Overview

Prescription drug abuse is the use of a prescription medication in a way not intended by the prescribing doctor. Prescription drug abuse or problematic use includes everything from taking a friend's prescription painkiller for your backache to snorting or injecting ground-up pills to get high. Drug abuse may become ongoing and compulsive, despite the negative consequences.

An increasing problem, prescription drug abuse can affect all age groups, but it's more common in young people. The prescription drugs most often abused include opioid painkillers, sedatives, anti-anxiety medications and stimulants.

Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction.

Symptoms

Signs and symptoms of prescription drug abuse depend on the specific drug. Because of their mind-altering properties, the most commonly abused prescription drugs are:

  • Opioids, such as oxycodone (Oxycontin, Roxicodone) and those containing hydrocodone (Vicodin, Lortab, Norco), used to treat pain
  • Anti-anxiety medications and sedatives, such as alprazolam (Xanax) and diazepam (Valium), and hypnotics, such as zolpidem (Ambien), used to treat anxiety and sleep disorders
  • Stimulants, such as methylphenidate (Ritalin, Concerta, others), dextroamphetamine and amphetamine (Adderall XR) and dextroamphetamine (Dexedrine), used to treat attention-deficit/hyperactivity disorder (ADHD) and certain sleep disorder
Signs and symptoms of prescription drug abuse
Opioid painkillers Sedatives and anti-anxiety medications Stimulants
Constipation Drowsiness Reduced appetite
Nausea Confusion Agitation
Feeling high (euphoria) Unsteady walking High body temperature
Slowed breathing rate Slurred speech Insomnia
Drowsiness Poor concentration High blood pressure
Confusion Dizziness Irregular heartbeat
Poor coordination Problems with memory Anxiety
Increased pain with higher doses Slowed breathing Paranoia

Other signs include:

  • Stealing, forging or selling prescriptions
  • Taking higher doses than prescribed
  • Excessive mood swings or hostility
  • Increase or decrease in sleep
  • Poor decision-making
  • Appearing to be high, unusually energetic or revved up, or sedated
  • Continually "losing" prescriptions, so more prescriptions must be written
  • Seeking prescriptions from more than one doctor

When to see a doctor

Talk with your doctor if you think you may have a problem with prescription drug use. You may feel embarrassed to talk about it — but remember that medical professionals are trained to help you, not judge you. It's easier to tackle the problem early before it becomes an addiction and leads to more-serious problems.

Causes

Teens and adults abuse prescription drugs for many reasons, such as:

  • To feel good or get high
  • To relax or relieve tension
  • To reduce appetite or increase alertness
  • To experiment with the mental effects of the substance
  • To maintain an addiction and prevent withdrawal
  • To be accepted by peers or to be social
  • To try to improve concentration and academic or work performance

Risk factors

Many people fear that they may become addicted to medications prescribed for medical conditions, such as painkillers prescribed after surgery. However, people who take potentially addictive drugs as prescribed don't often abuse them or become addicted.

Risk factors for prescription drug abuse include:

  • Past or present addictions to other substances, including alcohol and tobacco
  • Family history of substance abuse problems
  • Younger age, especially the teens or early 20s
  • Certain pre-existing psychiatric conditions
  • Exposure to peer pressure or a social environment where there's drug use
  • Easier access to prescription drugs, such as having prescription medications in the home medicine cabinet
  • Lack of knowledge about prescription drugs and their potential harm

Older adults and prescription drug abuse

Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol. Having multiple health problems and taking multiple drugs can put seniors at risk of misusing drugs or becoming addicted.

Complications

Abusing prescription drugs can cause a number of problems. Prescription drugs can be especially dangerous — and even lead to death — when taken in high doses, when combined with other prescription drugs or certain over-the-counter medications, or when taken with alcohol or illegal drugs.

Medical consequences

Here are examples of serious consequences of prescription drug abuse:

  • Opioids can cause low blood pressure, a slowed breathing rate and potential for breathing to stop, or a coma. Overdose has a significant risk of death.
  • Sedatives and anti-anxiety medications can cause memory problems, low blood pressure and slowed breathing. Overdose can cause coma or death. Abruptly stopping the medication may cause withdrawal symptoms that can include nervous system hyperactivity and seizures.
  • Stimulants can cause dangerously high body temperature, heart problems, high blood pressure, seizures or tremors, hallucinations, aggressiveness, and paranoia.

Physical dependence and addiction

Because commonly abused prescription drugs activate the brain's reward center, it's possible to develop physical dependence and addiction.

  • Physical dependence. Physical dependence (also called tolerance) is the body's response to long-term use. People who are physically dependent on a drug may need higher doses to get the same effects and may experience withdrawal symptoms when cutting back or abruptly stopping the drug. Physical dependence may also become evident if a drug the body becomes adjusted to over time, even without dosage change, is stopped abruptly.
  • Addiction. People who are addicted to a drug can have physical dependence, but they also compulsively seek a drug and continue to use it even when that drug makes their lives worse.

Other consequences

Other potential consequences include:

  • Engaging in risky behaviors because of poor judgment
  • Using illegal drugs
  • Being involved in crime
  • Motor vehicle accidents
  • Decreased academic or work performance
  • Troubled relationships

Prevention

Prescription drug abuse may occur in people who need painkillers, sedatives or stimulants to treat a medical condition. If you're taking a commonly abused drug, here are ways to decrease your risk:

  • Make sure you're getting the right medication. Make sure your doctor clearly understands your condition and the signs and symptoms. Tell your doctor about all your prescriptions, as well as over-the-counter medications, herbs and supplements, and alcohol and drug use. Ask your doctor whether there's an alternative medication with ingredients that have less potential for addiction.
  • Check in with your doctor. Talk with your doctor on a regular basis to make sure that the medication you're taking is working and you're taking the right dose.
  • Follow directions carefully. Use your medication the way it was prescribed. Don't stop or change the dose of a drug on your own if it doesn't seem to be working without talking to your doctor. For example, if you're taking a pain medication that isn't adequately controlling your pain, don't take more.
  • Know what your medication does. Ask your doctor or pharmacist about the effects of your medication, so you know what to expect. Also check if other drugs, over-the-counter products or alcohol should be avoided when taking this medication.
  • Never use another person's prescription. Everyone is different. Even if you have a similar medical condition, it may not be the right medication or dose for you.
  • Don't order prescriptions online unless they're from a trustworthy pharmacy. Some websites sell counterfeit prescription and nonprescription drugs that could be dangerous.

Preventing prescription drug abuse in teens

Young people are at especially high risk of prescription drug abuse. Follow these steps to help prevent your teen from abusing prescription medications.

  • Discuss the dangers. Emphasize to your teen that just because drugs are prescribed by a doctor doesn't make them safe — especially if they were prescribed to someone else or if your child is already taking other prescription medications.
  • Set rules. Let your teen know that it's not OK to share medications with others — or to take drugs prescribed for others. Emphasize the importance of taking the prescribed dose and talking with the doctor before making changes.
  • Discuss the dangers of alcohol use. Using alcohol with medications can increase the risk of accidental overdose.
  • Keep your prescription drugs safe. Keep track of quantities and keep them in a locked medicine cabinet.
  • Make sure your child isn't ordering drugs online. Some websites sell counterfeit and dangerous drugs that may not require a prescription.
  • Properly dispose of medications. Don't leave unused or expired drugs around. Check the label or patient information guide for disposal instructions, or ask your pharmacist for advice on disposal.

Prescription drug abuse care at Mayo Clinic

Sept. 19, 2015
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