Prescription medications can often mean the difference between excruciating pain, debilitating mental disorders, life-threatening illnesses, and being able to live a happy, healthy, longer life. Prescription drugs can help with everything from strep throat and asthma to depression and cancer, with a whole wealth of things in between.
Unfortunately, in the course of treating these illnesses, many people often fall victim to misuse and abuse, eventually ending up with a prescription drug addiction as they chase after the feelings of euphoria that their bodies and minds have become dependent upon. So how, then, does prescription use cross the threshold to recreational abuse?
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The Prescription Drug Issue In America
It’s no secret that prescription drug abuse has become a major problem in the United States. In part, this is due to the overwhelming number of medications being prescribed, with just under roughly four and a half billion prescriptions dispensed in 2016, a more-than-sizable jump from just under four billion only six years ago.
And when there are more prescriptions, it is only logical there will also be more instances of prescription drug misuse and abuse.
In fact, according to the National Institute on Drug Abuse (NIDA), in 2016 an estimated 54 million people in the United States reported having used prescription medications for nonmedical purposes at some point in their lives.
Prescription drug misuse may seem like a small thing, but misuse can escalate and progress to prescription drug addiction more quickly and easily than most people might realize.
What Is Prescription Drug Addiction
Prescription drug addiction can stem from misuse of prescription drugs. So what qualifies as prescription drug misuse? The answer is fairly simple and straightforward. Misuse is defined as:
- Taking prescription medications in higher doses than prescribed.
- Taking someone else’s prescription medications or just any prescriptions that are not your own.
- Taking prescription medication for recreational purposes—in other words, to get high.
When considering prescription drug addiction, the main drugs of concern can be classified into three categories:
Opioids are a class of drugs that include those both naturally derived from opium as well as synthetically created. Opioids are generally prescribed to treat pain that is either post-surgical or chronic and ongoing. In the wake of the current opioid crisis, when people think of prescription drug addictions, prescription painkillers are usually the first drugs to come to mind.
Opioids work by binding to opioid receptors in the brain in order to mask pain signals as well as increase feelings of relaxation and euphoria. These pain relievers are generally safe if taken for a short period of time. However, due to its euphoric effects along with pain relief, they can easily be misused and abused. In the event of an opioid overdose, the effects can be reversed if immediately given the overdose reversal drug naloxone.
Substances in this class are most often prescribed to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy, and sometimes weight loss. Stimulants increase alertness, attention, and energy, and elevate blood pressure, heart rate, and respiratory rate by increasing levels of dopamine and norepinephrine in the brain and central nervous system.
Drugs in this category are typically prescribed to treat the symptoms of anxiety or panic disorders as well as insomnia and are designed to slow down the brain’s operation. According to Psychology Today, most of these drugs impact the neurotransmitter gamma-aminobutyric acid (GABA), which is used in the brain’s communication system to regulate feelings of stress, anxiety, and fear
When used long-term, prescription drugs can lead to drug abuse and addiction. Specifically, when combined with other substances that impact the central nervous system such as alcohol, these drugs can result in respiratory suppression or even death.
The risk for drug addiction can depend largely on the person’s biology, social circumstances, and age/developmental stage, with studies supporting the idea that the earlier a person starts taking prescription drugs, the greater the chance for serious abuse and addiction.
What Are The Most Commonly Abused Prescription Drugs?
Although pills are prescribed by doctors and supplied by pharmacies, some medications aren’t safe for everyone. Prescription drugs can refer to a variety of substances, but statistically speaking, the most commonly abused drugs and the effects of abusing them are as follows:
Adderall is a CNS stimulant part of the phenethylamine class of drugs used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy. The active ingredient in this drug is a form of amphetamine mixed with other variants of amphetamines. It also can be used as an athletic performance and cognitive enhancer. The side effects associated with long-term Adderall abuse include:
- Abdominal pain
- Weight loss
- Heart disease
- Jitteriness and tremors
- Heart palpitations
- Difficulty breathing
Ambien is a CNS depressant medication, also known as a sedative, that is usually used to help people with short-term insomnia. It’s considered effective at getting people to sleep, but not maintaining sleep. Ambien’s active ingredient is zolpidem, and it works by easing the brain’s electrical activity while producing a sense of amnesia. The side effects associated with long-term Ambien abuse include:
- Impaired coordination
- Weakness in limbs
- Uncontrollable shaking
- Insomnia as a reverse effect
Ativan is a brand name prescription medication of the generic lorazepam and is part of the powerful class of drugs called benzodiazepines. It is used to treat anxiety disorders, acute alcohol withdrawal, and seizures. Lorazepam can give people a “rapid-onset high” in a short period of time, hence the potential to cause an addiction. The side effects associated with long-term Ativan abuse include:
- Potentially permanent cognitive impairment
- Concentration and memory problems
- Constant drowsiness
Fentanyl is an opioid pain medication considered 50 to 100 times more potent than morphine. It’s typically prescribed in patch or shot form to patients suffering from severe pain that did not respond to other forms of therapy. However, since fentanyl is often made illegally and used as a recreational drug, usually disguised as other medications and typically mixed with heroin, it has led to a spike in overdoses from 2000-2017.
For those who abuse fentanyl, the danger is not so much in the possible long-term side effects that may occur but in the incredibly high likelihood of a deadly overdose due to the drug’s immense potency. Many people will overdose fatally on fentanyl before they become dependent on it.
Klonopin, the brand name of the drug clonazepam, is a benzodiazepine used to treat people suffering from panic attacks and seizure disorders. Especially when mixed with other substances, Klonopin can be highly addictive and result in higher risks for suicidal thoughts and actions. According to Everyday Health, there were 76,557 Klonopin-related visits to the emergency room in 2011 alone.
The long-term effects of Klonopin abuse are essentially the same as those of Ativan, and for most benzodiazepines in general.
Morphine is a potent opioid pain medication from the poppy straw of the opium plant. It works by directly acting on the central nervous system to minimize the feeling of pain. The drug has a high potential for addiction and abuse, the effects of which include:
- Significant changes in weight
- Impaired coordination
- Abdominal cramps
- Kidney failure
- Difficult, forced breathing
- Low blood pressure
- Decreased metabolism
OxyContin is a “pure narcotic pain killing drug,” containing pure oxycodone. The extended-release OxyContin pill can provide pain relief for up to 12 hours. However, it’s easy for people to abuse the drug by snorting or injecting crushed pills. OxyContin was part of the first major rise in prescription opioid addictions, having been falsely marketed as a safe painkiller with a low risk of addiction. As an opioid, long-term OxyContin abuse has effects similar to morphine, but also some unique effects as well, including:
- Muscle spasms
- Reduced motor control
- Organ failure due to limited oxygen delivery
- Infection and inflammation from solidified chunks of crushed medication creating blockages in the bloodstream
Ritalin is a brand name amphetamine-like central nervous system stimulant prescribed to treat ADHD and narcolepsy. Because Ritalin can provide feelings of focus and euphoria, the substance has high abuse potential. The long-term effects of Ritalin abuse may include:
- Confusion and disorientation
- Increased risk of seizures
- Suicidal thoughts and behavior
- Significant weight loss
- Alternating periods of mania and depression
Vicodin is a prescription narcotic pain medication that is a mix of the opioid hydrocodone and acetaminophen. Vicodin is considered one of the most popular pain relief drugs; as there were 131 million prescriptions written in 2011. People who regularly take high levels of Vicodin can do severe, lasting damage to their livers due to the presence of acetaminophen, and may also experience:
- Kidney failure
- Brain damage
- Hearing loss
- Cardiovascular damage
- Sexual dysfunction
Valium, the name brand version of the drug diazepam, is a central nervous system depressant that is part of the benzodiazepine family and is used to treat anxiety disorders, muscle spasms, and seizures. Valium can affect the brain within minutes while staying active for a long period of time, especially when combined with alcohol. Along with the previously-mentioned effects of benzodiazepine abuse, those who abuse Valium may also experience:
- Heart attacks
- Aggressive behavior and mood swings
Xanax, the name brand medication of the generic drug alprazolam, is a benzodiazepine medication used to treat people with anxiety and panic disorders. It possesses sedative properties and can rapidly lead to addiction. In 2010, it was actually the 12th most prescribed medicine in the United States. The long-term effects of Xanax abuse mirror those of Ativan and Klonopin as well as the effects associated with Valium.
Who is Most Vulnerable to Prescription Drug Addiction?
According to NIDA, the rate of prescription drug addiction is increasing in people aged 50 and older, along with the highest reported instances of abuse coming from elderly Americans (aged 65 and above). Roughly 25 percent of older Americans use prescription psychoactive medications that have a potential to be misused and abused and are more likely to take them for longer periods than younger adults would.
Older adults are at higher risk of prescription drug abuse than other age groups due to factors such as elevated pain rates and higher instances of illness and sleep disorders. Particularly among the elderly, issues with cognitive decline from Alzheimer’s or dementia may also contribute to accidental misuse of prescription medication.
We’ve already mentioned the high rates of Adderall and prescription stimulant abuse among high school and college students, and because prescription medication has been given to them by a doctor, many young people are under the mistaken impression that these drugs are safer to misuse than illegal ones.
According to a 2013 Monitoring the Future survey, after marijuana, prescription medications are the most abused category of drugs among youths aged 12 to 17 in the United States. Teenagers have fairly easy access to many prescription medications by way of their parents’ medicine cabinets and may have an easier time accessing prescription drugs than illicit ones.
Those suffering from PTSD and other mental health issues are extremely vulnerable to prescription drug addiction and likely to misuse it to cope with symptoms of depression and anxiety. This group is also at a greater risk of mixing prescription medication with substances like alcohol, which could have potentially deadly results.
What Are The Signs of Prescription Drug Addiction?
Knowing the signs of a prescription drug addiction and being able to spot them before it’s too late can often be the difference between life and death, especially when it comes to prescription opioids, which have extremely high rates of overdose deaths.
These markers of prescription drug addiction can take on several different forms, including noticeable shifts in habits and behavior that can be applied to substance use dependency in general as well as some that specifically point to prescription drug abuse among both adults andteens.
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Some common tell-tale signs include:
- Impaired motor skills
- Significant changes in appetite
- Noticeable agitation and mood swings
- Disrupted sleep or unusual sleep patterns
- Appearing to be high, which, depending on the medication can be unusually energetic, euphoric, or sedated
- Difficulty remembering important things
- Impaired judgment and decision-making
Other observable signs include:
- Social withdrawal
- Increase in secretive behavior
- Money or valuables suddenly going missing
- Stealing, forging, or selling prescriptions
- Decline in performance at work or school
- Lack of interest in hobbies and activities they previously enjoyed
- Attempting to get prescriptions from more than one doctor (known as “doctor shopping”)
- Regularly “losing” prescriptions to get more of them written
These symptoms can manifest differently in each person suffering from prescription drug addiction. It’s worth noting if your loved one is behaving out of the norm, especially if you’re aware they had been prescribed any medication. They may require professional addiction treatment as well as medical detoxification to flush the drugs from their system and stem some of the damaging effects of long-term abuse.
What is Dangerous to Mix with Prescription Medication?
As we mentioned before, while abusing prescription drugs on their own can lead to many serious and life-threatening consequences, mixing prescription medication with other substances can create a whole separate set of health risks. According to NIDA, prescription opioids should never be mixed with substances that cause central nervous system depression, including:
This is due to the fact that prescription opioids already produce sedative and depressive effects that can lead to difficult or shallow breathing. Adding even more depressant substances to the mix increases the chances of severe respiratory depression, coma, and death.
Likewise, for the same reasons, prescription central nervous system depressants should not be used in combination with:
- Opioids and pain medications
- Certain over-the-counter allergy medications
Finally, while prescription stimulants can be used with certain other substances that also stimulate the nervous system, it should be done very carefully and under the supervision of a doctor, as the following medications can cause undue strain on the heart and lead to cardiac complications as well as blood pressure problems:
- Certain asthma medications
- Over-the-counter decongestants
How Can Prescription Drug Addiction Be Treated and Prevented?
For people suffering from addiction to prescription drugs, experts advise a treatment regimen including medical detox, intensive therapy, and support groups.
Those using prescription opioids may experience flu-like symptoms when they go through withdrawal, while individuals abusing central nervous system depressants can undergo seizures when trying to quit. This is where a medical detox can help, as treatment staff can use medication therapies and alternative medicinal techniques to help withdrawal be more safe and comfortable.
There are treatments with various medicines that can be used to counteract the symptoms of prescription drug abuse. These drugs include buprenorphine, naloxone, and suboxone. Also, many addiction recovery treatment programs seamlessly combine medication therapy with behavioral therapy, giving people the chance to better understand the underlying causes of their addiction with the help of professional therapists.
In the broad scope of prescription drug addiction prevention, officials have explored various methods in an effort to halt the ever-growing opioid crisis currently gripping the nation.
Since an initiative that began in 2011, prescription drug monitoring programs (PDMPs) in all 50 states have acted as “interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk.” Findings of the programs are still mixed, but continued research and state-level research can lead to improved practices and policies.
On the individual level, there are many ways to prevent or at least significantly lower the potential for prescription drug addiction, including:
- Always follow the prescription medication directions
- Take prescription drugs in the form prescribed (ex: do not crush, snort or inject tablets or pills)
- Never alter a prescribed dosage without first speaking to your doctor
- Be aware of a prescription drugs side effects and interactions with other substances
- Never take someone else’s prescription medication and do not allow someone else to take yours
- Properly discard unused or expired medications rather than leaving them around the house
Start Your Journey to Recovery Today
No one ever said the path to freeing yourself from drug addiction was easy. However, that’s why The Palm Beach Institute is here to provide you with all the help and support you need to successfully recovery from prescription drug addiction.
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