Prescription drug abuse is one of the most significant health problems in the United States. According to data from the National Survey on Drug Use and Health, an estimated 54 million people have used a prescription medication for reasons outside of medical requirements at least once in their lifetime, and an estimated 2.1 million used these types of drugs within the last year.
What is Prescription Drug Abuse
Prescription drug abuse occurs when someone takes a medication in a manner unrelated to medical requirements, usually outside the limits of dosage levels and for recreational purposes. This kind of abuse often occurs as a result of having excess medication leftover from treatment for an injury, or from merely developing an addiction to the euphoric high associated with these drugs. Borrowed medication from a friend or relative is a significant gateway for many prescription drug abusers.
The most commonly abused types of prescription drugs are:
- Opioids - A painkilling medication that includes codeine, oxycodone, hydromorphone, fentanyl, and methadone to name a few. Typically prescribed for chronic pain from a disease or traumatic injury.
- Central Nervous System Depressants - CNS, these depressants include tranquilizers, sedatives, and hypnotics that are typically used to treat anxiety and sleep disorders. Common drugs include barbiturates and benzodiazepines such as Xanax and Librium.
- Stimulants - Drugs typically prescribed to treat attention deficit hyperactivity disorder (ADHD) and that create euphoric highs. Common stimulant prescriptions that are abused include Adderall, Ritalin, and Vyvanse.
Prescription drug abuse is a dangerous habit that has increased dramatically in the last two decades. This is partly due to an overall increase in the number of diagnoses and prescription rates for these types of drugs but is also due to misleading perceptions about the danger of these drugs. The most vulnerable populations for this type of drug abuse are youth, seniors, and women.
Why is Prescription Drug Abuse so Dangerous
Prescription drug abuse begins under the auspices of medical treatment, so many users of these drugs typically start out believing they are not as dangerous as street drugs. Addiction can develop without the user even realizing they are becoming hooked on an addictive substance. Prescription drug abuse can have serious medical consequences, as evidenced by the increase in emergency room visits and overdoses associated with this type of drug. According to the National Survey on Drug Use and Health, among those who reported non-medical use of prescription medication in the last year, nearly 12% qualified for the classification of addiction. The most dangerous of these drug types, opioids, have seen a quadruple increase in overdose deaths since 1999.
Prescription Drug Abuse for Youths
Among adults aged 18 to 25 in the U.S., nearly 5% of respondents reported misusing a prescription medication in the last year. This number is higher than every other age demographic surveyed. For youth aged 12 to 17, the number shrunk to 1.6%. The National Institute on Drug Abuse Monitoring the Future Survey, found that after tobacco, alcohol, and marijuana, prescription drugs are the most common type of recreational substance used.
According to the survey, abuse of opioid painkillers and central nervous depressants has decreased slightly in recent years, but stimulant usage has increased. This could be due to a lack of public knowledge surrounding the addictive properties of stimulant medications as opposed to the national media coverage surrounding the opioid crisis. Many survey respondents also reported that they received these drugs from a friend or relative.
Prescription Drug Abuse for Older Adults
As age increases, the likelihood of taking a prescription medication increases. For example, more than 80% of older adults aged 56 to 86 years use at least one prescription medication daily, and more than 50% take multiple medications daily. Because of the high rates of comorbid chronic illnesses among seniors, as well as the health risks associated with prescription drug abuse, the senior population is especially vulnerable to the dangers of these drugs. Seniors should take care to limit their consumption of prescription drug medications to those given by their primary caregiver. Likewise, they should also store and lock their medicines in locations where they cannot be diverted. A small portion of prescription drug abusers acquires their supply by stealing from the medicine cabinet of older adults.
Prescription Drug Abuse for Women
Women are another susceptible population to prescription drug abuse. Overall, more men than women abuse prescription drugs, but adolescent females have higher usage rates for all forms of prescription medications including painkillers, sedatives, and stimulants. This age group is also more likely to meet the criteria for substance use disorders. The rate of overdose for women from opioids has also increased faster than the overdose rate for men.
How Dangerous is Prescription Drug Abuse
DAWN, the Drug Abuse Warning Network, reported in 2011 that more than 1.2 million emergency room visits that year were related to recreational use of prescription medication, comprising roughly 50% of all emergency room visits for the year. The most common drug opioids were involved in nearly 40% of those visits. This number represents a tripling rate between 2005 to 2011. Emergency room visits for central nervous system depressants also quadrupled during this period. The most common depressants involved in 85% of cases were benzodiazepines such as Xanax, Librium, and zolpidem, a prescription sleep aid.
Besides the false sense of safety and the relative ease of acquiring prescription medication, these types of drugs are also highly dangerous when combined with other substances. Many prescription drug users are aware that they should not mix medications with other materials, but they may not know the specific restrictions. Risk factors for certain combinations are also much higher for some patients than others. Even combining prescription medication with over the counter medicine or tobacco and alcohol can create dangerous side effects. Mixing any central nervous system depressants can be fatal because the effects are only multiplied when taken together. For example, mixing opioids with alcohol could cause respiratory depression, while mixing stimulants and over the counter, cold medicine can cause blood pressure to spike or lead to irregular heart rhythm.
Opioid medication is prescribed to help patients deal with the physical pain of a traumatic injury or chronic illness. Ironically, however, these drugs can wind causing even worse pain in the long term because of their chemically addictive properties. Common prescription opioid medications include:
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin, Percocet)
- Oxymorphone (Opana)
- Morphine (Kadian, Avfinza)
Hydrocodone is one of the most commonly prescribed medications in the U.S. It is used for a variety of purposes such as for dental and injury-related pain. Oxycodone and oxymorphone are also widely prescribed for moderate to severe pain relief. Morphine is used in surgery, while codeine and diphenoxylate are used to relieve a cough or severe diarrhea.
If opioids are taken as prescribed by a physician, they can be useful tools to manage pain safely. However, this does not eliminate the possibility of developing a debilitating addiction. It also does not entirely prevent the possibility of taking too large a dosage of the medication and risking severe respiratory depression. Using opioid medication daily for longer than a week can lead to withdrawal symptoms and risk of addiction if stopped. Tolerance grows quickly to opioid drugs. Opioid withdrawal can occur within hours of the last dosage depending on the addict’s situation. The first signs are usually watery eyes, runny nose, yawning, and sweating. Restlessness and irritability accompany these, along with a loss of appetite. As withdrawal peaks, the user suffers from diarrhea, shivering, sweating, cramps, muscle cramps, and increased sensitivity to light and pain. Insomnia and general malaise are also frequent. The symptoms have been described as similar to the flu, and these physical symptoms can last for a few days to a week. Beyond the painful withdrawal symptoms associated with opioid abuse, there is also the risk of getting hooked on heroin. Misuse of prescription opioids is a significant risk factor for transitioning to heroin.
Health care providers are struggling with the correct way to handle opioid prescriptions. On the one hand, they are the most effective means we have of temporarily eliminating physical pain, and the majority of patients who use the medication do not develop addictive habits. Research has proven inconclusive on precisely what rate of the population will develop an addiction to prescription opioid medicines. Numbers range anywhere from 3% to 26%, with differences in study sizes, demographics, and study durations accounting for a wide range of results.
To safely prescribe opioids, doctors will need to assess pain and evaluate their patient’s risk of developing an addiction before prescribing opioids. One way to mitigate the risk of addiction is to follow the CDC Guidelines for Prescribing Opioids for Chronic Pain. This outline gives clinicians clear rules to follow to administer these drugs appropriately. Doctors should also prescribe the lowest effective dose for the shortest duration necessary. Patients will also need routine monitoring to ensure they are not feeling dependent on the medication.
Prescription Central Nervous System Depressants
Central nervous system depressants are a category of drugs that help relieve anxiety, reduce stress, and slow brain activity. They are especially useful for treating mood related disorders and insomnia. However, much like opioids, they carry the risk of only exacerbating these maladies in the long run. The most common types of CNS depressants include:
Benzodiazepines - Benzodiazepines, or benzos, are part of the drug family falling under sedatives. All benzos are considered Schedule II-IV drugs by the DEA. Benzos produce similar calming and sedative effects to opioids but hold significantly less risk for overdose solely by themselves. However, when combined with opioids, both become substantially more lethal. Instead of targeting the opioid receptors, Benzos target the GABA receptor molecules, which are primarily concerned with cognitive processes outside of life functions. So instead of potentially shutting down your lungs (like with opioids), you run the risk of mental drowsiness, amnesia, and problems with learning and motor control. Common drugs include Xanax, Klonopin, Rohypnol (Roofies), Valium, and Librium
Barbiturates - Barbiturates are similar to benzos in that they reduce heart rate, breathing, and blood pressure by targeting the same GABA receptors. Barbiturates have been around for longer than most current opioid and benzo medications. Common barbiturates include Mebaral, Luminal, and Nembutal.
Central nervous system depressants are dangerous because they inhibit a person’s ability to make safe decisions and physical function. The longer a person uses these drugs, the more dosage is needed to achieve the therapeutic qualities they were initially taken for. Overdose for these types of drugs is possible, though not as likely as opioids. Withdrawal can be an intensely painful process.
Stimulant drugs are used for a variety of medical and recreational purposes. Medically, stimulants are used to treat ADHD and are intended to raise alertness and attention, as well as increase blood pressure, heart rate, and breathing. Recreationally, stimulants are taken to achieve high alertness, energy, and a pleasurable sense of well being. When injected or smoked, stimulants can produce intense feelings of euphoria. Stimulants come in a variety of forms, including amphetamines, cocaine, methamphetamines, pseudoephedrine, and more. The most common individual forms of prescription stimulants are amphetamine (Adderall, Dexedrine) and methylphenidate (Ritalin).
Stimulants are one of the more commonly prescribed medications for young adults and adolescents. For this reason, it is also one of the most highly abused in this age demographic. Stimulants promote wakefulness, focus, attention, energy and more, making it an ideal drug to assist students or workers. There is also a long historical precedent for military personnel to abuse prescription stimulants to increase their fighting and awareness capabilities. These types of drugs offer a competitive advantage in the world of academics and the workforce, leading many to believe that these drugs are necessary to remain competitive. However, the adverse side effects of prolonged usage and withdrawal symptoms make this drug a dangerous substance to become hooked on. Users who are suffering from withdrawals experience lethargy, anxiety, constant tiredness, and difficulty focusing.
Prescription drug abuse could be affecting millions of Americans, but there are ways we can prevent the misuse of the medications while eliminating the risk of transitioning to a harder substance. Doctors are in a unique position to diagnose and monitor patients who may need a prescription medicine as part of their treatment. State governments can implement prescription drug monitoring programs to better track and identify cases of prescription abuse. For those suffering an addiction to prescription medication, there is hope in the form of drug rehab centers. At Landmark Recovery, we believe in creating a supportive network of love and access to resources that can help you break free from the chains of addiction. Visit our website to learn more about our drug and alcohol rehabilitation program.