The Risks Of Prescription Abuse And Misuse
July 11, 2019
Prescription abuse might not seem like a big deal, but there are many grave consequences of misusing these prescriptions medications, including opioids and stimulants.
The scale of this problem really shouldn’t be underestimated. According to the 2014 NSDUH (National Survey on Drug Use and Health), the 27.1 million Americans using illicit drugs included 6.4 million people misusing psychotherapeutic drugs. The category of psychotherapeutics is used by NSUH to combine prescription painkillers, stimulants, sedatives and tranquilizers.
Of these, opioids are perhaps the most publicized drugs of abuse with some of the most severe risks attached. The US Centers for Disease Control and Prevention has noted a 200% increase in the rate of overdose from opioids since 2000.
Maybe those figures look alarming but they’re actually getting worse, so what is the scope of this problem today?
How Serious Of a Problem is Prescription Abuse?
The 2017 NSDUH showed that 18 million Americans taking prescription medications had misused them at least once over the course of 2017.
In that same year, 2 million Americans misused prescriptions painkillers for the first time. The survey also showed over 1 million people misusing prescription stimulants, 1.5 million misusing prescription tranquilizers and over a quarter-million misusing sedatives for the very first time. This translates to thousands of people starting to misuse their prescription medication every day alongside millions of others already entrenched in abuse.
As we examined recently in our study of opioid use disorder, misinformation about the addictive properties of opioids back in the 1990s led to increasing numbers of these drugs being prescribed by doctors in good faith. Throw in medication that’s much easier to access than street drugs and the problem is intensifying.
The misuse of prescription drugs can have serious medical consequences including addiction and overdose.
Before we examine the main forms of prescription abuse and misuse, it’s worth quickly clearing those terms up. While sometimes used interchangeably, there are subtle differences in meaning.
What Is Prescription Misuse?
To misuse drugs is to use them in any way that does not follow either legal or medical guidelines. This term is frequently applied to prescription medications.
The most common forms of misuse are taking more of the medication than prescribed, or taking a medication that was not prescribed for you in the first place.
Prescription misuse often but not always leads to abuse.
What Is Prescription Abuse?
When using prescription drugs either illicitly or in excessive quantities starts to impair your life, a more serious problem is developing.
You’re likely to have crossed from misuse into abuse if one of more of the following results from taking medication:
- You’re noticing any kind of health problems
- You start to neglect your responsibilities
- Physical dependence is setting in
- If you try to stop taking the medication, you experience withdrawal symptoms
- You begin to crave the medication
Although the Diagnostic and Statistical Manual of Mental Disorders (DSM) no longer uses the term substance abuse in the most current DSM-5, the above criteria are based on that model and assessed on a sliding scale of severity.
Misuse, then, can easily turn into abuse and the risks of improperly using prescription medications can be significant. These risks vary depending on the type of medication in question so what are the most common culprits?
Most Frequently Misused Medications
Prescription abuse occurs mainly with the following three types of medication:
- Opioid painkillers: OxyContin, Vicodin, Percocet
- CNS (central nervous system) depressants: Valium, Ambien, Ativan
- Stimulants: Ritalin, Adderall, Dexedrine
The way in which these medications are abused along with the signs and symptoms differs to such an extent they need to be examined separately.
1) Opioid Painkiller Abuse
Opioids are often prescribed for the management of severe pain. This class of medication acts on the opioid receptors in your brain and spinal cord to lessen the way in which you perceive pain.
Used for centuries as a general painkiller, opioids have been employed in recent years primarily to treat acute pain. Since the 1990’s, though, opioids have also been prescribed in swelling numbers to treat chronic pain. Not only is there scant evidence to suggest opioids are effective when used long-term, it’s also remarkably easy to become dependent on this type of medication. Tolerance rapidly builds as opioids act on the reward centers. In some cases, sensitivity to pain actually becomes worse not better. This is known as hyperalgesia.
Why, then, have opioids been increasingly prescribed for chronic pain leading to the opioid epidemic being declared a public health emergency back in 2017?
The influence of pharmaceutical companies is one reason for this spike.
In 1991, there was a sharp spike in deaths from opioids. Pharmaceutical companies and medical societies had been promoting the prescription of opioid painkillers to treat pain claiming there was no meaningful risk of addiction.
By 2010, deaths from heroin abuse had also increased dramatically. Early efforts to reduce the number of opioids being prescribed caused many people unable to obtain prescription opioids to start taking heroin with lethal consequences. While this might sound alarming, 80% of heroin users reported using prescription painkillers before heroin.
The CDC (US Centers for Disease Control and Prevention) has laid down detailed guidelines in an attempt to mitigate the over prescribing of opioid painkillers in the face of persistent lobbying by pharmaceutical companies to hamstring these attempts at crisis management.
There’s no question that the misuse of opioids is still a grave problem in the US so what should you look out for if you think you’re becoming over-reliant on these prescription painkillers?
Signs and Symptoms
If you notice any of these symptoms as a result of using prescription opioids, you might have slipped into the realm of misuse and even abuse:
- Impaired coordination
- Increased dose required for pain relief
- Increased sensitivity to pain
- Slow breathing rate
Alongside these physical and psychological symptoms, if you’re seeking prescriptions from more than one doctor or requesting early refills, you’re already starting to misuse your medication.
If you feel you’re developing a problem, you should not hesitate to speak openly and honestly with your doctor. If misuse of opioids descends into abuse and addiction, the consequences can be disturbing.
When taken as prescribed, opioid painkillers will usually help to manage pain effectively and safely. If taken for just a few days as directed by your doctor, it’s rare for opioid use disorder to manifest.
Long-term use or prescription abuse, on the other hand, can easily lead to heightened tolerance and dependence. Dependence can occur in as little as 4 to 8 weeks. Trying to stop using opioids can bring on withdrawal symptoms so unpleasant that quitting without outside assistance can be problematic and even dangerous.
When opioids are abused, the risk of overdose is heightened. By taking just a single heavy dose, respiratory depression can occur. This is sometimes even fatal. These risks are further amplified if opioids are used along with either alcohol or sedatives.
Also, as mentioned above, abusing opioid prescriptions can be a risk factor precipitating heroin use. With almost one-third of Americans using drugs for the first time starting the potential path to addiction with prescription painkillers, the perils of prescription abuse with opioid painkillers are dire and widespread.
If you or anyone you know shows any of the above symptoms, you should speak with your doctor even if he is the one prescribing you the medication. The sooner you take control, the easier it will be to recover from dependence on opioids. Start rebuilding your life before a drug designed to help you starts having the opposite effect.
2) CNS Depressant Abuse
Central nervous system (CNS) depressants include:
All of these medications can slow down your brain activity. This makes them useful for the treatment of sleep disorders and anxiety disorders.
Different classes of CNS depressants work in different ways.
The benzodiazepine family includes Valium, Klonopin and Xanax. While these medications can be effective in the short-term for managing sleep disorders, tolerance builds easily. For this reason, they are seldom prescribed on an ongoing basis but many people who start using benzodiazepines go on to misuse their prescriptions or obtain the medication on the black market.
Non-benzodiazepine sleep medications don’t share the same chemical structure and have far fewer side effects. Nevertheless, medication like Ambien is still frequently misused.
Tranquilizers like Nembutal carry a far higher risk of overdose and they are more often prescribed to treat seizure disorders than to treat anxiety or sleep disorders.
While the drowsy and calming effect of CNS depressants has many medical benefits, this class of medication also has the potential for misuse.
Signs and Symptoms
If you’re taking CNS depressants of any nature and notice the following symptoms developing, you might be straying into the territory of misuse.
- Lowered concentration levels
- Memory problems
- Slowed breathing
- Slurred speech
- Unsteadiness when walking
Just like any other prescription medication, CNS depressants should only ever be used as directed.
If taken over a longer period than recommended by your doctor, it’s very easy for tolerance to set in. You’ll need more of the medication to achieve the same effects. For this reason, central nervous system depressants are rarely prescribed for more than a few days.
Continuing to use the medication from this point can lead to dependence and withdrawal symptoms when you attempt to discontinue use. While uncomfortable, withdrawal from benzodiazepines doesn’t often become life threatening. With tranquilizers, on the other hand, complications can be fatal.
If you have been misusing your CNS depressant prescription and decide to take action to stop this, you should always discuss this with your healthcare provider rather than trying to abruptly stop alone.
3) Stimulant Abuse
Prescription stimulants have been used to treat a diverse spread of conditions over the years. Nowadays, they are normally only used to treat ADHD (attention deficit hyperactivity disorder) and narcolepsy.
Due to the more limited applications, fewer people tend to misuse prescription stimulants but it still represents a problem, particularly among young adults.
When used as directed, prescription stimulants can boost alertness and energy levels while also enhancing your ability to concentrate by working on dopamine signaling in the brain.
Ritalin and Adderall are frequently misused by students attempting to increase their ability to focus and stay alert. Stimulant medications can also induce a feeling of euphoria so they are also regularly misused in an attempt to get high.
How can you tell if you’re starting to abuse these prescription stimulants?
Signs and Symptoms
If any of the following symptoms start to present, it’s worth asking yourself whether you’re misusing your prescription for stimulants:
- Enhanced alertness
- High body temperature
- High blood pressure
- Irregular heartbeat
- Lowered appetite
Don’t hesitate to speak with your doctor if you’re concerned about your use of this type of medication. The consequences of misuse can be extreme…
While it can take some time for dependence to kick in with prescription stimulants, once you’re addicted to this class of drug, withdrawal symptoms can be harsh. From overall body fatigue and depression to disturbed sleep patterns, you might find it tough to stop using this type of medication without some assistance.
Repeated and excessive misuse of stimulants can bring about feelings of hostility along with a sense of overwhelming paranoia. In the worst-case scenario, this can result in psychosis.
You also run the risk of your body temperature reaching dangerously high levels and an irregular heartbeat.
While rare, cardiovascular failure and seizure means there’s a size-able overall risk from the abuse of prescription stimulants that shouldn’t be overlooked. With more prescriptions over recent years making this type of medication readily available, misuse often takes the form of using drugs intended for someone else.
What To Do If You Are Misusing Any Type of Prescription Drugs
Each of the types of prescription drugs above come with their own medical risks if abused.
In all cases, misuse of prescription drugs can lead to physical dependence and addiction. Beyond this, misusing medication can also increase the chance of accidents, tempt you into using illicit drugs or becoming involved in some form of criminal activity along with impacting your performance at work and causing relationships to unravel.
Even though using prescription drugs may start out sanctioned by your doctor and perfectly legal, misuse can lead to any of the more severe consequences outlined above before you know it.
Speak with your doctor if you or anyone you know is misusing prescription medication.
You can also call our Indiana treatment center at 375-325-8331 for advice on any aspect of prescription abuse.