Prescription drug addiction, the use of drugs in ways different from what your healthcare provider prescribes them, is an epidemic in the United States. According to the National Center for Drug Abuse Statistics, 16 million (6%) of Americans over the age of 12 abuse prescription drugs in a year, and 12% of them are addicted to prescription drugs.
Strikingly, across various prescription drug classes such as non-opioid pain relievers, sedatives, stimulants and Psychotherapy4 out of 5 prescriptions issued by pharmacies are for opioids, which are abused by 9.3 million people each year, 57.1% of which are from individuals with a prescription.
This article further discusses addiction, addictive prescription drugs, signs of addiction, and treatment options.
Causes and Risk Factors
Anyone can develop a substance use disorder, and it can happen at any time. However, certain conditions increase the risk of substance abuse, including:
- mental health problems
Other factors include reliance on prescription medications to manage pain, but personal circumstances also play a role in increasing the risk of substance abuse. These factors may include peer pressure, physical and sexual abuse, and early drug use. Adolescents are one of the most vulnerable groups because the parts of the brain that control judgment, decision-making and self-control are not fully developed, leading to a higher risk of substance use disorders.
When opioids and other addictive drugs are introduced, neurons in the brain that send and receive signals through their neurotransmitters are destroyed. Because of their chemical composition, certain addictive drugs activate neurons that cause abnormal messages to be sent through brain circuits and networks. An important effect of taking certain prescription drugs is the release of dopamine, a neurotransmitter that responds to pleasurable activities. But over time, individuals become more dependent on the drug in order to achieve the effects of dopamine, thereby increasing the risk of substance use disorder.
In the United States alone, 16.3 million people abuse prescription drugs each year. The breakdown was that 43.3% of first-time abusers used painkillers, compared to 32.1% of sedatives. Prescription drugs are the third most abused illicit substance after marijuana and cocaine.
Dependence on prescription drugs can be physical or psychological. While the body can develop tolerance to the drug, the dose must be increased to achieve sustained dopamine action and achieve the desired results.
Overreliance on prescription drugs can lead to substance use disorder. Signs of abuse can lead to problems at home, school, and work, leading to feelings of isolation, helplessness, and shame.
Signs may include changes in appetite, sleep patterns, weight loss, bloodshot eyes, smaller or larger than normal pupils, abnormal body odor, little interest in appearance, and lack of motor coordination.
Behavioral signs include covert behavior, excessive absences or absenteeism, and dramatic changes in friends and social activities.
Psychological signs include mood swings, irritability, anxiety, fear, unprovoked paranoia, and significant changes in personality and attitude.
The most commonly abused prescription drugs are divided into sedatives, opioids and morphine derivatives, stimulants, and other compounds in cold and cough medicines.
Suppressants are primarily known as substances that help you sleep, relieve anxiety and muscle spasms, and help prevent seizures. Health risks include lower blood pressure, slower breathing, increased risk of respiratory distress, and death when combined with alcohol. In this category, there are three types:
- Barbiturates It can be taken orally or injected. Side effects specific to barbiturates include euphoria or abnormal excitement, fever, irritability, and life-threatening withdrawal. Commercial names include Amytal, Nembutal, Secondal and Phenobarbital.
- Benzodiazepines Oral, including Ativan, Halcion, Librium, Valium, Xanax, and Klonopin.
- Sleep medications were swallowed, including Ambien, Sonata and Lunesta.
Opioids and Morphine Derivatives
Opioids come in many forms, including tablets, capsules, skin patches, powders, liquids, suppositories, and lollies. They can be injected, swallowed, sniffed or smoked. Physical effects include: pain relief, euphoria, drowsiness, sedation, weakness, dizziness, nausea, coordination disturbance, confusion, dry mouth, itching, sweating, clammy skin, constipation, slowed or stopped breathing, pulse and blood pressure Depression, unconsciousness, coma, and death. Increased risk of death when co-administered with alcohol or other central nervous system depressants.
Types of opioids include:
- Codeine can be swallowed or injected.The National Institute on Drug Abuse states that codeine contains less Pain relief, sedative and respiratory depression better than morphine. Commercial 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. If used improperly, the risk of overdose is high. Trade names: Methadox and Doprofen.
- Fentanyl can be injected, snorted, or snorted. Fentanyl is 80-100 times more potent than morphine. Commercial names: Actiq, Duragesic and Sublimaze.
- Other opioid pain relievers include oxycodone hydrochloride (a muscle relaxant that is twice as potent as morphine and has a high abuse potential), hydrocodone tartrate, hydromorphone, Oxymorphonepethidine and propoxyphene.
Prescription stimulants are drugs commonly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. They increase alertness, concentration and energy. Side effects include: euphoria, increased energy, mental alertness, increased heart rate, blood pressure and metabolism, decreased appetite, weight loss, nervousness, insomnia, seizures, heart attack, and stroke.
Types of stimulants include:
- Amphetamines It can be injected, swallowed, snorted or snorted. Commercial names: Biphetamine, Dexedrine and Adderall. Side effects include: shortness of breath, tremors, loss of coordination, irritability, anxiety, restlessness/delirium, panic, paranoia, hallucinations, impulsive behavior, and aggression.
- methylphenidate It can be injected, swallowed or snorted. Commercial name: Ritalin and Concerto. Side effects include: increased or decreased blood pressure, gastrointestinal problems, loss of appetite, and weight loss.
- Other compounds, often found in cold and cough medicines, come in the form of tablets, capsules or syrups.The most common compounds are DextromethorphanSide effects include: euphoria, slurred speech, increased heart rate and blood pressure, dizziness, nausea, vomiting, confusion, paranoia, distorted visual perception and impaired motor function.
For effective and successful treatment, several elements need to be combined, including detoxification, counseling, and medication. In many cases, patients may require multiple sessions to fully recover.
The two main categories of treatment are:
- Behavioral therapy, such as cognitive behavioral therapy (CBT), involves changing unhealthy thinking and behavioral patterns. Individuals will learn strategies for managing cravings, avoiding cues, and situations that lead to relapse; or, in some cases, providing motivation to abstain. CBT may include individual, family or group counseling.
- medical treatement. Prescription opioid addiction can be treated with buprenorphine, methadone, and naltrexone, which can prevent other opioids from affecting the brain (naltrexone) or relieve withdrawal symptoms and cravings (buprenorphine and methadone), and help Patients avoid recurrence. These medications are combined with psychosocial support or behavioral therapy, called medication-assisted therapy (MAT). Medications to relieve withdrawal symptoms (lofexidine) are also available.
When to see a healthcare provider
The first step in recovery is recognizing that you have a substance use disorder. Then, seek help as soon as possible by seeking treatment from your healthcare provider and/or a therapist referral or any other counseling services dealing with substance abuse.
If your loved one has a prescription drug addiction, don’t ignore it. Get their help now. There are many treatment options available to help and guide. But remember, treatment is not a quick fix, but a long process that takes time to overcome.
Prescription drug addiction is a chronic disease that has adverse effects on individuals, family members and friends. The most commonly abused prescription drugs include sedatives, opioids and morphine derivatives, stimulants, and cold and cough medicines. Symptoms of substance use disorder include physical, behavioral, and psychological changes. If you have a substance use disorder or a loved one shows signs of addiction, get help right away. Talk to your healthcare provider for a referral to a therapist who specializes in substance use disorders.