Prescription drug addiction can be a serious medical problem. It is caused by dependence upon prescription medications which affect the brain and many people will require medical treatment to overcome this mental disease. Side effects of prescription abuse can be severe, chronic and even life-threatening but with treatment, many patients can overcome their addiction to mediations such as benzodiazepines, opioids and amphetamines.
Addiction Treatment Challenges
Many people believe that addiction is a choice which can be cured with simple abstinence. In reality, most people who are addicted to prescription drugs will require assistance, often with both medical and psychological treatment.
The largest part of the medical community and governmental agencies recognize that addiction causes a disease of the brain. Though some of the general public and certain health professionals believe that people who are addicted to drugs can and should simply “quit”, most addicts are unable to do so. In addition, many people believe that prescription drugs are not as dangerous as illegal drugs. These two fallacies, make treating prescription drug addiction a significant challenge.
Addiction vs Abuse
Drug abuse is defined as the use of a medication or substance for non-medical reasons. Prescription drug abuse is the use of a prescription medication in a way, other than as prescribed, to experience alternative feelings. Prescription drug abuse is a serious and growing problem in the U.S. reaching near epidemic proportions. More than 50 million Americans over the age of 12 admit to using prescription medication for non-medical reasons once or more during their lifetime and it is the third most-abused substance, surpassed only by alcohol and marijuana. Prescription drug abuse can occur in the actual patient or others who have access to the mediation.
Drug addiction is not always the same as drug abuse. Prescription medications can become addictive if the drug is not taken as prescribed or even when the medication is appropriately prescribed and taken as directed. This occurs because certain drugs make changes in the brain which make the central nervous system unable to function normally without the drug. This is known as dependence. Estimates show that 14 percent of people who abuse drugs become dependent on them.
Prescription drugs are responsible for more overdose or side effect related deaths than traffic accidents each year in the U.S.
Prescription Drugs Most Likely to be Abused or Cause Addiction
Prescription drugs which are known to be susceptible to abuse and dependence are classified by the Drug Enforcement Agency as “controlled substances”. In theory, these medications are more tightly controlled and more difficult to access but many people still abuse and become dependent on them.
Common drugs of abuse include:
- Opioids or Opiates – also known as narcotics, used as pain killers
- Oxycodone (OxyContin)
- Oxycodone/Acetaminophen (Percocet)
- Hydrocodone/Acetaminophen (Lorcet, Lortab, Vicodin, Norco)
- Hydromorphone (Dilaudid)
- Morphine (MS Contin, Kadian, Opana)
- Fentanyl (Duragesic, Actiq, Fentora)
- Benzodiazepines – also known as depressants or sedatives, used for anxiety or insomnia
- Alprazolam (Xanax)
- Diazepam (Valium)
- Clonazepam (Klonopin)
- Lorazepam (Ativan)
- Stimulants – used for ADHD, weight loss and narcolepsy
- Amphetamine/dextroamphetamine (Adderall)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Ritalin, Concerta)
- Modafanil (Provigil)
- Armodafanil (Nuvigil)
Prescription Drug Abuse Side Effects
An estimated 1 million Emergency Room visits are caused each year by prescription drug abuse, many of which are serious overdoses.
Prescription drugs commonly used as substances of abuse have all of the side effects these drugs have when taken as directed. They are also commonly taken in much higher doses and can cause additional effects which may be life threatening.
Overdose is the most common reason for an Emergency Room visit. In most cases, overdoses are accidental in that the person intended to take the medication but accidentally took too much. In some cases, overdose is intentional as an attempt at suicide.
Opiates are the most common cause of overdose which has a high potential to be life-threatening through suppression of the breathing reflex. Second to that are the benzodiazepines, which may also result in unconsciousness and failure to breathe, causing death. Stimulants are not as common as a cause of death but may result in an emergency room visit due to cardiac abnormalities or psychotic behavior. They are also more likely to involve interactions with law enforcement.
Prescription Drug Addiction Side Effects
Addiction occurs when a person who is taking the medication “needs” the medication to feel normal. Addiction may be psychological, physical or both.
Psychological addiction occurs when a person taking a prescription medication on a regular basis for reasons of abuse, develops “cravings” for that drug. Physical addiction occurs when a person taking the medication develops a tolerance to the substance. Over a period of time, more and more drug is needed to reach the same effect.
Even patients who are taking controlled substance prescription medication as it is intended can become physically dependent upon it. In this case, the brain has been changed and the medication is needed to function normally. This is most common with opiates and benzodiazepines.
Though many people believe a person who is addicted to prescription drugs should be able to simply quit, in a lot of cases, this isn’t possible. Most of the prescription drugs which are commonly abused or addicting can cause withdrawal symptoms when the drug is suddenly discontinued.
Withdrawal symptoms can be severe and even life-threatening. In general, stimulant withdrawal causes severe psychological cravings along with a period of depression and excessive sleeping. Sudden opiate withdrawal may cause a severe “flu-like” syndrome with nausea, vomiting, diarrhea, body aches, and cold sweats along with a sense of panic. Benzodiazepine withdrawal can result in a life-threatening series of seizures but in less severe cases can cause auditory disturbance, insomnia and anxiety which may last for many months.
Who is at risk for addiction
Anyone can potentially become addicted to prescription drugs but some people are at a greater risk. Factors indicating greater risk may include:
- Family history of drug abuse or alcoholism
- Family history of traumatic abuse – physical, sexual, or severe emotional
- Family history of criminal behavior
- Family history of certain mental disorders, particularly if left untreated
- Early drug or alcohol use while brain is still in development
- Being subjected to peer pressure
Help is needed
In most cases, people who are addicted to prescription medications will require assistance to quit using the medication. In almost all cases, medical treatment is needed and some of those patients will even require other medications to help discontinue the drug of abuse. This should be carefully supervised by medical health professionals with experience in drug withdrawal.
Most people will also require psychological support. Attendance at a 12-step program or other support group may be successful but others find success through individual therapy or participation in other group support programs.
The first step in getting treatment is always recognizing that help is needed. Family members may already know through recognition of behavioral changes, but the addict must recognize and admit that help is necessary.
In many cases, the person with the addiction may not want family or friends to be involved in treatment, but family members and loved ones should persist. They may be helpful in persuading or even coercing the person into treatment and later through provision of support.
The best way for a family member or loved one to begin helping is by avoiding judgement. Reducing the stigma of abuse and addiction will allow the addict to receive support.