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Prescription Drug Abuse

By Jeffrey Sterling, MD September 20, 2019

Introduction

This Straight, No Chaser post discusses prescription drug abuse.

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I often have to explain to patients such as chronic sufferers from migraines, low back pain and other conditions that even if they weren’t “drug-seeking,” they still could be addicted to various medications. Marijuana, alcohol and tobacco are the most frequently abused drugs in the U.S. Beyond these, prescription and over-the-counter (OTC) drugs are the next most common culprits. Think about it. A physician prescribing pain or other medications with mind-altering properties (known as psychoactive medications) is a relatively simple way to get a “clean” supply of “high-quality” drugs.

Now if you paid attention to that last sentence, you’ll note the quotes, and perhaps you picked up on the irony. As an independent consideration, prescription and OTC drugs are safer than illicit drugs. However, that’s only true when they are taken exactly as prescribed for the reasons prescribed. When misused or abused, prescription and OTC drugs can be addictive and put abusers at risk for adverse health effects, including overdose and death. Taking these medicines at the same tie as other drugs (or with alcohol) increases these risks.

Classes of Prescription Drugs

The classes of prescription drugs most commonly abused are the following:

  • Opioid pain relievers, such as Vicodin or Oxycontin
  • Stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall, Concerta, or Ritalin
  • Central nervous system (CNS) depressants for relieving anxiety, such as Valium or Xanax
  • OTC drugs are cough and cold remedies containing dextromethorphan

These medications all produce mind-altering properties when taken other than prescribed (i.e. by a different person and/or in a different dose than prescribed). These can produce effects that some would describe as pleasurable, all the while causing other damage to your body.

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How Prescription Drugs Get Abused

What I’d like to accomplish next is to advise you how your children or others with access to your medicine cabinet may be abusing drugs.

  • Taking a medication prescribed for somebody else. We all have heard time and again to never take medicine prescribed for someone else’s use. Unaware of the dangers of sharing medications in general or pain medications specifically, people often unknowingly participate in this form of abuse by sharing their unused pain relievers with friends and family members. In fact, most teenagers who abuse prescription drugs receive them for free by a friend or relative.
  • Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets. However, many abusers 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. This is dangerous and produces unintended effects, including death.
  • Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects at certain quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them. Unfortunately they can also produce deadly effects at certain qualities. A common example is the use of ADHD drugs (e.g. Adderall) to improve students’ academic performance. Although these drugs may boost alertness, there is little evidence they improve cognitive functioning for those without ADHD. There is evidence they produce adverse effects under certain circumstances.

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Prescriptions Drugs are Gateway Drugs

Finally, prescription opioid abuse are a first step to heroin use. Pain medications such as Oxycontin and Vicodin have effects similar to heroin. In three recent studies, nearly half of young people who inject heroin surveyed reported abusing prescription opioids before starting to use heroin. Additionally, some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.

In other words, pay attention to what’s happening with medications in your home and possession.

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