Growing Epidemic & Risk

Just because a drug was prescribed by a doctor makes it safe, right? Or, because I can buy this drug over-the-counter (OTC) at the drugstore, nothing can happen to me if I take it. Right? Not even close.

Many people think that prescription and OTC medications are safer than illicit or illegal drugs bought on the street. Unfortunately, this isn’t true but the dangers of addiction and abuse of these drugs is real.

Across the U.S. we’re currently experiencing an epidemic of prescription drug abuse, according to the National Institute on Drug Abuse (NIDA).

Non-Medical Use
Certain medications are prescribed for individuals to treat a specific medical issue and based on their individual health concerns taking into consideration a number of factors. When a person takes a prescription drug for a non-medical reason, this is considered misuse.

Some drugs, while medically necessary when used as prescribed, cause psychoactive or mind-altering effects, and may be highly-addictive. The prescription drug epidemic includes opiates, stimulants, sedative-hypnotics, and other medications that are medically necessary but are considered to have highly-addictive properties. Not only is this a challenge for the individuals who are becoming addicted to prescription drugs, but also for the communities, healthcare providers, and treatment programs as they try to manage the societal and medical costs of the growing number of individuals with addiction involving prescription drugs.

Community Health Challenges
The increasing numbers of prescription drug abuse and addiction is creating problems for families, communities, healthcare providers, and the legal system. As a result, healthcare and government agencies are working towards developing prescription drug abuse prevention programs, awareness efforts, and treatment resources to help curb prescription drug abuse and its effects.

Prescription Drug Addiction

According to the National Survey on Drug Abuse & Health, more than 6.5 million people in the U.S. self-identified as non-medical users of prescription drugs. This number has been fairly consistent over the past decade, which indicates a serious problem – about 2.5 percent of our population uses prescription drugs to get high.

Prescription Drugs of Abuse

As described by the Centers for Disease Control & Prevention, this epidemic is most visible around the misuse of opioid prescription painkillers, which commonly leads to using heroin as a cheap, available substitute. Other prescriptions drugs such as benzodiazepines, stimulants, and sedative-hypnotics are also used for non-medical reasons. These drugs are especially dangerous when combined with alcohol, including a high potential for overdose and physical withdrawal symptoms that can be fatal.

How Prescription Abuse Starts

For many people, prescription drug abuse starts with legitimate use of a prescription to treat pain, a medical condition (such as insomnia), or a mental health issue. Due to the addictive nature of some drugs, misuse by either using a higher dosage than prescribed or using the substance for long-term treatment may cause the brain to develop a tolerance for the drug and higher doses are necessary for the desired effect or to function normally. Drug tolerance is an indicator that the person will continue using the drug, and may be a common route to addiction.

Risk Factors
According to NIDA, the development of addiction to any type of drug is often based in a number of factors, including:

  • Previous drug abuse, mental illness, or family history of disorders
  • Stress, anxiety, or depression
  • Friends or family who use or encourage drug use
  • Lack of positive social network
  • Abuse, neglect, or other difficult issues during childhood

These factors, when paired with the addictive nature of prescription drugs, may lead a person to use medications for non-medical use and increase the odds of dependence.

Who Abuses Prescription Drugs?

The majority of people use prescription drugs appropriately, are able to follow their doctor’s instructions and finish their medication without incident. When the course of treatment is over, the person stops taking the drug but some people continue to use the drug which may lead to misuse, drug tolerance, and illicit drug use.

People of different ages, socioeconomic groups, and all walks of life develop problems with prescription drugs and did not start out taking them to seek recreational drug highs. Still, there are some populations that may have a higher risk of prescription drug abuse and addiction. These include:

  • Adults and seniors from ages 50 up, per an article in Addictive Behaviors
  • According to NIDA, teenagers and young adults 12-25
  • People with mental illness or family history of mental illness or drug addiction
  • More women than men develop prescription drug abuse issues

Commonly Abused Prescription Drugs

As described by WebMD, certain prescription drugs are most prone to abuse:

Opioid painkillers: These drugs are legally prescribed to treat pain like minor to moderate chronic pain, and acute pain that occurs with injuries or surgery. Opioids are created from a substance extracted from the opium poppy, and help to diminish the pain response and increase feelings of pleasure. Opioids are also used in medications that treat coughs and seizures. Because of their abuse potential, they are only prescribed for short-term use. When misused for non-medical reasons in higher doses or for longer periods of time than recommended, tolerance and addiction may occur. When availability of drugs, legal prescriptions, and prices prohibit getting opioids, users may go out on the street and turn to heroin. Specific opioid painkillers include:

  • Vicodin (hydrocodone)
  • OxyContin (oxycodone)
  • Codeine
  • Morphine derivatives
  • Fentanyl

Sedative-hypnotics
Central nervous system depressants: Benzodiazepines (benzos), barbiturates, and sleep aids are also prescriptions that are frequently abused. These drugs slow the responsiveness of neurotransmitters and nerve cells in the brain, resulting in a calming effect. As a result, these drugs are generally used to treat anxiety, depression, and conditions such as insomnia. Benzos are also used as club drugs and in combination with alcohol, a dangerous and sometimes deadly combination which intensifies their effects. Commonly used benzos include:

  • Valium (diazepam)
  • Xanax (alprazolam)
  • Ativan (lorazepam)
  • Ambien

Stimulants
Central nervous system stimulants: Conditions like attention deficit hyperactivity disorder (ADHD) are treated with stimulants, which accelerate neural responses and assist with a person’s ability to focus, stay alert, and complete tasks. In addiction, stimulants may be used to treat sleep disorders like narcolepsy. Some of these medicines contain amphetamines, which are similar to street drugs like methamphetamine (meth and crystal meth). The drugs include:

  • Ritalin
  • Adderall
  • Dexedrine
  • Provigil

Recognizing Prescription Drug Abuse

Prescription drug addiction can be recognized by the same signs used to identify substance abuse in general. According to the Diagnostic and Statistical Manual of Mental Disorders, these signs include:

  • High level of focus on getting/using the drug, and recovering from its effects
  • Challenges in relationships related to drug use
  • Inability to keep up with work, social, and familial responsibilities
  • Lack of desire to participate in activities that were previously enjoyed
  • Cravings for the drug
  • Inability to stop using the drug or control the amount of drug used

Behaviors of Abuse
These signs may indicate the severity of the prescription drug abuse. In addition, specific signs of abuse include missing pills or running out of prescription sooner than expected, stealing drugs, or forging/falsifying prescriptions to get more drugs.

Physical Appearance
An individual using painkillers or sedatives may appear to be sleepy all the time and have a lack of focus or ability to comprehend. A person who is struggling with stimulant abuse may seem abnormally energetic and have issues with low appetite and weight loss.

Treatment for Prescription Abuse

As with other forms of substance abuse, prescription drug abuse is treatable. With proper care, it can be managed to help the person recover from addiction and maintain abstinence from prescription drugs. A reputable, research-based treatment program can provide medical treatment and therapy that help the person learn to manage cravings and respond to triggers with positive behaviors that do not involve use of these drugs.

It is important to get professional help with prescription drug abuse due to the serious risks involved with these medications. For example, a study in Addiction discusses that withdrawal from benzos can result in severe and life-threatening symptoms, such as seizures and psychosis. To avoid these dangers, observation and medical assistance in tapering dosages during withdrawal are important. Treatment through a professional, comprehensive treatment program can also make it more likely that the individual will avoid relapse, decreasing the risk of overdose.

With commitment to a strong, professional treatment program that provides comprehensive drug treatment services, a person struggling with prescription drug abuse can achieve recovery, maintaining abstinence long into the future.