Prescription Drug Addiction and Abuse
Prescription medications are used to treat a variety of physical and mental health conditions, either for a short period of time, or on an ongoing basis, however, this can sometimes lead to potential prescription drug addiction and abuse.
Patients can only access these medications legally with a written prescription from a licensed physician or doctor.
The popularity of prescription drugs has been growing steadily; between 1997 and 2016, the number of prescriptions written for adults and children in America increased 85 percent, from 2.4 billion to 4.5 billion. According to a Consumer Reports survey, 55 percent of Americans regularly take prescription medications; many are taking multiple prescription drugs at any given time.
For many people, prescription medications are beneficial and even life-saving. They can help people recover from short-term illnesses and injuries, or treat chronic conditions so that people can function and continue to live healthy, productive lives.
However, prescription medications are still drugs that affect the brain’s chemistry; as such there is the potential for abuse and addiction, even when medications are prescribed by a doctor. In this article, we will look at the three most commonly abused groups of prescription medications – stimulants, opioids, and depressants – as well as how to recognize the signs of abuse, and seek treatment.
What Are Prescription Drugs?
There are two types of drugs common in the prevention, treatment, or cure of diseases and medical conditions – prescription drugs and over-the-counter (OTC) drugs. Over-the-counter drugs can be purchased off the shelf in pharmacies, grocery stores, convenience stores, without a doctor’s prescription. They are regulated by the Food and Drug Administration (FDA), but not as closely as prescription drugs, as they are not as powerful and don’t have the same potential for abuse as prescription drugs.
In order to purchase a prescription drug, you need a prescription from a licensed doctor or physician. You can only legally get prescription drugs through a pharmacy, and the prescription is only intended for the person for whom it was written, and the drugs should be taken only in the recommended dosage and for the recommended time period.
There are two types of prescription drugs – name-brand and generic. Generic drugs are designed to work exactly the same as their name-brand counterparts, just for a lower cost. When a doctor writes a prescription, they will usually indicate if it is acceptable for the patient to take the generic brand, if one exists.
Medications work in a variety of ways, and fall into several different categories, typically based on the system or disorder they treat. The three most commonly abused types of prescription drugs – stimulants, opioids, and depressants – all significantly impact the brain’s chemistry, specifically those areas of the brain controlling reward, pleasure, and satisfaction.
Prescription stimulants are designed to increase energy and alertness, and are a common treatment for psychological or sleep disorders like Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy. They typically come in pill form, although there are some stimulants that can be taken as a skin patch or in liquid form.
One of the key differences among stimulants is how long they last. Stimulants are divided into short-acting, intermediate-acting, and long-acting classification. Common short-acting stimulants include:
Intermediate-acting stimulant drugs will last longer, but still need to be taken at regular intervals to be effective. Some common intermediate-acting stimulants are:
- Ritalin SR
- Methylin ER
- Metadate ER
Long-acting stimulants are effective for hours or even days, so they do not need to be taken in regular doses.
Common long-acting stimulants include:
- Adderall XR
- Metadate CD
- Focalin XR
- Adzenys XR-ODT
- Ritalin LA
- Quillivant XR
Opioids are synthetically created drugs that mimic the effects of naturally-occurring opiates derived from the opium poppy plant. They provide pain relief and sedation be working on the brain’s pain receptors, and are commonly prescribed to individuals with moderate to severe pain following surgical procedures or injuries.
Because opioids are very addictive, they are generally not considered for long-term use. The usually come in pill form, but some can be administered through transdermal patches.
Some common opioids include:
- Morphine (Brand names: Avinza, Kadian, MS Contin)
- Oxycodone (Oxycontin, Percocet, Percodan)
- Hydrocodone (Lorcet, Vicodin, Lortab)
- Fentanyl (Duragesic)
- Methadone (Dolphine)
- Diphenoxylate (Lomotil)
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
Depressants, also called sedatives or tranquilizers, are essentially the opposite of stimulants. They inhibit the function of the central nervous system, leading to feelings of relaxation, calmness, drowsiness, and pain relief. These drugs are commonly prescribed to individuals suffering from anxiety or sleep disorders, although because they are habit-forming, they may not be a good option for treating long-term or chronic conditions. Depressants usually come in pill form, and are categorized as short-acting or long-acting.
Depressants usually fall into one of three categories:
- Benzodiazepines, such as
- Diazepam (Valium)
- Estazolam (ProSom)
- Triazolam (Halcion)
- Non-benzodiazepine sleep medications
- Zolpidem (Ambien)
- Eszopiclone (Lunesta)
- Zalepon (Sonata)
- Barbiturates, such as
Phenobarbital (Luminal Sodium)
- Pentobarnital sodium (Nembutal)
- Mephobarbital (Mebaral)
Causes of Prescription Drug Abuse and Addiction
Depressants, stimulants, and opioids are commonly abused because they affect the brain’s chemistry. These changes to brain function may be beneficial – for example, benzodiazepines can produce feelings of calm and relaxation that help those suffering from anxiety function normally.
However, when taken long-term, in higher doses than prescribed, or recreationally by individuals who do not have a treatable disorder, they can alter the brain so that it cannot function without the drugs.
Opioids bind to receptors in the brain, and trigger the release of endorphins. This blocks pain, which is why opioids are often used for severe pain relief. It also creates a rush of pleasure and satisfaction.
Over time, the brain will stop producing its own endorphins, creating a dependence on opioids to create pleasure feelings. The brain also quickly develops a tolerance to opioids, so increasingly stronger doses are needed to create the same effect.
Once the brain starts relying on the endorphin rush produced by opioids, an individual can experience physical and mental withdrawal symptoms if they stop taking opioids. At this point, an individual may continue taking opioids even though they no longer need them for pain relief, or will turn to illegal opiates like heroin to continue their addiction.
Depressants affect the brain by stimulating gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits the excitability of neurons and produces a calming effect. As with opioids, individuals taking depressants can become dependent on the drugs to produce happy, calming feelings. They will also develop a tolerance, and require more of the drug to produce similar effects.
Stimulants increase energy, alertness, and attention, which is why they are a popular treatment for individuals coping with attention and sleep disorders. They also trigger the release of the brain chemicals dopamine and norepinephrine, which are related to pleasure and rewards. Individuals abusing stimulants will come to rely on the drugs to help them focus, give them energy, and trigger pleasurable feelings. If prescription stimulants are no longer available, they may turn to illegal stimulants like cocaine or methamphetamine.
There are some factors that can increase the likelihood of developing a prescription drug addiction, such as personal history, the nature of the disorder or issue being treated, and co-occuring disorders. Additionally, individuals who begin taking prescription medications without a doctor’s supervision may be more prone to abuse and addiction. To lower the risk of abuse and addiction, only take prescription medications as advised by a doctor or physician, in the appropriate dosage and only for the length of time prescribed.