or a medication that made you feel much worse—can rewire your brain to see all medicine as a potential threat.

Your body remembers that experience, even if a new medication is completely different. This isn’t a failure of logic; it’s a protective mechanism. Your anxiety is trying to keep you safe by sounding the alarm on anything that feels like a threat you’ve faced before.

Stigma associated with needing medication

Sometimes the fear isn’t about the pill itself, but about what taking it means. In a world that often prizes self-reliance, needing medication for your health can be misinterpreted as a personal failing.

This feeling of shame is often made worse by the well-meaning but deeply unhelpful comments from others. Hearing things like “Have you tried yoga?” or “You don’t need a crutch” can make you question your own reality and amplify your anxiety.

How to respond to unhelpful comments from others

When someone makes a comment that feels dismissive or judgmental, remember that you do not owe them a detailed explanation of your medical care. A simple, firm boundary is often the best response.

Consider a calm, direct statement like:

“I appreciate your concern, but my medical decisions are between me and my doctor. This is what we’ve decided is best for my health right now.”

This response doesn’t invite debate. It states a fact and closes the conversation, allowing you to protect your energy and focus on your own well-being.

Fear of addiction or dependency

The words “addiction” and “dependency” are heavy and often misunderstood. It’s crucial to separate the two:

  • Dependency is when your body adapts to a substance, and you experience withdrawal symptoms if you stop it abruptly. This is a normal physiological response to many medications, including some blood pressure drugs and antidepressants. It can be managed safely by tapering off under a doctor’s care.
  • Addiction is a compulsive, psychological need to use a substance for its psychic effects, despite harmful consequences.

This confusion is understandable, and the fear of addiction stops many people from getting the help they need, especially with controlled substances. Discussing the specific risks for the medication you’ve been prescribed with your doctor is the best way to address this fear with facts.

Understanding the nocebo effect (expecting bad outcomes)

The placebo effect is when you feel better because you expect to. The nocebo effect is its dark twin: when you experience negative side effects because you expect to. Your brain is a powerful prediction machine.

When you are terrified of a side effect, your brain goes on high alert, scanning your body for any sensation that could be evidence of that fear coming true.

A minor headache, a moment of dizziness, or a slight stomach ache—normal feelings you might otherwise ignore—are suddenly interpreted as proof that the medication is harming you. This isn’t “all in your head”; it’s a well-documented process where negative expectations can create real, physical symptoms.

A step-by-step plan for your first dose

Understanding your fears is one thing; facing them is another. This is where a clear, practical plan can turn overwhelming anxiety into a series of small, manageable actions. The goal isn’t to be fearless; it’s to be prepared.

Preparing for your first dose

The moments before you take a new medication are often the most difficult. Your mind is racing with “what ifs,” and the anxiety can feel paralyzing. Taking back control starts here, before the pill ever touches your lips, by gathering information and creating a bubble of safety for yourself.

How to talk to your doctor about your fears

Your conversation with your doctor is your single most important tool. This isn’t about being difficult; it’s about being an active partner in your own care.

Before your appointment, write down your specific fears. Being prepared helps you stay focused if you get nervous. Try framing your questions collaboratively:

  • To address side effect fears: “I’m feeling very anxious about the side effects, especially [name a specific one, like nausea or dizziness]. Could we talk about how likely that is and what we can do if it happens?”
  • To address loss of control fears: “My biggest worry is that this medication will change my personality or make me feel numb. Can you tell me about your experience with other patients and this medication?”
  • To address past negative experiences: “I had a really bad reaction to [Previous Medication], and I’m scared it will happen again. How is this new medication different?”
  • To manage expectations: “Could you tell me what a realistic timeline looks like for this medication? When might I start to notice a positive change, and what should I do if I don’t feel anything at first?”

What to do if your doctor dismisses your concerns

It is a deeply disheartening experience to share a vulnerability and be met with a dismissive wave, a quick “you’ll be fine,” or a clinical explanation that doesn’t acknowledge your fear. Your concerns are not an inconvenience; they are a vital part of your treatment.

If you feel unheard, you have options:

  1. Try one more time, directly. Calmly say, “I understand the medical reasons, but my fear itself is becoming a barrier to starting. It’s important to me that we make a plan to manage that fear.”
  2. Ask for a referral. It is always appropriate to ask for a referral to a therapist or psychiatrist who specializes in anxiety. Therapies like CBT are specifically designed to help with these fears.
  3. Seek a second opinion. You have the right to a doctor who listens to you and makes you feel like a partner. It is never wrong to find a provider who values shared decision-making.

Creating a first-dose safety plan

Building a safety plan is about controlling your environment when you feel like you can’t control your body. It creates a predictable, calming space for an unpredictable experience.

Your plan could include:

  • Choosing your time: Pick a low-stress day, like a weekend, when you don’t have major obligations.
  • Involving a support person: Ask a trusted friend or family member to be with you or be available by phone. Let them know your plan and your fears.
  • Preparing your space: Have a comfortable spot to rest with calming activities ready, like a favorite movie, a soothing playlist, or a simple craft.
  • Having essentials on hand: Keep water, some plain snacks like crackers, and your doctor’s phone number nearby.

What to do during and after taking it

Once you’ve taken the medication, your brain will likely go into high alert, scanning for any sign of trouble. The goal in this phase is to distract, ground, and observe yourself with gentle curiosity rather than panicked scrutiny.

Grounding techniques for a medication-induced panic attack

If you feel a wave of panic rising, your nervous system is sending a false alarm. Grounding techniques are like a manual override, helping your brain realize you are safe. They are powerful tools for managing intense anxiety in the moment.

Try the 5-4-3-2-1 Method:

  • 5: Name five things you can see in the room. (The lamp, the blue rug, my hands.)
  • 4: Name four things you can feel. (The soft blanket, the cool glass of water.)
  • 3: Name three things you can hear. (The hum of the fridge, a car outside.)
  • 2: Name two things you can smell. (The laundry detergent on my shirt.)
  • 1: Name one thing you can taste. (The water I just sipped.)

When to call your doctor or seek immediate help

Knowing the difference between anxiety and a true medical issue is key. Before you take your first dose, ask your doctor to be very specific about what warning signs require action.

  • Call your doctor if: You experience side effects that are persistent, distressing, or interfere with your ability to function, but are not an emergency. This includes things like ongoing nausea, a headache that won’t go away, or feeling intensely drowsy.
  • Seek immediate help if: You experience signs of a serious allergic reaction. Go to the nearest emergency room or call 911 if you have:
    • Difficulty breathing or wheezing
    • Swelling of your lips, tongue, or throat
    • A sudden, severe rash or hives
    • Chest pain or a feeling of doom

Having this clear, pre-established plan turns a vague, terrifying “what if” into a simple, actionable “if-then” list. Knowing exactly what to do in an emergency gives you a powerful sense of control.

Practical strategies to manage medication fears

Getting through the first dose is a huge victory. Now, the goal shifts from surviving a single moment to building a sustainable sense of confidence for the journey ahead. These strategies are about creating a system of support around you, so the daily act of taking your medication feels less like a leap of faith and more like a deliberate step.

Communicating effectively with your healthcare team

Your relationship with your doctor doesn’t end when you get the prescription; it begins. Ongoing, open communication is the foundation of managing your anxiety long-term.

This means scheduling follow-up appointments and tracking your experience. Keep a simple daily log of your symptoms, side effects, and mood. 

This isn’t for self-diagnosis; it’s to give your doctor clear, objective data so you can make decisions together. This simple act of tracking and sharing makes it much easier to stick with your treatment plan.

Starting with a lower dose or a different format

If the thought of a full dose feels overwhelming, ask your doctor about starting with a smaller dose. Many medications can be introduced gradually to help your body adjust and to minimize the intensity of side effects.

This process, called titration, allows you to start with a dose that feels manageable and slowly increase it as you build confidence. For some medications, there may also be different formats, like a liquid instead of a pill, that can feel less intimidating. This approach isn’t “making a fuss”; it’s a medically sound strategy to help your body adapt gently to a new medication and give you a real sense of control.

Relying on a trusted friend or family member for support

You don’t have to do this alone. Social support is a powerful tool for managing the day-to-day reality of starting a new medication. This isn’t about someone else managing your health, but about having an ally.

This could look like:

  • A check-in text: Asking a friend to send a simple “Did you take it today?” message can provide gentle accountability.
  • A sounding board: Having someone you can call to say “I’m feeling weird” who will listen without judgment is invaluable.
  • A practical helper: In moments of high anxiety, leaning on a friend for support is a powerful and effective way to cope.

Creating a consistent daily routine

Anxiety thrives on uncertainty. A predictable routine is one of the most effective ways to calm a worried mind because it removes the daily, stressful decision of when and how you’re going to face this challenge.

Instead of letting the dread build all day, anchor the act of taking your medication to an existing, stable habit. This is called “habit stacking.”

  • Link it to a calm moment: Take your medication immediately after a pleasant activity, like brushing your teeth in the morning or right after you finish your dinner.
  • Create a sensory signal: Use a specific cup for the water you take your pill with, or play the same song each time. This creates a neural association that signals safety.
  • Plan a post-pill reward: Immediately after you swallow the pill, do something you enjoy for five minutes. This could be listening to a favorite podcast, doing a quick crossword puzzle, or watching a funny video. This helps your brain associate the act with relief and pleasure, not just anxiety.

Safely stopping medication (tapering off)

One of the deepest fears about starting a medication is the worry that you’ll be trapped on it forever. Knowing you have a safe way off can make it feel much safer to get on.

Never stop taking a prescribed medication abruptly. This can cause withdrawal symptoms or a return of your original symptoms. If you and your doctor decide it’s time to stop, you will create a tapering plan. 

This involves a slow and gradual reduction of your dose over weeks or months. This slow, controlled process allows your body to adjust safely, minimizing discomfort and giving you a sense of control from start to finish.

Your medication anxiety toolkit

The strategies you’ve just read are your roadmap. These tools are the practical, pen-and-paper resources to help you navigate that map. They are designed to turn abstract ideas into concrete actions, giving you a sense of control when you feel overwhelmed.

Doctor visit planner: questions to ask your provider

Walking into a doctor’s office with a racing mind can make it impossible to remember your most important questions. This planner is your script—a way to ensure your concerns are heard and answered. Using a structured list like this helps you and your doctor have a more productive conversation.

How to use this planner:
This isn’t a test. It’s a space for you to honor your fears by giving them a voice. Before your appointment, sit with these prompts. There are no right or wrong answers. The goal is to walk in feeling prepared, not put on the spot.

My medication questions planner

Section 1: understanding the goal
(This helps you and your doctor agree on what success looks like.)

  • What is the single biggest positive change you hope this medication will bring for me?
  • What is a realistic timeline for me to start noticing that change?

Section 2: managing my fears & side effects
(This turns vague worries into a concrete plan.)

  • My biggest fear about this medication is __________________________. How can we address this specifically?
  • What are the 2-3 most common side effects people feel in the first week? What is the best way to manage them if they happen?
  • What is one serious (but rare) side effect that would require me to call you or seek help immediately?

Section 3: creating a safety net
(This ensures you know exactly what to do next, no matter what.)

  • If I don’t feel any better after [X weeks], what is our next step?
  • If I feel this medication isn’t right for me, what is the process for safely stopping it?

Symptom tracker: is it anxiety or a side effect?

When your heart is pounding, is it panic or the pill? This simple log helps you become a curious observer of your own body, gathering the clues you and your doctor need to see clear patterns. The goal is not to judge what you feel, but simply to notice it. This practice of observing your own experience leads to more productive conversations and a greater sense of control.

How to use this tracker:
Keep this log for the first one to two weeks of starting a new medication. When you notice a physical or emotional sensation that feels significant, take 30 seconds to fill out an entry.

My daily symptom & side effect log

Date & time: ________________

The feeling/sensation: (Be specific. Instead of “felt bad,” try “dull headache,” “stomach churning,” or “sudden wave of dread.”)
__________________________________________________________________

Intensity (1-10): ________________

What was I doing? (context is key): (e.g., “30 mins after taking pill,” “During a stressful work call,” “Woke up with it,” “Sitting calmly on the couch.”)
__________________________________________________________________

Quick guide: what’s the difference?

  • Anxiety often feels like: A racing heart, shortness of breath, sweating, trembling, and a sense of doom. A thought can trigger it and may come in intense waves (panic attacks).
  • Common initial side effects can include drowsiness, nausea, dry mouth, dizziness, or a mild, persistent headache. They are often more constant and directly linked to when you take the medication.

Medication fear exposure hierarchy worksheet

This tool, based on a powerful therapy called Exposure and Response Prevention (ERP), is about facing your fear in small, manageable steps, like walking into a cold lake one inch at a time instead of diving in. It’s a structured, evidence-based way to show your brain that you can handle this fear.

Important: This is a powerful tool that is most effective and safest when used with a therapist. They will guide you through this process at a pace that feels right for you.

How to build your fear ladder with your therapist:

  1. Brainstorm the scary steps: Together, list everything about the medication that makes you fear it.
  2. Rate the fear (0-10): Assign a number to how much anxiety each step causes.
  3. Build your ladder: Arrange the steps from easiest to hardest. You will start with the very bottom rung.
  4. Practice and reflect: You’ll practice a step until your anxiety naturally comes down. The final column is the most important—it’s where you prove to yourself that your feared outcome didn’t happen.

My medication fear ladder

The step (my fear)Anxiety rating (0-10)What actually happened?
(Example) Look at the closed pill bottle.2Nothing. It was just a bottle. I felt a little nervous, but it passed.
(Example) Hold one pill in my hand for 30 seconds.6My hand trembled a bit, but nothing bad happened. The pill didn’t hurt me.
(Example) Swallow the pill with water.10I felt a huge wave of panic right after, but I used my grounding skills to manage it. The terrible side effects I feared didn’t happen.

Your ladder

The step (my fear)Anxiety rating (0-10)What actually happened?

When to seek professional help for pharmacophobia

The tools in this guide can build a powerful foundation, but for a fear this deep, you don’t have to be your own architect. If your anxiety is preventing you from taking a necessary medication or causing you significant daily distress, that is a clear sign that it’s time to bring in an expert.

Seeking therapy for medication anxiety isn’t a sign of failure; it’s a sign of strength. It means you’ve identified a specific problem and are making a strategic choice to use a proven solution. Evidence-based therapies can provide the structure and support you need to overcome this hurdle.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a structured, goal-oriented approach that is one of the most effective treatments for anxiety.

It operates on a simple, powerful principle: your thoughts, feelings, and behaviors are all connected. To change a powerful feeling like fear, you must learn to change the thought patterns and behaviors that fuel it.

Think of CBT as having a coach for your thoughts. A therapist helps you:

  • Identify the core fear: You’ll pinpoint the specific catastrophic thought that gets triggered by the medication (e.g., “This pill will cause a fatal allergic reaction”).
  • Challenge that thought: You’ll learn to examine the evidence for and against your fear, separating anxious speculation from objective reality.
  • Develop coping skills: You’ll build a toolkit of practical strategies, like the ones in this guide, to manage anxiety in the moment.

Exposure and Response Prevention (ERP) therapy

Exposure and Response Prevention (ERP) is a specific type of CBT that acts as the behavioral workout for your anxiety. It’s one of the most powerful approaches for treating phobias and OCD-related symptoms because it directly targets the cycle of avoidance that keeps fear alive.

The process is gradual, collaborative, and always guided by your therapist. It’s like learning to swim by starting in the shallow end, not by being thrown into the deep.

  • The Exposure: You will work with your therapist to create a “fear ladder” (like the one in the toolkit) and gradually expose yourself to the things you fear, starting with the least scary step. This might begin with simply looking at the pill bottle.
  • The Response Prevention: This is the crucial part. You learn to sit with the anxiety that arises during the exposure without resorting to your usual safety behaviors (like distracting yourself, seeking reassurance, or avoiding it).

By doing this in a controlled way, you teach your brain a new, profound lesson: “I can feel this anxiety, and I am still safe.”

Mindfulness and meditation techniques

Mindfulness is not about clearing your mind or stopping anxious thoughts. It’s about changing your relationship to them.

These techniques are often a valuable part of a larger therapy plan to help you tolerate the discomfort of facing your fears. Think of your anxious thoughts as leaves floating down a river.

  • The old way: You jump into the river and get swept away by each leaf, struggling against the current.
  • The mindful way: You learn to sit on the riverbank and simply watch the leaves float by. You notice them (“There’s that fear about my heart rate”), acknowledge them without judgment, and let them pass.

This skill helps you create a small pocket of space between you and your fear, giving you the clarity you need to choose a wise response rather than react automatically.

How to find a qualified therapist

Knowing you need help is the first step; finding the right person is the next. You are looking for a licensed mental health professional who specializes in anxiety and evidence-based treatments like CBT or ERP. Here are a few practical places to start your search:

  • Ask your doctor for a referral: Your primary care physician or prescribing doctor often has a network of trusted mental health professionals. Ask them for a specific referral to someone who treats phobias or anxiety disorders.
  • Use a professional directory: Websites like the Anxiety & Depression Association of America (ADAA) or Psychology Today have searchable directories. You can filter by location, insurance, and specialty (look for “CBT,” “Exposure Therapy,” or “Anxiety Disorders”).
  • Contact your insurance provider: Call the member services number on the back of your insurance card and ask for a list of in-network therapists and psychologists who specialize in anxiety.

Supporting a loved one with medication anxiety

Watching someone you love struggle with this fear is a painful exercise in helplessness. You want to take the anxiety away, but your role isn’t to be their rescuer; it’s to be their anchor—a calm, steady presence that helps them find their own footing.

What to say and how to help

When someone is drowning in fear, your instinct might be to throw facts and logic at them. But anxiety isn’t logical. The most powerful thing you can offer is not a solution, but validation.

Validation is the act of acknowledging that their fear is real to them, even if it seems irrational to you. It’s the difference between arguing with their reality and sitting with them in it.

  • Instead of saying: “You’re being irrational. The doctor said it’s safe.”
  • Try saying: “It sounds like you’re feeling really scared right now. I’m here with you.”

Effective support is both emotional and practical. Simply listening without judgment can be one of the most powerful ways to reduce a loved one’s immediate distress. You can also offer practical help that empowers them, rather than taking over:

  • Offer to join them: “Would it be helpful if I came with you to your next doctor’s appointment?”
  • Help them prepare: “Let’s sit down and write out your questions and fears together before you go.”
  • Be their safety person: “I’ll be available by phone when you take your first dose, just in case you need to talk.”

How to avoid enabling the fear

There is a fine line between supporting someone and enabling their anxiety. Support validates the feeling; enabling validates the avoidance.

Avoidance is the fuel that keeps anxiety disorders going. Every time a person avoids the thing they fear, their brain gets a small hit of relief, which reinforces the idea that the feared thing is truly dangerous. While it comes from a place of love, you can accidentally make the fear stronger by helping them avoid it. 

Enabling can look like spending hours on anxious research or constantly providing reassurance about the same fear. Holding a compassionate boundary is not unkind; it is the most supportive thing you can do.

  • When they ask you to research a side effect for the tenth time:
    • Instead of enabling: Opening your laptop and falling down the rabbit hole with them.
    • Try holding a boundary: “I know you’re looking for certainty, and it’s so hard not to have it. We agreed to trust the plan you made with your doctor, and I want to support you in that. How about we put our screens away and do something else to get your mind off it for a bit?”
  • When they ask “Are you sure I’m going to be okay?” repeatedly:
    • Instead of enabling: Saying “Yes, I’m sure, you’ll be fine!” over and over.
    • Try empowering them: “I know that fear feels very real right now. What’s one of the grounding techniques we talked about that we could try together?”

Encouraging them to speak with a professional

Bringing up therapy can feel like a delicate conversation. The key is to frame it not as a criticism, but as a practical, hopeful, and strategic next step. Many people put off getting help because of the stigma or simple uncertainty about where to start, so how you introduce the idea matters.

  • Instead of saying: “You really need to see a therapist about this.”
  • Try saying: “I can see how much this is hurting you, and I feel helpless to fix it. I’ve been reading about therapists who specialize in this exact fear. Would you be open to me helping you find someone to talk to?”

This approach does three important things: it expresses your care, it names the problem as a specific, treatable issue, and it offers your help as a partner in the process. Offering to help with the logistics—like finding names or making the first call—can be the small act of support that makes all the difference.

Hope for your journey

Facing a fear this deep isn’t about finding a magic button that turns off the anxiety. It’s about the small, intentional act of choosing to trust yourself, one single dose at a time. Start by taking one question from the planner and writing it down, without judgment. That small moment of preparation is how you learn to trust yourself again.

Care at Modern Recovery Services

Feeling trapped between your symptoms and a deep fear of the medication is a painful, paralyzing place to be. At Modern Recovery Services, our clinical experts guide you through this specific anxiety with structured, compassionate care, empowering you to make a clear and confident health decision.

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