Prescription Drug Addiction
Deaths from drug overdoses are the leading cause of injury/death in the United States, ahead of deaths linked to motor vehicles and firearms, according to the new 2015 National Drug Threat Assessment (NDTA), released by the Drug Enforcement Administration.
Deaths from drug overdoses are the leading cause of injury/death in the United States, ahead of deaths linked to motor vehicles and firearms.
A surprising 50 percent of U.S. drug overdoses are caused by prescription drugs, 22,000 annually, according to a new report, The Facts Hurt: A State-By-State Injury Prevention Policy.
Prescription drug abuse is intentionally taking medication in a way that was not prescribed. For example, some people may do this to get high or change their mood.
The most common types of prescription drugs abused include:
- Opioids (used to treat short term and long term pain)
- Benzodiazepines (used to treat anxiety and sleeping disorders)
- Stimulants (used to treat attention deficit disorder)
Addiction to these prescribed medications can cause serious health effects, including addiction to heroin, overdose and even death. Many people are not aware of these potential risks and abuse drugs for many years.
The risk of harm, overdose, and death rises when these medications are:
- Taken at higher doses
- Taken in a different way or for different reasons than prescribed
- Used with alcohol or other substances (prescription, over-the-counter or illegal drugs)
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Treatment Options for Opioid Addiction
Treatment options for prescription drug addiction vary, depending on the type of drug abused and your needs. But counseling, or sometimes psychotherapy, is typically a key part of treatment. Treatment may also require withdrawal (detoxification), addiction medication and recovery support.
Treatment may typically include some form of detoxification
Treatment for prescription drug addiction is, in many ways, similar to treatment for other types of drug addictions. Before successful treatment can begin, a person must first recognize and admit that an addiction exists. The exact treatment for prescription drug addiction will then depend on the individual, as well as the type of drug being abused. Typically, treatment will include some form of detoxification from the drug, as well as intensive therapy. Sometimes other drugs given in a controlled setting may be necessary to ease prescription drug addiction cravings and withdrawal symptoms.
Addiction to alcohol and other mind-altering substances is a neurological disease, but is one that can be cured with time and a thorough commitment to a treatment program. Beyond abstaining from a drug, treatment for prescription drug addiction includes equipping addicts with tools to cope with life off of drugs. This usually begins with individual therapy, but may also include group or family therapy if it will assist the addict in working on some of the underlying issues that led to addiction, as well as offering support in repairing damaged relationships that may have occurred as the result of addiction.
Pros and Cons of Detox
While it is not considered a treatment for prescription drug addiction alone, detoxification is a necessary part of an overall treatment strategy. This includes completely abstaining from the substance an individual is addicted to. Many addicts try detoxification alone, believing it is enough to cure an addiction, but detoxification is just the first step in treating drug abuse, as counseling and more intensive, long-term drug rehab strategies may be always necessary. In fact, addiction experts do not recommend that individuals addicted to benzodiazepines attempt withdrawal on their own without undergoing supervised medical treatment for prescription drug abuse, as withdrawal from benzodiazepines, such as Xanax, Valium or Ativan, can be dangerous.
Treatment for prescription drug addiction will, at times, include a medical detox to help free a person from physical drug dependency. This is particularly true for individuals who were addicted to opioids, such as codeine or morphine, which are commonly prescribed to treat pain. Treatment for prescription drug abuse often includes a tapering off of drugs. By gradually decreasing dosages, withdrawal symptoms may be lessened, as well as the mental anxiety of being off of the drug may be lessened, too. With therapeutic supervision, a person may learn to gradually cope with life drug-free once again. Overall, treatment for prescription drug abuse takes time, patience and a staunch dedication to the process of stopping prescription medication abuse.
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Prescription Drugs of Abuse and Over-the-Counter Medications
Classes of Prescription Drugs
The classes of prescription drugs most commonly abused are: opioid pain relievers, such as Vicodin® or Oxycontin®; stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall®, Concerta®, or Ritalin®; and central nervous system (CNS) depressants for relieving anxiety, such as Valium® or Xanax®.1 The most commonly abused OTC drugs are cough and cold remedies containing dextromethorphan.
People often think that prescription and OTC drugs are safer than illicit drugs. But they can be as addictive and dangerous and put users at risk for other adverse health effects, including overdose—especially when taken along with other drugs or alcohol. Before prescribing drugs, a health care provider considers a patient’s health conditions, current and prior drug use, and other medicines to assess the risks and benefits for a patient.
How Are Prescription Drugs Abused?
Prescription and OTC drugs may be abused in one or more of the following ways:
Taking a medication that has been prescribed for somebody else. Unaware of the dangers of sharing medications, people often unknowingly contribute to this form of abuse by sharing their unused pain relievers with their family members.
Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain and amplifies its effects.
Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects at sufficient quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them.
ADHD drugs like Adderall® are also often abused by students seeking to improve their academic performance. However, although they may boost alertness, there is little evidence they improve cognitive functioning for those without a medical condition.
How Do Prescription and OTC Drugs Affect the Brain?
Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs.
For example, stimulants such as Ritalin® achieve their effects by acting on the same neurotransmitter systems as cocaine. Opioid pain relievers such as OxyContin® attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and Rohypnol®. And when taken in very high doses, dextromethorphan acts on the same cell receptors as PCP or ketamine, producing similar out-of-body experiences.
When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.
What Are the Other Health Effects of Prescription and OTC Drugs?
Opioids can produce drowsiness, cause constipation, and—depending upon the amount taken—depress breathing. The latter effect makes opioids particularly dangerous, especially when they are snorted or injected or combined with other drugs or alcohol.
Opioids and Brain Damage
While the relationship between opioid overdose and depressed respiration (slowed breathing) has been confirmed, researchers are also studying the long-term effects on brain function. Depressed respiration can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term psychological and neurological effects, including coma and permanent brain damage.
Researchers are also investigating the long-term effects of opioid addiction on the brain. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.
More people die from overdoses of prescription opioids than from all other drugs combined, including heroin and cocaine (see “The Prescription Opioid Overdose Epidemic” below).
The Prescription Opioid Overdose Epidemic
More than 2 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers. The terrible consequences of this trend include overdose deaths, which have more than quadrupled in the past decade and a half. The causes are complex, but they include overprescription of pain medications. In 2013, 207 million prescriptions were written for prescription opioid pain medications.
Stimulants can have strong effects on the cardiovascular system. Taking high doses of a stimulant can dangerously raise body temperature and cause irregular heartbeat or even heart failure or seizures. Also, taking some stimulants in high doses or repeatedly can lead to hostility or feelings of paranoia.
CNS depressants slow down brain activity and can cause sleepiness and loss of coordination. Continued use can lead to physical dependence and withdrawal symptoms if discontinuing use.
Prescription Opioid Abuse: A First Step to Heroin Use?
Prescription opioid pain medications such as Oxycontin® and Vicodin® can have effects similar to heroin when taken in doses or in ways other than prescribed, and research now suggests that abuse of these drugs may actually open the door to heroin abuse.
Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.
Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration.
Dextromethorphan can cause impaired motor function, numbness, nausea or vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred due to the combination of dextromethorphan with decongestants often found in the medication.
All of these drugs have the potential for addiction, and this risk is amplified when they are abused. Also, as with other drugs, abuse of prescription and OTC drugs can alter a person’s judgment and decision making, leading to dangerous behaviors such as unsafe sex and drugged driving.
