Medical information on Prescription Drug Addiction

Busting the myths about prescription drugs:

Nearly three out of ten teens (29% or 6.8 billion) believe prescription pain relievers even if not prescribed by a doctor are not addictive.

One-third of teens (31% or 7.3 million) believe there’s “nothing wrong” with using prescription medicines without a prescription once in a while.

When teens abuse prescription drugs, they often characterize their use of the drugs as “responsible, controlled or safe,” with the perception that the drugs are safer than street drugs.

The 11 Most Abused Prescription Drugs in America:

OxyContin
Lortab
Darvon
Vicodin
Dilaudid
Demerol
Valium
Xanax
Nembutal
Adderall
Ritalin

What can you do to prevent prescription drug abuse?

Know your drugs. Talk to your doctor and pharmacist about what you are taking. Read the inserts that come with your drugs.

Control your drugs. Know how many you have, where they are, and who has access to them. You may need to lock them up to prevent abuse by anyone who may have access.

Properly dispose of unused and out of date drugs.

Prescription medications such as pain relievers, central nervous system (CNS) depressants (tranquilizers and sedatives), and stimulants are highly beneficial treatments for a variety of health conditions. Pain relievers enable individuals with chronic pain to lead productive lives; tranquilizers can reduce anxiety and help patients with sleep disorders; and stimulants help people with attention-deficit hyperactivity disorder (ADHD) focus their attention. Most people who take prescription medications use them responsibly. But when abused—that is, taken by someone other than the patient for whom the medication was prescribed, or taken in a manner or dosage other than what was prescribed—prescription medications can produce serious adverse health effects, including addiction.

Patients, health care professionals, and pharmacists all have roles in preventing the abuse of and addiction to prescription medications. For example, patients should follow the directions for use carefully; learn what effects and side effects the medication could have; and inform their doctor/pharmacist whether they are taking other medications [including over-the-counter (OTC) medications or health supplements], since these could potentially interact with the prescribed medication. The patient should read all information provided by the pharmacist. Physicians and other health care providers should screen for past or current substance abuse in the patient during routine examination, including asking questions about what other medications the patient is taking and why. Providers should note any rapid increases in the amount of a medication needed or frequent requests for refills before the quantity prescribed should have been finished, as these may be indicators of abuse.

Similarly, some OTC medications, such as cough and cold medicines containing dextromethorphan, have beneficial effects when taken as recommended; but they can also be abused and lead to serious adverse health consequences. Parents should be aware of the potential for abuse of these medications, especially when consumed in large quantities, which should signal concern and the possible need for intervention.

The abuse of certain prescription drugs-opioids, central nervous system depressants, and stimulants can alter the brain's activity and lead to addiction. While we do not yet understand all of the reasons for the increasing abuse of prescription drugs, we do know that accessibility is likely a contributing factor. In addition to the increasing number of medicines being prescribed for a variety of health problems, some medications can be obtained easily from online pharmacies. Most of these are legitimate businesses that provide an important service; however, some online pharmacies dispense medications without a prescription and without appropriate identity verification, allowing minors to order the medications easily over the Internet.

Commonly Abused Prescription Medications

Although many prescription medications can be abused, the following three classes are most commonly abused:

Opioids—usually prescribed to treat pain.
CNS depressants—used to treat anxiety and sleep disorders.
Stimulants—prescribed to treat ADHD and narcolepsy.

Drug Dependence

Drug addiction, or dependence, is the compulsive use of a substance, despite its negative or dangerous effects.

However, a physical dependence on a substance (needing the drug to function) is not always part of the definition of addiction. Some drugs (for example, certain blood pressure medications) do not cause addiction but they can cause physical dependence. Other drugs cause addiction without leading to physical dependence. Cocaine is an example.

Tolerance to a drug (needing a higher dose to attain the same effect) is usually part of addiction.

Drug Abuse

Drug abuse is the use of illegal drugs, or the misuse of prescription or over-the-counter drugs.

Causes of Drug Abuse

Drug abuse can lead to drug dependence or addiction. People who use drugs for pain relief may become dependent, although this is rare in those who don't have a history of addiction.

The exact cause of drug abuse and dependence is not known. However, a person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors.

Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have depression, attention deficit disorder, post-traumatic stress disorder, or another mental health problem.

Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons.

Commonly abused substances include:

Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and feelings of euphoria. These include heroin, opium, codeine, meperidine (Demerol), hydromorphone (Dilaudid), and oxycodone (Oxycontin).
Central nervous system stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). Caffeine and nicotine are the most commonly used stimulants. These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance).
Central nervous system depressants include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepine (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a sedative and anxiety-reducing effect, which can lead to dependence.
Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "angel dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence.
Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish. Although used for their relaxing properties, THC-derived drugs can also lead to paranoia and anxiety.