Prescription Drug Abuse and Addiction
Prescription drug addiction occurs when a person develops a physical dependence and a psychological obsession with one or more pharmaceutical medications. This kind of addiction can occur with people who are legitimately prescribed medications by a doctor. It is also common for people to purchase pharmaceutical medications illicitly. Most cases of prescription drug abuse and misuse are a result of a person pursuing the euphoric feelings — or “high” — that these medications often provide as a side effect.
There is a common misconception that prescription drugs are safe and risk-free. People believe prescription drugs are safe because they are legal. It is important to recognize that just because a drug is legal or serves a recognized medical purpose, that does not mean that it is safe. In fact, many prescription drugs are more dangerous than so-called “street drugs.” For this reason, when doctors prescribe medication, they ask that patients follow strict guidelines for taking their medication. Addictive medications are often only prescribed for short periods of time to avert the potential for physical dependence. However, it should be noted that even people who take their drugs as prescribed and follow medical directions to the letter are still at risk.
When people seek euphoric effects from prescription drugs or seek additional relief from their medical ailment, it is common for them to misuse them. This form of misuse generally comes in the form of taking higher doses than prescribed. However, when an individual takes prescription drugs over an extended period of time, they are likely to develop a tolerance for these drugs. When a person increases their dosage, this tolerance can become even stronger. Once a person’s body has acclimated to the effects of a drug and develops a tolerance, it takes even greater quantities of the drug to produce any desired effect. The euphoric feeling becomes more difficult to achieve, and the result is that people further increase their dosage.
Once this tolerance for prescription drugs has set in, people generally struggle to resist the urge to abuse their medication. Physical dependence on prescription medication can cause people to experience debilitating withdrawal symptoms when they try to quit. They may reach a point where they are unable to function without their prescription drug or drugs. If their brain and central nervous system have adapted to the effects of the drug, being high may be the new normal for them, and being sober can become intolerable.
Prescription drug addiction can make substance abuse compulsive and almost impossible to manage without outside help. Moreover, addiction to prescription drugs can lead to a wide range of negative consequences in a person’s life. These consequences range from physical and mental health problems to relationship issues. As these difficulties build, prescription drug abuse can become even more appealing as a form of short term relief from life’s challenges. The result is a vicious cycle. Fortunately, it is possible for people to recover from addiction and rebuild their lives. Outpatient addiction treatment programs, such as NuView Treatment Center, can offer people the tools, support, and medical attention they need.
The Most Commonly Abused Prescription Drugs
What are prescription drugs? Prescription drugs, sometimes known as prescription medications, are pharmaceutical drugs that can only be sold to people who possess a medical prescription issued by a doctor or licensed physician. There is a distinction between prescription drugs and over-the-counter (OTC) drugs. While both over-the-counter drugs and prescription drugs are designed to treat medical ailments, and both can be abused, prescription drugs are unique in that they can only be legally obtained with a medical prescription.
The fact that obtaining prescription drugs legally requires a doctor’s signature means that recreational drug users often need to be creative in order to obtain them. Prescription drugs can be acquired and misused in a number of ways, including:
- Obtaining them from a family member or friend who has a prescription
- Taking larger doses than medically recommended
- Taking doses more frequently than medically recommended
- Refilling the prescription without a doctor’s permission
- Abusing the drug using another route of administration (smoking, injecting, or crushing and snorting)
- “Doctor shopping” (If one doctor refuses to prescribe the drug, going to another doctor until it is prescribed)
- Buying prescription drugs online or on the street
There are thousands of prescription drugs on the market, and each one is sold under multiple brand names. However, not all prescription drugs are prone to misuse and abuse. There are many prescription drugs that do not offer a “high,” and many of them are non-addictive or simply subjectively unpleasant. However, certain categories of prescription drugs have a high potential for abuse. These psychoactive prescription drugs have widely varying effects and dangers, and each one is prescribed for a different purpose. Understanding the nature of these drugs and their risks is essential.
Prescription stimulants are drugs that increase activity in the central nervous system. Taking a prescription stimulant can increase a person’s energy, alertness, and focus. They can also suppress appetite, elevate blood pressure, and increase sex drive. Prescription stimulants are generally used as treatments for attention deficit hyperactivity disorder (ADHD), a mental health condition that causes problems with impulsivity, hyperactivity, and inattentiveness. However, prescription stimulants are often abused by people who do not suffer from this condition, especially college students who use prescription stimulants to improve their academic performance.
There are many street drugs that are classified as stimulants, such as cocaine, crack, and methamphetamine, and many prescription stimulants are no safer than these drugs. ADHD medication is often prescribed in pill form, though it is sometimes available in a skin patch or liquid formulation. It is common for people abusing these drugs to use alternative routes of administration, such as snorting or injection. Stimulant pills can be crushed and snorted, or they can be dissolved in liquid and injected; both methods make the effects more powerful and therefore more dangerous, especially when combined with other substances. Stimulants are generally grouped into three classifications: long-acting, intermediate-acting, and short acting.
Long-acting stimulants are often meant to be taken once a day or even less frequently, since many of them have effects that last for days. When taken recreationally, however, these powerful drugs are sometimes abused multiple times a day. Common long-acting stimulant prescription drugs include:
- Adderall XR
- Adzenys XR-ODT
- Metadate CD
- Focalin XR
- Quillivant XR
- Quillichew ER
- Ritalin LA
Intermediate-acting prescription stimulants require more regular dosage to work properly. Common intermediate-acting prescription stimulants include:
- Metadate ER
- Methylin ER
- Ritalin SR
Short-acting prescription stimulants are designed to provide immediate effects that wear off relatively quickly. The most common short-acting prescription stimulants are:
Opioids are drugs that are derived from the naturally growing opium poppy, though in recent years powerful synthetic opioids that are entirely lab-produced have become popular. Opioids are generally prescribed as analgesics, or painkillers, because their effect on the brain’s opioid receptors causes the suppression of pain signals. However, opioids also cause people to experience intense euphoria, and they can be extremely addictive.
Prescription opioids, especially synthetic opioids, are often stronger than opioid street drugs. Fentanyl, for instance, is many times more potent than heroin. In fact, the majority of heroin users started off by becoming addicted to prescription opioids. The United States and much of the world is currently facing an unprecedented opioid epidemic. In 2017 alone, 47,600 people died of opioid overdoses in the United States, with many more people being adversely affected without necessarily losing their lives.
It should be noted that prescription opioids are essential medications that are very effective for treating severe and chronic pain, helping people who are getting surgery or undergoing cancer treatment. However, tolerance and physical dependence builds so quickly that even people who are taking opioids for a legitimate purpose are at a high risk of addiction. Individuals who misuse or abuse their prescriptions can experience acute side effects, including life-threatening overdoses.
Commonly abused prescription opioids include:
- Diphenoxylate (Lomotil)
- Hydrocodone (Vicodin, Lorcet, Lortab)
- Oxycodone (Percocet, Percodan, OxyContin)
- Meperidine (Demerol)
- Methadone (Dolphine)
- Hydromorphone (Dilaudid)
- Propoxyphene (Darvon)
- Fentanyl (Duragesic)
- Codeine (Vopac, Tylenol with Codeine)
- Morphine (Avinza, Kadian, and MS Contin)
Tranquilizers, which include benzodiazepines, non-benzodiazepine sleep medications, and barbiturates, are a class of drugs that slows down brain activity. Sometimes known as sedatives, these drugs are central nervous system (CNS) depressants. Prescription opioids are also CNS depressants, but tranquilizers are distinct because they are generally prescribed for the specific purpose of producing calmness or drowsiness. Prescription tranquilizers and sedatives are common treatments for anxiety disorders and sleep disorders.
Benzodiazepines are often abused because they produce euphoric feelings, anecdotally similar to the experience of drinking alcohol. While they can be effective treatments for panic attacks, severe stress, and anxiety, they can quickly cause a person to develop physical dependence. In fact, the withdrawal effects that occur when a person tries to stop using benzodiazepines can be so severe that they can be life-threatening. Commonly abused benzodiazepines, or “benzos,” include:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Estazolam (ProSom)
- Triazolam (Halcion)
Many sleep medications are related to benzodiazepines on a chemical level but are not technically benzodiazepines. Non-benzodiazepine sleep medications act on the same receptors and, while they have a lower risk of physical dependence, they can still cause a wide range of harms when abused. Common non-benzodiazepine sleep medicines include:
- Zaleplon (Sonata)
- Eszopiclone (Lunesta)
- Zolpidem (Ambien)
Barbiturates are a class of tranquilizers that in recent years has become less commonly prescribed than benzodiazepines. These prescription sedatives have a very high risk of overdose. Common barbiturates include:
- Mephobarbital (Mebaral)
- Phenobarbital (Luminal Sodium)
- Pentobarbital sodium (Nembutal)
Risk Factors for Prescription Drug Abuse
There is no one single factor that causes a person to develop a substance use disorder. Research shows that most cases of substance abuse come about due to a combination of a wide range of factors. However, the two most important elements that can predispose someone to substance abuse are genetics and environmental factors. People who have a family history of substance abuse have a high likelihood of engaging in substance abuse themselves. Part of this is due to genetics, but growing up in an unstable environment also plays an important role. Trauma, mental health disorders, economic hardship, and early exposure to drugs and alcohol are all factors that make people more likely to abuse drugs later in life.
When it comes to prescription drug abuse specifically, other circumstances play an important role. The risk of developing an addiction to a prescription drug can be affected by:
- The specific drug they are taking
- Whether they are actually using it to treat a disorder or chronic pain
- Height, weight, and other personal factors
- The influence of friends, family, or peers
- Mental health
- Knowledge and education about the drug
It is important to recognize that while prescription drugs are often purchased illicitly, many people become addicted while using legitimate prescriptions to treat very real medical problems. It is common for a person who would never consider abusing drugs recreationally to begin misusing their prescription slowly. They may begin by increasing their dosage for more relief, and then they may discover that they have developed a physical dependence. To avoid withdrawal symptoms, many people end up switching to alternative routes of administration, such as snorting or injecting. Ultimately, they may end up switching to a more potent medication — or even a “street” drug, such as heroin. Many prescription drug addicts work hard to keep their addiction secret, until it is too late.
Signs and Symptoms of Prescription Drug Abuse
Most people who suffer from prescription drug addiction work hard to conceal their struggles. After all, if they confess to their doctor, there is a good chance that their prescription will not be renewed. If they tell friends or family members, loved ones will probably try to help them get treatment. This means they won’t be able to get high anymore! While “functional” drug addicts may succeed in hiding the overt signs of their substance abuse, their attempts at secrecy can be revealing clues. Furthermore, drug addictions are progressive conditions that tend to get worse over time. Eventually, even the most careful prescription drug addict eventually begins to exhibit concerning physical and behavioral changes.
While the signs of prescription drug abuse vary widely and depend on the specific drug being abused, common signs of addiction include:
- A lack of interest in activities or hobbies that used to be important
- Missing important obligations at school or work
- Neglecting relationships or reacting negatively to close friends or loved ones
- A willingness to take dangerous risks, especially in order to obtain drugs
- A change in sleeping patterns or energy levels
- Ignoring the negative consequences of their actions
- Increased secrecy and a tendency to lie
- Financial or legal problems
- A sudden change in peer group
Over time, people who are engaging in prescription drug abuse tend to experience health problems. These health problems can sometimes be ambiguous, since they can often be attributed to other causes than addiction. Someone who is not eating, for instance, may be diagnosed with an eating disorder — but the truth may be that they are addicted to prescription opioids. Someone who is getting sick constantly may be diagnosed with the flu, but they may have a compromised immune system due to prescription drug abuse. It is often helpful to look for clusters of symptoms rather than one tell-all sign.
Common health problems associated with substance abuse include:
- Constant illness
- Bloodshot or glazed eyes
- Abrupt changes in weight or eating patterns
- Unexplained injuries
- Increased tolerance to drugs
- Bad skin, teeth, hair, and nails
- Memory loss or problems with recall
- Change in speech patterns, such as slurred words or a tendency to ramble
- Physical withdrawal symptoms, like sweating, vomiting, or trembling
Prescription Drug Abuse and Mental Health Disorders
Prescription drug abuse and addiction can lead to a wide variety of cognitive and emotional changes. Mental changes that can indicate a substance use disorder include:
- Aggressive behavior
- Sudden changes in mood
- Suicidal ideation or actions
It is important to note that the relationship between prescription drug abuse and mental health disorders is very strong. The causal connection between substance use disorders and mental health conditions goes in both directions. This can make it exceedingly difficult to treat both problems.
Many people begin taking prescription drugs initially as a way to treat symptoms of a mental health disorder. Psychiatrists frequently prescribe benzodiazepines, for instance, to treat the symptoms of anxiety or panic disorders. Prescription stimulants like Adderall and Vyvanse are generally prescribed to help people manage attention deficit hyperactivity disorder (ADHD). These are only a few examples. Moreover, many people begin taking prescription medications illicitly — without a prescription — as a way of dealing with emotional distress. In many cases, they are self-medicating and suffer from undiagnosed and untreated mental health disorders. Self-medication, however, can quickly become dependence and addiction. An individual who abuses prescription drugs to treat their mental illness will usually find that they are unable to function without their drug of choice.
To make matters worse, substance abuse tends to cause people to develop further mental illness. Not only does substance abuse directly lead to emotional and cognitive problems, but the consequences of addiction in a person’s life can be profoundly destabilizing. Losing a job, isolating from loved ones, and suffering from legal, financial, and health problems can exacerbate the symptoms of pre-existing mental health conditions and lead to the development of new ones. Unfortunately, people who suffer from addiction are very likely to turn to drugs as a solution to these new problems — even though these new problems are caused by drugs!
Individuals who suffer from substance use disorders in addition to mental health disorders are known as dual diagnosis patients. It is essential for dual diagnosis individuals to get help for all of their comorbid conditions. No matter how thoroughly a person addresses their addiction, for instance, a flare-up of depression or anxiety can easily trigger a relapse. On the other hand, no matter how well a person addresses their mental health issues, continued substance abuse is likely to make the whole process futile. Mental health disorders and addictions are inextricably linked. Quality treatment programs provide a form of comprehensive care known as integrated treatment. Integrated treatment is designed to address comorbid conditions simultaneously, so that a person can enjoy lasting recovery.
Long Term Dangers of Prescription Drug Abuse
While prescription drugs are legal (as long as they are obtained using a legitimate prescription), that does not mean that they are safe. It doesn’t take long for people to develop a physical dependence on the medications they are taking, whether they are taking them legally or illicitly. In many cases, this physical dependence progresses and becomes an addiction. Once a drug addiction has developed, the condition has grown beyond mere physical dependence. Addiction is a mental health condition that causes people to obsessively crave drugs, and it makes them unable to manage or control their substance abuse. Individuals who suffer from addiction may recognize that harms that their substance abuse leads to, but they may find that they are unable to stop despite having a desire to do so. Some people do manage to stop using for short periods of time, sometimes even fully withdrawing and ending their physical dependence, but they are likely to relapse.
Prescription drug addiction causes people to prioritize their drug abuse over all other relationships and activities in their lives. As a result, many of the most important foundations of their lives can begin to crumble. As they avoid friends, family members, and loved ones, they may find themselves increasingly isolated. Unpredictable or violent behavior can further alienate loved ones and cause people to lose their social support systems. Meanwhile, completing everyday tasks can become difficult. Addiction often causes people to drop out of school and lose their jobs. Without a future to look forward to, obtaining and using drugs can become their sole preoccupation. Health problems tend to accumulate and go untreated. Lacking a job and financial assets, many turn to crimes in order to access the drugs they need. Isolated and sick, burdened by debt and legal problems, people who suffer from addiction are likely to become increasingly miserable, which often only further drives them to abuse their drug(s) of choice.
In many cases, people who start off abusing prescription drugs eventually move on to street drugs. This can happen to people who, before being addicted, would never consider abusing an illegal recreational drug. However, it often becomes a matter of practicality. Prescription opioids, for instance, are fairly expensive. They are also often difficult to obtain. When a person’s prescription runs out, they can try to buy prescription opioids online or off the street, but it is often easier and far more affordable to switch to heroin. After all, an opioid addiction is an opioid addiction. In fact, the majority of heroin users started off abusing prescription opioids.
Prescription Drug Overdoses
By far the greatest risk people face while abusing prescription drugs is the risk of an accidental overdose. Medicines that are available by prescription only are generally restricted because they are so potent, and taking a dosage that is above the medically recommended one can have life-threatening consequences. A prescription drug overdose occurs when a person takes a greater quantity of the drug than their body can tolerate. Tolerance levels can fluctuate over time, and they can dip down when a person attempts to quit abusing drugs. For this reason, it is common for people to overdose when they relapse after a period of abstinence.
The exact nature of an overdose varies considerably, depending on the specific medication involved. However, the most common type of drug overdose involves synthetic opioids. In fact, it may come as a surprise that the rate of prescription opioid overdoses has far surpassed the rate of heroin overdoses. In 2017 alone, 17,029 people in the United States died of a prescription opioid overdose. The vast majority of these overdoses occur due to the potency and the wide availability of synthetic opioids, including fentanyl. Fentanyl is 50-100 times stronger than morphine, and certain fentanyl analogs are thousands of times stronger than heroin. Even a small miscalculation in dosage can be sufficient to cause an opioid overdose. Even people who are not intentionally abusing synthetic opioids are at risk, since fentanyl is often used as an additive in other drug products, including heroin.
How do prescription opioid overdoses occur? Ultimately, opioid overdoses occur through the same mechanism that causes people to get “high.” Opioids are central nervous system depressants that slow down the body and brain’s functions. While this can result in feelings of relaxation and euphoria at lower doses, at higher doses essential life-sustaining activities can cease entirely. During an opioid overdose, respiratory depression occurs. Unless treated immediately, loss of life is almost an inevitability.
The symptoms of an opioid overdose include:
- The body goes limp
- The person’s face feels clammy to the touch and appears extremely pale
- The person starts vomiting or making gurgling noises
- Their fingernails, finger tips, or lips have a purple or blue color
- They cannot be awakened
- They are unable to speak
- Their heartbeat slows down or stops entirely
- They find it difficult to breathe or stop breathing entirely
Combining drugs, an activity known as polysubstance abuse, dramatically increases the risk of overdose. The overlapping effects of multiple CNS depressants can quickly overwhelm the body. For this reason, drinking alcohol with prescription opioids or combining opioids and prescription sedatives is often a fatal combination. However, people who take prescription stimulants alongside CNS depressants also face unique risks. Because stimulants overtax the body and depressants slow it down, the body often struggles to keep up with the demands placed on it. Combining stimulants and depressants is known as speedballing, and it is one of the most dangerous forms of drug abuse.
If you or a loved one is experiencing a prescription drug overdose, it is essential to get medical help as soon as possible. In the case of prescription opioid overdoses, it is crucial to administer naloxone even before medical professionals arrive. Naloxone, which can be administered easily even to unconscious people via a nasal spray, immediately reverses the effects of an overdose. Administering naloxone in time can save lives. However, getting medical help is still necessary.
Prescription Drug Addiction Treatment at NuView Treatment Center
Ultimately, even people who overdose and experience other terrifying consequences tend to keep abusing prescription drugs unless they get help for their addiction. It is important to recognize that substance use disorders are legitimate mental health conditions that require treatment. Dealing with a substance use disorder involves far more than just quitting drugs. As a psychological condition, addiction continues to afflict people even after they have withdrawn from drugs. They may recognize the insanity of returning to substance abuse, but without outside help most people are helpless to say no.
Unfortunately, addictions are highly stigmatized and misunderstood. Prescription drugs are often seen as harmless because they are “medicine.” Moreover, our culture often celebrates substance abuse or glamorizes the lifestyle. Even people who are struggling with the consequences of addiction are often told to just “try harder” to control their problem. Shame, stigma, and a belief that it is weak to ask for help means that only 11% of people with addictions actually seek aid of any kind. Unfortunately, self-will is rarely enough for someone who suffers from a substance use disorder. Addictive prescription drugs hijack the brain, making it impossible for a person to follow through on their desire to quit. In most cases, addictions progressively get worse, and in many cases they result in death.
NuView Treatment Center is an outpatient treatment center that helps people escape from the vicious cycle of prescription drug addiction. Our outpatient programs provide treatment for people at the pace and intensity they need, and they are flexible enough to allow people to continue to live at home, go to work, and support their families. At NuView Treatment Center, we offer a wide range of levels of care to meet the needs of patients suffering from different addiction intensities. Our programs include a partial hospitalization program (PHP), intensive outpatient program (IOP, outpatient program (OP), and aftercare planning. No matter where you are on the addiction spectrum, we are here to meet your needs.
At NuView Treatment Center, we believe that compassionate and holistic care is essential to addiction recovery. Our highly trained and personable staff work to develop individualized treatment plans for each of our clients. We recognize that everyone has a unique story, and the underlying issues behind each addiction are unique. To that end, we not only help people develop coping tools for dealing with triggers, but we help them address underlying mental health disorders, family problems, and even unemployment. Utilizing the latest evidence-based treatment modalities, NuView Treatment Center aims to help people recover from their substance use disorders. In the process, our clients rebuild their lives.
If you are tired of struggling with prescription drug addiction, contact NuView Treatment Center today.