Prevention of Prescription Drug Abuse

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What is Drug Abuse

-Compulsive, excessive, and self-damaging use of habit forming drugs or substances, leading to addiction or dependence, serious physiological injury (such as damage to kidneys, liver, heart) and/or psychological harm (such as dysfunctional behavior patterns, hallucinations, memory loss), or death. Also called substance abuse.

A prescription drug (also prescription medication or prescription medicine) is a licensed medicine that is regulated by legislation to require a medical prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs that can be obtained without a prescription. Different jurisdictions have different definitions of what constitutes a prescription drug.

Is Anyone Who Uses Drugs at Risk for Addiction? How Can I Protect Myself?

Not all drugs have the potential for abuse and addiction—many drugs don’t even act in the brain. For example, antibiotics, which are used to treat infections, are not addictive.

You should read the label on drugs and any information that comes with the prescription. This will include the doctor’s instructions for how much to take and how often, as well as warnings about possible side effects. Read the label and learn whether you should take the medication with or without food, whether it will make you drowsy, and whether you can take it with other medicines. You can protect yourself by taking drugs only according to these instructions. That includes the dosage and duration prescribed. If you have a question about a drug that has been prescribed for you, call your doctor or pharmacist.

If the drug is creating problems for you (e.g., if you experience unpleasant side effects or think you may be becoming addicted), consult your doctor immediately to see if a change is needed, or if the medication should be stopped altogether. But do not make these decisions on your own—there can be risks to changing dosage or stopping a medication abruptly.

Taking prescription drugs not prescribed for you by a doctor or in a way that hasn’t been recommended by a doctor, can be more dangerous than you think. In fact, it can be fatal.

Prescription drugs are the third most commonly abused category of drugs, behind alcohol and marijuana and ahead of cocaine, heroin, and methamphetamine. Some prescription drugs can become addictive, especially when used in a manner inconsistent with their labeling by someone other than the patient for whom they were prescribed, or when taken in a manner or dosage other than prescribed. Overall, an estimated 48 million people have abused prescription drugs, representing nearly 20% of the U.S. population.

The drug medications that are most commonly abused include:
  • Pain relievers
  • Tranquilizers and sedatives
  • Stimulants
1 What are prescription pain relievers?

Prescription pain relievers include the opioid class of drugs, such as hydrocodone (i.e., Vicodin), oxycodone (i.e., OxyContin), morphine, fentanyl and codeine. Opioids work by mimicking the body’s natural pain-relieving chemicals, attaching to receptors in the brain to block the perception of pain. Opioids can produce drowsiness, nausea, constipation, and slow breathing. Opioids also can induce euphoria by affecting the brain regions that mediate what we perceive as pleasure.

Dangers when abused:

  • Highly addictive
  • Can slow one’s breathing to dangerous levels, including accidental overdose
  • Particularly dangerous when used in combination with alcohol
2  What are tranquilizers and sedatives?

Tranquilizers and sedatives are central nervous system depressants, such as Xanax, Valium, and Librium, which are often prescribed to treat anxiety, panic attacks and sleep disorders. Central nervous system depressants, known as barbiturates and benzodiazepines, slow normal brain function to produce a drowsy or calming effect.

Dangers when abused:

  • Can slow breathing and heartbeat, especially if combined with other prescriptions, alcohol, or over-the-counter (OTC) cold and allergy medications
  • Can lead to withdrawal and seizures when discontinued after prolonged use
3  What are stimulants?

Stimulants such as Ritalin, Adderall and Dexedrine increase alertness, attention and energy and are often prescribed for health conditions such as attention-deficit/hyperactivity disorder, narcolepsy and depression. Stimulants enhance the effects of norepinephrine and dopamine in the brain, increase blood pressure and heart rate, constrict blood vessels, and open up the pathways of the respiratory system. They can also produce a sense of euphoria.

(Others are: Bittercola, Kola, caffein)

Dangers when abused:

  • Addictive
  • Can create extremely high body temperature
  • Can cause seizures/irregular heartbeat

How Are Prescription Drugs Abused?

It depends—some people take other people’s medications for their intended purposes (e.g., to relieve pain, to stay awake, or to fall asleep). Others take prescription medications to get high, often at larger doses than prescribed, or by a different route of administration, such as by breaking or crushing a pill or capsule and then snorting the ingredients.

Why People of all ages abuse prescription drugs

  • To feel good or get high
  • To relax or relieve tension (painkillers and tranquilizers)
  • To reduce appetite (stimulants)
  • To experiment
  • To be accepted by peers (peer pressure) or to be social
  • To be safe — it’s a false belief that prescription drugs are safer than street drugs
  • To be legal — it’s a mistaken thought that taking prescription drugs without a prescription is legal
  • To feed an addiction

Aren’t Prescription Drugs Safer Than Illegal Drugs, Such as Cocaine or Heroin?

No. Many people think that abusing prescription drugs is safer than abusing illicit drugs like cocaine and heroin because the manufacturing of prescription drugs is regulated or because they are prescribed by doctors. These circumstances don’t mean these drugs are safe for someone who was not prescribed for or when taken in ways other than as prescribed.

Like illicit drugs, prescription drugs can have powerful effects in the brain and body. Opioid painkillers act on the same sites in the brain as heroin; prescription stimulants have effects in common with cocaine. And people sometimes take the medications in ways that can be very dangerous in both the short and long term (e.g., crushing pills and snorting or injecting the contents). Also, abusing prescription drugs is illegal—and that includes sharing prescriptions with friends.

prescription drugs

What Is Wrong With Abusing Prescription Drugs?

Virtually every medication presents some risk of undesirable side effects, sometimes even serious ones. Doctors consider the potential benefits and risks to each patient before prescribing medications. They understand that drugs affect the body in many ways and take into account things like the patient’s age, weight, and medical history; the drug’s form, dose, and possible side effects; and the potential for addiction. People who abuse drugs might not understand how these factors interact and put them at risk, or that prescription drugs do more than cause a high, help them stay awake, help them relax, or relieve pain.

  • Personal data. Before prescribing a medication, doctors take into account a person’s weight, how long they’ve been prescribed the medication, and what other medications they are taking. Someone abusing prescription drugs may overload their system or make themselves vulnerable to dangerous drug interactions that can cause seizures, coma, or even death.
  • Form and dose. Doctors know how long it takes for a pill or capsule to dissolve in the stomach, release drugs to the bloodstream, and reach the brain. When abused, prescription drugs may be taken in inappropriate doses or by routes of administration that change the way the drugs act in the body and brain, presenting overdose risk. For example, when people who abuse OxyContin crush and inhale the pills, a 12-hour dose hits their central nervous system all at once—which increases the risk of addiction and overdose.
  • Side effects. Prescription drugs are designed to treat a particular illness or condition, but they often have other effects on the body, some of which can be dangerous. These are referred to as side effects. For example, OxyContin stops pain, but it also causes constipation and drowsiness. Stimulants such as Adderall increase attention but also raise blood pressure and heart rate. These side effects can be worse when prescription drugs are not taken as prescribed or are abused in combination with other substances—including alcohol, other prescription drugs, and even over-the-counter drugs, such as cold medicines. For instance, some people mix alcohol and benzodiazepines (e.g., Valium), both of which can slow breathing. This combination could stop breathing altogether.
  • Studies show that when people take a medication as it is prescribed for a medical condition—such as pain or attention deficit hyperactivity disorder (ADHD)—they usually do not become addicted, because the medication is prescribed in dosages and forms that are considered safe for that person. The person is also monitored by a physician. The drug addresses a real problem, which makes the person feel better, not high. But medications that affect the brain can change the way it functions—especially when they are taken repeatedly or in large doses. They can alter the reward system, making it harder for a person to feel good without the drug and possibly leading to intense cravings, which make it hard to stop using. This is no different from what can happen when someone takes illicit drugs—addiction is a real possibility.

Alarming Trends in Prescription Drug Use:

Although prescription drug abuse affects many people, some concerning trends can be seen among older adults, adolescents and women.

Seniors and Elderly: Seniors and the elderly are at significant risk for prescription drug abuse in which they intentionally or unintentionally take too much medication or medications that are not medically necessary. In addition, a large percentage of older adults also use over-the-counter (OTC) medicines and dietary supplements, sometimes in combination with alcohol, increasing the potential for negative drug interactions and cognitive impairment.

Adolescents/Teens: The non-medical use of prescription drugs has been rising steadily for adolescents, particularly in the area of prescription pain relievers, anti-anxiety medications, stimulants and steroids. With a greater number of prescriptions being written, such drugs are more widely available (including parents’ prescriptions) and abusers may mistakenly believe that such drugs, because they come from a doctor, are safer to take than street drugs. The possible combination with alcohol significantly increases the risk of accidental overdose.

Young Women: Overall, men and women have roughly similar rates of prescription drug abuse, though an exception is found among 12- to 17-year-olds. In this age group, young women are more likely than men to misuse psychotherapeutic (treatment of mental disorders by psychological methods)  drugs. In addition, research has shown that women are at increased risk for non-medical use of painkillers and tranquilizers.

Recognizing prescription drug abuse, symptoms include:

  • General Signs – misses deadlines, appointments, makes frequent mistakes, fails to follow instructions, mood fluctuations, loss of personal esteem
  • Absenteeism – frequent sick leave, late for work, illness with no medical certificate
  • On the Job absenteeism – frequent trips to the lavatory, poor time keeping, Poor decision-making
  • Prone to incidents – repeated incidents on the job and violations of safe working practices
  • Confusion and poor concentration – difficulty in understanding and recalling instructions, details
  • Problems with other employees – over-reaction to criticism, expresses unreasonable resentment and rebellion against authority
  • Personal appearance – sloppy, untidy, unsteady walk, glazed and red eyes, weight loss or gain, withdrawn.
  • Stealing borrowing, forging or selling prescriptions
  • Excessive mood swings
  • Increase or decrease in sleep
  • Appearing to be high, unusually energetic or revved up, or sedated
Treatment and Recovery From Prescription Drug Addiction:

Addiction to any drug (illicit or prescribed) is a disease that, like other chronic diseases, can be treated. In fact, millions of people are living in long-term recovery. No single type of treatment is appropriate for all individuals addicted to prescription drugs. Treatment must take into account the type of drug used and the needs of the individual and may need to incorporate several components, including detoxification, counseling, and, in some cases, the use of pharmacological therapies as well as mutual aid/self help and recovery support.

What You Can Do

  1. Safeguard Your Medicine. Keep prescription medicine in a secure place, count and monitor the number of pills you have and lock up your medicine.
  2. Dispose Properly of Your Unused Medicine. Learn how to safely dispose of medicine at home — and find a medicine take-back site near you.
  3. Educate Yourself. Find helpful resources for Parents & Grandparents, Health Care Providers, Communities & Law Enforcement officials and Educators.
  4. Share What You Know. If you’re a parent, share information with family, friends and neighbors. If you’re a doctor or other health care provider, share educational materials with your patients. If you’re a community leader or law enforcement official, share information with the people in your community. If you’re a teacher, school nurse or administrator, share information with the parents and students in your school.
  5. Get Help. If you think your child or colleague has a problem with prescription drugs or over-the counter cough medicine, please seek urgent help.
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