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Not true at all....ok, so as your SICKNESS level climbs, you become more reliant on the pills. You start out the game with a level 4, i believe, sickness and you need to take a pills about every 45 minutes. As you progress through the game, your sickness decreases and you take less pills. Then towards the end of the game is climbs back up again.
Your rep has nothing to do with how many pills you take. Regardless, it doesnt matter because only progressing through the storyline prompts you to take the Underground missions for pills. Even if you dont take a single pill in between doing 2 missions, you will still have to do an Underground mission. TRUTH