Prescription drugs are medications prescribed by a doctor to treat different illnesses and diseases. These medications may alleviate symptoms from a variety of medical conditions including chronic illnesses, pain, psychological disorders, and many more.
Prescription drugs and their use
When taken as directed, they can be extremely beneficial. However, use of prescription drugs may become problematic and lead to addiction and abuse.
A misconception about prescription drugs is that they cannot be harmful because they are legal and prescribed by a doctor. But their use, particularly improper use, can be just as risky as using illicit drugs like cocaine or heroin. Abuse of prescription drugs may involve using medication more frequently or at higher doses than prescribed by a doctor. They may also be mixed with other substances, leading to dangerous interactions.
Opioids
Prescription opioids attach to opioid receptors in the brain, which are associated with the sensation of pain. These opioids block the sensation of pain by interrupting the nervous system message relay. Thus, prescription opioids such as Vicodin and Oxycontin are used to treat severe or chronic pain such as after surgery or due to illnesses like cancer.
In addition to reducing pain, prescription opioids can cause intense feelings of euphoria and pleasure through their effect on the reward pathway in the brain. This mood-boosting effect increases the drug’s potential for abuse and addiction. It may be abused by those who suffer from chronic pain or mental health issues.
Stimulants
Stimulants are substances that increase the activity of the central nervous system. Certain prescription drugs have this effect to alleviate symptoms of certain disorders such as attention-deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD). By increasing the activity of the nervous system, these medications improve attention and focus.
Stimulants may be abused by those who do not have a prescription or underlying medical need. In these cases, stimulants produce bursts of energy and feelings of euphoria that may be attractive to users. However, stimulant use may also lead to negative effects like elevated blood pressure and problems sleeping.
Depressants
Drugs that decrease the effect of the nervous system are known as depressants. They affect neurotransmitters in the central nervous system that slow down communication between neurons. This can help those suffering from anxiety or panic disorders reduce these incapacitating symptoms.
When used without a prescription, depressants may have a mildly sedative effect and lead to feelings of well-being and mild euphoria. Depressant abuse can have side effects such as impaired reasoning and judgment, vomiting, shallow breathing, and loss of consciousness.
Prescription drug interactions
It’s common to experience negative interactions when prescription drugs are taken with other substances. It’s important to be aware of potentially harmful interactions to avoid taking medications that can’t safely be mixed. In some cases, two different prescription drugs can compound each others’ effects, creating a more powerful and dangerous reaction. For example, two nervous system depressants can dangerously reduce breathing and heart rate, potentially leading to coma or death.
Mixing prescription drugs can also worsen common side effects, increasing the likelihood of more severe effects such as heart or blood pressure problems. In addition to potentially amplifying adverse effects, some drug interactions may actually negate the positive effects of each other. For example, a nervous system stimulant may negate the calming effects of anxiety medication.
Transparency with your doctor is important to ensure that no negative or dangerous interactions occur. A doctor can recommend what substances to avoid while taking certain medications, but this hinges on your honest disclosure of the substances you are currently taking.
Prescription drugs are regulated like other illicit substances of concern by the US Drug Enforcement Administration (DEA). The DEA classifies prescription drugs into five different categories, known as schedules, according to their potential for abuse and addiction.
Schedule I
Schedule I drugs have no medical use and carry the highest potential for abuse and addiction. Schedule I drugs include heroin, LSD, and ecstasy. Marijuana is also considered a Schedule I substance even though it has been legalized by some states for medical or recreational use.
Schedule II
Schedule II substances are those that are closely regulated because of their high potential for abuse and addiction. Some prescription drugs like Adderall and Oxycodone are considered Schedule II substances.
Schedule III
Schedule III drugs carry a moderate risk of abuse and addiction and generally require a medical prescription. Substances such as ketamine, steroids, and testosterone are examples of schedule III drugs.
Schedule IV
Schedule IV drugs have a lower potential for abuse but are still regulated for their risk of addiction. Prescription drugs like Xanax and Valium are Schedule IV substances.
Schedule V
Schedule V drugs also require a prescription even though their potential for abuse or addiction is considered low. Some examples of schedule V drugs are cough medicines that include codeine and antidiarrheal medications that contain atropine/diphenoxylate.
Fentanyl
Fentanyl is one of the most powerful and dangerous prescription narcotics, implicated in increasing overdose deaths. It is a synthetic opioid that is prescribed in cases of severe pain which is not responsive to other medications. Fentanyl may also be produced illicitly for recreational use. Fentanyl is the active ingredient in prescription medications such as Duragesic and Fentora.
Oxycontin
Oxycontin is a powerful painkiller that is typically prescribed to alleviate pain over a long period of time. Because it produces powerful feelings of pleasure and sedation, it is one of the most commonly abused prescription drugs.
Vicodin
Vicodin is a painkiller that contains a combination of acetaminophen and hydrocodone. Hydrocodone is the opioid component of Vicodin. It is prescribed to treat moderate to severe pain but can be abused to achieve a powerful high. High doses of Vicodin can be harmful to the liver.
Morphine
Morphine is a naturally derived opioid used to treat pain. It is available in immediate-release and extended-release forms, so its duration of action depends on the formulation. Misuse can cause overdose, including dangerously slowed breathing.
Adderall
Prescribed primarily to treat attention and hyperactivity disorders, Adderall is commonly abused by teens and young adults to improve focus and increase energy. It is one of the most abused substances on college campuses.
Ritalin
Ritalin is a brand name for methylphenidate, a central nervous system stimulant used to treat ADHD and narcolepsy. Methylphenidate can be habit-forming, and misuse can increase the risk of overdose and death. It should be taken only as prescribed.
Valium
Valium is a depressant used to treat anxiety and other related disorders. Diazepam is the active ingredient in Valium, which can drastically affect the nervous system in a short time. It may be abused in conjunction with other substances such as painkillers, leading to dangerous or unpredictable effects.
Xanax
Xanax is a brand name for alprazolam, a benzodiazepine prescribed for anxiety and panic disorders. It can be habit-forming. Combining it with opioids, alcohol, or other sedating substances can increase the risk of serious harm, including breathing problems. Follow your prescriber’s instructions and discuss any dose changes or plans to stop treatment with them.
Ativan
Ativan is a fast-acting benzodiazepine that can treat anxiety and sleep disorders by causing a sedative effect. It is a nervous system depressant, reducing activity in the brain and nervous system and allowing people to feel sedate and drowsy. Its active ingredient is lorazepam.
Klonopin
Klonopin is a brand name for clonazepam, a benzodiazepine used to treat panic disorder and certain seizure disorders. It can cause drowsiness and can be habit-forming. Combining it with opioids or other sedating substances can cause serious breathing problems, and alcohol can worsen side effects. Take it as prescribed and speak with your clinician before reducing or stopping it.
Ambien
Ambien is a depressant that treats insomnia and other sleep disorders. Since it slows down the nervous system, it helps people fall asleep. Its sedative and calming effects make it a dangerous drug of potential abuse. It is fast-acting but also long-lasting.
Abuse of prescription drugs
Some prescription medicines can cause tolerance or physical dependence even when taken as directed. Tolerance means the same dose has less effect over time; physical dependence means reducing or stopping a medicine can cause withdrawal. Neither, by itself, establishes addiction. Addiction involves compulsive use despite harmful consequences. Discuss changes in a medicine’s effects or concerns about dependence with your prescriber before changing the dose or stopping it.
Some signs and symptoms that may indicate that prescription drug use has slipped into drug abuse include:
- Repeated attempts to obtain prescriptions illegally including the practice of doctor shopping
- Inability to control how much of the drug is used
- Inability to stop using despite attempts to
- Mixing prescription drugs with other substances deliberately to achieve a high
- Using prescription drugs in a way that will create a more potent high such as injecting or snorting them
Getting help for prescription drug abuse
Perhaps because of its perceived safety, prescription drug abuse is one of the most common types of drug abuse. It may also be more difficult to resolve because the underlying illness the prescription drug was prescribed to treat may worsen when discontinuing its use. This may complicate the addiction treatment process. Since many prescription drugs also affect important systems in the body and nervous system, withdrawal symptoms may be severe, hindering attempts to quit.
Treatment begins with an assessment of the substances involved, withdrawal risk, and physical and mental health needs. Care may include medically supervised withdrawal management, behavioral therapy, and medication when appropriate. Detox alone does not provide ongoing addiction treatment. A treatment plan should also address the condition for which the medication was originally prescribed.
Prescription Drugs FAQs
How can I keep treating my underlying illness if I become addicted to prescription drugs?
Several methods exist to treat most common illnesses. If one prescription drug becomes problematic, medical professionals or addiction specialists may be able to recommend a safer alternative that can treat the illness with less likelihood of addiction.
What’s the safest way to stop using prescription pills?
Discontinuing prescription use suddenly may lead to withdrawal symptoms as the body adjusts to not having the medication. Doctors should supervise a gradual decrease of dosage to ensure that the process is safe and less distressing.
Can I die from prescription drug use?
Some prescription medicines can cause life-threatening effects, including overdose or serious interactions. Taking medicine as prescribed helps reduce risk, but all medicines have potential benefits and harms. Ask your doctor or pharmacist about side effects and interactions before combining medicines, supplements, or alcohol.
