Prescription drug addiction is the use of a drug in a different way than prescribed by your health care provider, and it’s an epidemic in the United States. The National Center for Drug Abuse Statistics cites that 16 million (6%) Americans over the age of 12 abuse prescriptions within a year, and that 12% of them are addicted to prescription drugs.
What is striking is that among the various categories of prescription drugs, for example, non-opioid analgesics, sedatives, stimulants and psychotherapeutic4 out of 5 prescriptions filled by pharmacies are for opioids which are consumed annually by 9.3 million people, 57.1% of which come from people with prescriptions.
This article discusses addiction, prescription drugs that are addictive, signs of addiction, and treatment options in more detail.
Causes and risk factors
Anyone can develop a substance abuse disorder, and it can happen at any time. However, certain circumstances increase the risk of addiction, including:
- Mental health problems
Other factors also include a reliance on prescription medications for pain management, but an individual’s environment also plays a role in increasing the risk of addiction. These factors can include peer pressure, physical and sexual abuse, and the early introduction of drugs. Teenagers are among the most vulnerable because the part of the brain that controls judgments, decision-making, and self-control is not fully developed, leading to a higher risk of substance abuse.
When opioids and other addictive drugs are introduced, neurons in the brain that send and receive signals through their neurotransmitters are disrupted. Due to their chemical makeup, some addictive drugs activate a neuron, causing abnormal messages to be sent through the circuits and network of the brain. An important effect of taking certain prescription medications is the release of dopamine, a neurotransmitter that responds to pleasurable activities. But after a certain period of time, to reach that dopamine hit, the individual becomes more dependent on the drug, increasing the risk of an addiction disorder.
In the United States alone, 16.3 million people abuse prescription drugs every year. The distribution is 43.3% of first-time abusers who use analgesics against 32.1% who abuse sedatives. Prescription drugs are the third most widely used illegal substance after marijuana and cocaine.
Addiction to prescription drugs can be both physical and psychological. Although the body may develop a tolerance to the drug, the dose must be increased to achieve this continued dopamine effect and achieve the desired results.
Overreliance on prescription drugs can lead to substance abuse disorder. Signs of abuse can lead to problems at home, school, and work, which can lead to feelings of isolation, helplessness, and shame.
physical signs may include changes in appetite, sleep patterns, weight loss, bloodshot eyes, smaller or larger than normal pupils, unusual body odor, little or no interest in sex appearance and no motor coordination.
Behavioral signs include secretive behavior, excessive absences from school or work, and dramatic changes in friendship and social activities.
Psychological signs include mood swings, irritability, anxiety, fear, paranoia for no reason, and a significant change in personality and attitude.
The most commonly used prescription medications are categorized as depressants, opioids and morphine derivatives, stimulants, and other compounds found in cold and cough medicines.
Depressants are primarily known as substances that aid in falling asleep, relieve anxiety and muscle spasms, and prevent seizures. Health risks include lower blood pressure, slowed breathing, increased risk of respiratory distress, and death from alcohol consumption. In this category, there are three types:
- Barbiturates can be taken orally or injected. Side effects specific to barbiturates include euphoria or unusual excitement, fever, irritability, and life-threatening withdrawal. Trade names include Amytal, Nembutal, Seconal and Phenobarbital.
- Benzodiazepines are taken orally and include Ativan, Halcion, Librium, Valium, Xanax and Klonopin.
- Sleeping tablets are swallowed and include Ambien, Sonata and Lunesta.
Opioids and morphine derivatives
Opioids are available in many forms, including tablets, capsules, patches, powders, liquids, suppositories, and lollipops. They can be injected, swallowed, snorted or smoked. Effects on the body include: pain relief, euphoria, drowsiness, sedation, weakness, dizziness, nausea, impaired coordination, confusion, dry mouth, itching, sweating, clammy skin, constipation, slowing or stopping of breathing, decreased pulse and blood pressure, unconsciousness, coma, and death. The risk of death was increased when combined with alcohol or other central nervous system depressants.
Types of opioids include:
- Codeine can be swallowed or injected. The National Institute of Drug Abuse notes that codeine has less analgesia, sedation and respiratory depression than morphine. Trade names include Empirin with codeine, Fiorinal with codeine, Robitussin AC and Tylenol codeine.
- Morphine can be swallowed or injected. Trade names: Roxanol and Duramorph.
- Methadone can be swallowed or injected. Methadone is used to treat opioid addiction and pain. The risk of overdose is high when not used correctly. Trade names: Methadose and Dolophine.
- Fentanyl can be injected, snorted or smoked. Fentanyl is 80 to 100 times more potent than morphine. Trade names: Actiq, Duragesic and Sublimaze.
- Other Opioid Analgesics include Oxycodone HCL (a muscle relaxant twice as potent as morphine with high abuse potential), Hydrocodone Bitartrate Hydromorphone, Oxymorphonemeperidine and propoxyphene.
Prescription stimulants are medications typically used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. They increase alertness, attention and energy. Side effects include: feelings of euphoria, increased energy, alertness, increased heart rate, blood pressure and metabolism, decreased appetite, weight loss, nervousness, insomnia, seizures, heart attack and stroke.
Types of stimulants include:
- Amphetamines can be injected, swallowed, snorted or smoked. Trade names: Biphetamine, Dexedrine and Adderall. Side effects include: rapid breathing, tremors, loss of coordination, irritability, anxiety, agitation/delirium, panic, paranoia, hallucinations, impulsive behavior and aggression.
- Methylphenidate can be injected, swallowed or snorted. Trade names: Ritalin and Concerta. Side effects include: increasing or decreasing blood pressure changes, gastrointestinal problems, loss of appetite and weight loss.
- Other compounds, which are normally found in cold and cough medicines and come in the form of tablets, capsules or syrup. The most common compound is Dextromethorphan. Side effects include: euphoria, slurred speech, increased heart rate and blood pressure, dizziness, nausea, vomiting, confusion, paranoia, distorted visual perceptions and impaired motor function.
For effective and successful treatment, several elements must be incorporated, including detoxification, counseling, and medication. In many cases, it may take several treatment cycles for the patient to fully recover.
The two main categories of treatment are:
- Behavioral treatment, such as cognitive-behavioral therapy (CBT) which involves changing unhealthy thought and behavior patterns. The individual will learn strategies to manage cravings, avoid signals and situations that lead to relapse; or, in some cases, provide motivation to abstain. CBT can include individual, family or group counseling.
- Medical treatment. Prescription opioid addiction can be treated with buprenorphine, methadone, and naltrexone, which can stop other opioids from affecting the brain (naltrexone) or relieve withdrawal symptoms and cravings (buprenorphine and methadone ), and help the patient avoid relapses. These drugs are combined with both psychosocial support or behavioral treatments, called drug treatments (MAT). A drug to reduce the physical symptoms of withdrawal (lofexidine) is also available.
When to See a Health Care Provider
The first step in your recovery is recognizing that you have a substance abuse disorder. Then seek help as soon as possible by asking your health care provider to recommend treatment and/or a therapist or other addiction counseling service.
If you have loved ones with a prescription drug addiction, don’t ignore it. Get them to help immediately. There are many treatment programs available that are able to provide help and advice. But remember, treatment is not a quick fix, but a long process that will take time to overcome.
Prescription drug addiction is a chronic condition that has detrimental effects on individuals, their families and friends. The most commonly used prescription drugs are depressants, opioid and morphine derivatives, stimulants, and cold and cough medicines. Symptoms of substance abuse disorder include physical, behavioral, and psychological changes. If you have a substance abuse disorder or a loved one shows signs of addiction, get help right away. Speak to your health care provider to be referred to a therapist who specializes in treating substance use disorders.