Prescription Drug Addiction

When most people think about drug abuse, they picture a person roaming the streets to purchase illegal drugs like cocaine and heroin. But the truth is that more and more people are turning to their own medicine cabinets to get “high.” Prescription drug abuse is a growing problem in the US. It affects people of all ages and from all walks of life. People who misuse prescription medications risk serious health issues and addiction. Also, taking medications not prescribed to you can cause dangerous interactions with other medications or substances you are using.

Prescription drug abuse or misuse refers to:

• Taking a larger dose of a medication than prescribed.
• Taking someone else’s prescription medication.
• Using a prescription medicine to get high.
• Taking a medicine in ways not prescribed. For example, crushing pills and snorting them.

Some of the most common prescription drugs that people abuse are opioid painkillers, sedatives and tranquilizers (anti-anxiety medications), and stimulants used to treat ADHD. These prescription drugs are habit-forming, especially in people who have a history of addictive behaviors like smoking or alcohol use.

What Is Prescription Drug Addiction?

Prescription drug addiction refers to a person misusing or abusing a prescribed medication and becoming physically or psychologically dependent on it. This can happen when a person takes an addictive (habit-forming) drug as even as prescribed, but it is much more likely to occur when a person misuses their medication.

Misuse is the use of prescription medications in a way not authorized by the prescribing physician. This can mean taking a prescription medication at a dose or in a manner other than prescribed. For example, taking extra doses, taking larger doses, or crushing pills that are meant to be swallowed all qualify as prescription drug misuse. Prescription drug misuse can also mean taking a medication that has been prescribed to someone else, even if there is a legitimate medical reason. For example, using a family members opioid pain medication to treat chronic pain caused by an injury.

Commonly Misused Prescription Drugs

Prescription drug addictions occur with drugs that cause pleasurable, relaxing, energizing, or euphoric effects. These include stimulants, sedatives, anti-anxiety medications, and pain medications.

People can develop an addiction to prescription drugs that have valid medical uses but are considered dangerous because of a high potential for abuse and addiction, including: ^[1]

• Opioid pain relievers: These powerful narcotic drugs are used to treat moderate to severe pain after injuries or surgery or in cancer patients. Examples include OxyContin, Vicodin, Percocet, and Opana. Street names for prescription opioids include vikes, percs, oxy, and OC.
• Stimulants: These drugs are prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy (excessive sleepiness). Examples of prescription stimulants include Adderall, Ritalin, and Concerta. Common street names for these drugs are uppers, speed, bennies, black beauties, smart drug, and vitamin R.
• CNS depressants (tranquilizers, sedatives, and hypnotics): These drugs are used to treat sleep disorders and anxiety. Examples are Valium, Xanax, Klonopin, and Ambien. Street names for prescription sedatives include chill pills, sleeping pills, zanies, and zombies.

Many of the most commonly abused prescription medications are classified as Scheduled or Controlled drugs by the Drug Enforcement Administration (DEA). Misuse or abuse of controlled medications can lead to severe physical or psychological dependence. ^[2]

Prescription Drug Abuse in the United States

Over the last few years, prescription drug abuse and addiction have become a serious health crisis in the United States. The number of prescriptions written for some of the most commonly abused medications has increased dramatically since the 1990s.

From 1991 to 2001, the prevalence of non-medical prescription drug use increased by more than 50%. The prevalence of prescription drug use disorders (addiction) increased by 67%. ^[3] This dramatic increase in prescription drug addiction prompted the need for urgent action.

Clinicians were encouraged to balance access to prescription drugs for those who need them against the potential for abuse and addiction in vulnerable individuals. Despite various efforts, prescription drug addiction has reached epidemic proportions in the United States. In 2018, past-month misuse of prescription pain relievers was reported by 2.9 million Americans. Also, 1.8 million Americans reported misusing prescription tranquilizers or sedatives within the past month. Approximately 1.7 million Americans reported prescription stimulant misuse within the past month. ^[4]

According to the 2022 NSDUH survey, within the past month, 2.4 million Americans reported misusing prescription pain pills, 1.5 million reported misusing sedatives, and 1.3 million reported misusing stimulants. ^[5] Therefore, while the numbers are marginally better, prescription drug abuse continues to be a major public health crisis in the US.

Prescription Drug Addiction: Facts and Figures

The statistics listed below demonstrate the scale of the prescription drug addiction crisis in the United States. The numbers show how this has become an increasingly worrisome problem over the past few decades:

Years 2000-2011

• Admissions for prescription opioid addiction represented 16% of all primary opiate admissions in 2003. This number increased to 33% in 2013. ^[6]
• From 2004 to 2011, medical emergencies related to non-medical pharmaceutical use increased by 132%. Involvement of prescription opioids increased by 183%. There was also an 85% increase in the involvement of CNS stimulants.
• In 2011, more than 50% of all emergency department (ED) visits for drug abuse involved non-medical use of pharmaceuticals, with pain relievers being the most common drugs abused (46%).^[7]
• From 2004 to 2011, there was a significant increase in ED visits and overdose deaths from the combined use of opioids and benzodiazepines. ^[8]

Years 2012-2018

• Between 2000 and 2016, there was a 200% increase in overdose deaths involving opioids (prescription opioids plus heroin). ^[9]
• In 2017, there were almost 58 opioid prescriptions written for every 100 Americans.
• In 2018, pain-reliever abuse was the second most common type of drug abuse in the US, with 3.6% of the population misusing these drugs. ^[10]
• In 2018, an average of 41 Americans died every day from prescription opioid overdoses, with roughly 15,000 deaths per year.

Years 2019-2022

• In 2020, the primary substances of abuse were opiates (other than heroin) in nearly 89,000 treatment admissions. This is down from a peak of 201,000 admissions involving non-heroin opiates in 2011.
• The primary substance of abuse was benzodiazepines in just under 14,000 treatment admissions in 2020. This is down from a peak of over 20,000 in 2017. ^[11]
• In 2022, nearly 8.5 million people reported past year misuse or abuse of prescription pain relievers, almost 4.3 million people reported using prescription stimulants in the past 12 months, and 4.8 million reported misusing tranquilizers or sedatives in the past year. ^[12]

Reasons for Misusing Prescription Drugs

People misuse and abuse prescription drugs for various reasons. Many people begin using the medication as prescribed but end up taking more because they develop a tolerance (meaning, their symptoms are not controlled on the prescribed dose and they take more of the medicine in an effort to obtain relief). Others begin using a prescription medication more often than they are recommended because of the pleasurable or euphoric effects of the drug or how it makes them feel.

Different prescription medications cause different effects and are abused by people who desire these specific effects of the medication.

Prescription Stimulants

Some people misuse prescription stimulants to improve academic or work performance. They are commonly called “study drugs” because they are used to gain a competitive edge at work or school. Older adults sometimes misuse prescription stimulants to improve concentration and memory. ^[13]

Appetite suppression and weight loss are common side effects of prescription stimulants. About 12% of young adults surveyed by a group of researchers reported that they used prescription stimulant drugs for weight loss. ^[14]

Prescription Opioids

Opioids are powerful pain relievers that alter the concentrations of certain brain chemicals. These drugs make people feel relaxed and euphoric. Some people abuse opioids for non-medical reasons to feel good and get “high.” Others misuse prescription pain pills to manage chronic pain or stressful situations. People who have developed a prescription opioid addiction may take the drug to avoid withdrawal symptoms. ^[15]

Prescription Sedatives, Hypnotics, and Tranquilizers

These drugs are habit-forming and are often abused by people who struggle with anxiety or insomnia. Once a person becomes addicted, they can experience symptoms of withdrawal, which makes it harder to stop using the drug or prevent relapse. ^[16]

Who Is at Risk of Prescription Drug Addiction?

Anyone who takes a prescription medication in a way other than prescribed or for a non-medical reason is at risk of developing an addiction. Many people mistakenly believe that prescription drugs are safer than illegal street drugs. Also, some people are unaware of the addictive potential of prescription drugs.

Certain people are at higher risk of developing an addiction to prescription medications like sedatives, opioids, and stimulants, for example, older adults, females, those with poor general health, and daily alcohol drinkers. ^[17] Family members and friends of high-risk individuals should remain vigilant to ensure that prescription drug misuse does not spiral out of control, leading to dependence and addiction.

Alcohol Use and Prescription Drug Misuse

People with an alcohol use disorder (alcoholism or alcohol addiction) are 18 times more likely to report non-medical use of prescription medications compared to people who don’t drink. ^[18] Also, the combination of alcohol and some prescription medications like opioid pain pills can result in a dangerous slowing of breathing which can be fatal.

Adolescents and Young Adults

Adolescents sometimes start non-medical use of prescription drugs under peer pressure. Teenagers and young adults who have poor relationships with adults in the family are at greater risk of being influenced by friends. The risk of prescription drug abuse and addiction is also higher in teens who live with parents who abuse substances themselves. Some high-school and college students misuse stimulants to improve academic performance.

People with Mental Illness

Studies show that younger patients with depression, illicit drug use, and chronic pain are at risk of prescription drug abuse and addiction. ^[19] About half the people with a mental illness also have a co-occurring substance use disorder and vice versa. People with mental illnesses such as anxiety, depression, and post-traumatic stress disorder (PTSD) are at increased risk of developing prescription drug addiction because they may try to use these medications to deal with the emotional turbulence associated with their mental illness.

Chronic Pain and Prescription Drug Addiction

Another group of people at a high risk of prescription drug addiction are those with chronic medical conditions that cause severe, longstanding pain. Prescription drug abuse and addiction is reported in up to 45% of patients with chronic pain by some researchers. ^[20]

Elderly People and Prescription Drug Misuse

Older adults are often on multiple medications for a variety of medical conditions. Also, due to problems with memory or dementia, elderly people can mix up medications, resulting in an unintentional misuse of prescription drugs. On the other hand, some elderly people may intentionally misuse prescription medicines to self-treat unpleasant symptoms. Moreover, metabolism is slower in older adults, affecting how quickly drugs are broken down and removed from the body. This can result in dangerous toxicity of prescription medications. Last but not least, social isolation and depression can also contribute to prescription drug abuse in elderly people. All these factors increase the risk of prescription drug addiction in older individuals. ^[21]

Signs and Symptoms of Prescription Drug Misuse

If you suspect that a loved one may be misusing prescription medications, certain signs and symptoms should raise concern. Some of the common symptoms include:

Opioids

• Poor reflexes
• Constipation
• Confusion
• Nausea and sickness
• Slowed breathing
• Drowsiness and tiredness
• Hyperalgesia (increased sensitivity to pain) with high doses

CNS Depressants (Sedatives and Anti-Anxiety Medications) 

• Confusion and memory-recall issues
• Difficulty concentrating
• Drowsiness and tiredness
• Dizziness
• Slurred speech
• Slowed breathing

Stimulants

• Increased alertness
• Increased body temperature
• Increased blood pressure
• Irregular heartbeat
• Reduced appetite
• Insomnia
• Anxiety, agitation, paranoia

Besides the above-mentioned physical signs, it’s important to be vigilant for behavioral changes that often accompany prescription drug addiction. This can include things like stealing to pay for prescription medications obtained from drug dealers, forging prescriptions, or “shopping” for doctors/pharmacies to obtain medications from multiple sources. Repeated instances of misplacing prescriptions or requesting early refills are red flags. Behavioral changes, such as mood swings, hostility, change in sleep habits, poor decision-making, or being unusually energetic are signs that something may be amiss.

Health Effects of Prescription Drug Addiction

When prescription medications are used as prescribed, they are relatively safe. However, misuse and abuse of prescription drugs can lead to many health problems, including addiction, overdose, and death. Some of the serious health consequences of prescription drug addiction are:

Opioids: Low blood pressure, slowed breathing, coma, overdose, and death.

Stimulants: High body temperature, high blood pressure, heart problems, seizures, hallucinations, paranoia, and aggression.

CNS Depressants: Low blood pressure, slowed breathing, memory problems, coma, overdose, and death. Abruptly stopping sedatives, hypnotics, tranquilizers, and anti-anxiety medicines can lead to seizures and withdrawal symptoms.

Prescription drugs can be especially dangerous when they are combined with other prescription or over-the-counter medications, illegal or recreational drugs, or alcohol.

Mixing Prescription Drugs with Other Substances

A prescription or over-the-counter medication can interact with other drugs and cause serious adverse effects. Drugs can also interact with food, caffeine, and alcohol. That’s why it is important to tell the prescribing doctor about any other drugs, supplements, alcohol, or illicit substances you are using. This can prevent dangerous interactions between your prescription medications and other substances.

An estimated 8.5 million Americans reported misusing prescription opioids in the past year in 2022. ^[22] The consequences of opioid misuse are particularly dangerous when prescription pain relievers are misused in combination with alcohol. Drinking alcohol while using opioid painkillers can lead to a dangerous suppression of the drive to breathe. This can lead to slowed or stopped breathing which can be fatal. This happens because both alcohol and opioids are central nervous system (CNS) depressants. ^[23]

In more than half of overdose cases in which opioid drugs are implicated, concomitant use of alcohol plays a prominent role. ^[24]

Prescription stimulant medications should not be mixed with over-the-counter cold medicines that contain decongestants. Combining these drugs can lead to a dangerous increase in blood pressure or irregular heart rhythm.

Prescription Drug Addiction and Pregnancy

Some prescription medications, such as opioid pain pills, can cause problems for both the expectant mother and her baby when taken during pregnancy. The baby is exposed to the opioid drugs through the mother and can develop a dependence on them. After birth, this can lead to a condition called neonatal abstinence syndrome (NAS) because the baby no longer is exposed to the opioid. Babies with NAS experience opioid withdrawal symptoms when they no longer get the opioid drug from their mother. Treatment for NAS can require a prolonged stay in the neonatal intensive care unit. Also, healthcare workers are mandated to report this condition, which means that child protective services (CPS) will be notified. CPS workers can remove a child from the custody of the parents if there is a positive drug screen.

With the increasing prevalence of prescription drug addiction in the United States, the incidence of neonatal abstinence syndrome has also been increasing. Opioid-associated NAS increased five-fold from 2000 to 2012. Hospital charges related to NAS were an estimated $1.5 billion in 2012. ^[25]

In 2019, approximately 7% of pregnant women reported using prescription opioid pain relievers. Of these, 20% reported misusing these drugs, i.e., obtaining them from non-medical sources or using them for reasons other than pain relief.

The number of women with opioid related health complications at the time of delivery increased by 131% from 2010 to 2017. The number of babies born with NAS increased by 82% from 2010 to 2017.

In 2020, about 6 newborn babies were diagnosed with neonatal abstinence syndrome (NAS) for every 1,000 newborn hospital stays. More than 59 babies are diagnosed with this condition every day, which is one every 24 minutes.

The cost of a hospital stay for a newborn with NAS is nearly 7 times that of other newborn hospital stays ($7,800 in 2020 compared to $1,100).

The average length of stay for a newborn with NAS is nearly 5 times longer (9 days in 2020 compared with 2 days for other newborn babies). ^[26]

Preventing Prescription Drug Addiction

Many people take prescription drugs such as opioid painkillers, stimulants, or sedatives for various medical conditions. They can obtain the benefits of these drugs without becoming addicted to them. However, some people, unfortunately, develop a prescription drug addiction. If you have been prescribed a commonly abused prescription drug, you can reduce your risk of prescription drug addiction by: ^[27]

• Following your doctor’s dosing instructions carefully.
• Telling your doctor about all your other prescription and over-the-counter medicines, dietary supplements, herbal products, as well as any illegal drugs or alcohol use.
• Checking with your doctor regularly to report symptoms. Making changes in your dose only if approved by your healthcare provider.
• Never using someone else’s prescription medication, even if you have very similar symptoms.
• Never ordering prescription medications from unauthorized sources. These drugs could be counterfeit and may be harmful.
• Asking your doctor about the long-term risks (including addiction) of any prescribed medication.
• Taking “drug holidays” or skipping days (with your doctor’s approval) to avoid tolerance and dependence.

Parents and guardians of teenagers can do several things to reduce the risk of prescription drug addiction in their children. It’s important to frankly discuss the dangers of misusing prescription medications, including addiction and overdose. Parents should set clear rules about taking medications prescribed to others, including friends and relatives. All prescription medications should be kept safely out of reach of children at home. Parents should keep track of prescription pill quantities. Also, adults should take precautions to ensure that adolescents cannot order prescription drugs online. Unused prescription medicines should be carefully disposed of.

Prescription Drug Overdose

Like street drugs, a person can overdose on prescription medications. An overdose occurs when someone uses large amounts of the drug within a short period, producing life-threatening symptoms. A prescription drug overdose can be intentional or unintentional.

The signs and symptoms of overdosing on commonly abused prescription medications are as follows:

CNS depressant overdose symptoms: Slowed or stopped breathing, leading to hypoxia (lack of oxygen) in the brain, coma, and permanent brain damage.

Prescription opioid painkiller overdose: Slowing or stopping of breathing, leading to a decreased amount of oxygen reaching the brain, resulting in coma, permanent brain damage, and death.

Prescription stimulant overdose symptoms: Rapid breathing, tremors, restlessness, overactive reflexes, confusion, hallucinations, aggression, panic, high fever, weakness, and muscle aches.

A drug overdose is a medical emergency. If you suspect someone has overdosed, call 911 for immediate medical attention. Medications are available that can reverse the effects of an overdose and save the person’s life.

Prescription Drug Withdrawal

People who have developed a prescription drug addiction may experience withdrawal symptoms and severe cravings if they abruptly stop using the drug or reduce the dose. Withdrawal symptoms include both physical and psychological effects. They can begin within a few hours of the last dose. The withdrawal symptoms associated with commonly abused prescription drugs are as follows:

CNS depressant withdrawal symptoms: Seizures, agitation, anxiety, insomnia, hallucinations, increased heart rate, increased blood pressure, sweating. ^[28]

Opioid pain pill withdrawal symptoms: Sleeping problems, muscle and bone pain, vomiting, diarrhea, cold flashes, uncontrolled leg movements. ^[29]

Prescription stimulant withdrawal symptoms: Depression, sleep problems, fatigue.

If you suspect that a loved one may be misusing or abusing prescription medications, talk to a healthcare provider to get help. Medically supervised detoxification and behavioral therapies can effectively help people to stop abusing these drugs and overcome prescription drug addiction.

Treating Prescription Drug Addiction

Treatment programs for prescription drug addiction include medically managed detox and withdrawal-symptom management. This is often followed by counseling and therapy to change behaviors and better equip the person to deal with cravings and triggers. Some of the common forms of treatment for prescription drug addiction include:

• Inpatient rehab or detox
• Residential or sober living programs
• Intensive outpatient group/individual treatment
• Individual outpatient counseling

Some prescription drug addictions, such as opioid pain pills, can be treated with medicines such as methadone and suboxone. These medicines reduce the effects of opioids, lessen cravings, and control withdrawal symptoms.

What to Expect when Calling A Prescription Drug Helpline

When you call a prescription drug addiction hotline, you will connect with an advisor who is experienced in helping people struggling with substance abuse. They will not judge you or make you feel bad about what you’ve been through. Instead, they will listen to your story and answer your questions. Prescription pill abuse hotlines have helped countless others dealing with this problem find the information and resources to finally get help.

During your call, you can talk about whatever is on your mind. Our prescription drug helpline specialists are there to answer all your questions. Here are some topics that are often discussed during calls to our helpline:

• Signs of drug abuse and addiction
• The history of the affected person’s drug use
• How drugs are currently affecting you (e.g. family problems, fired from work, etc.)
• How to talk to a loved one about drug abuse
• Treatment options available
• Preventing prescription drug abuse
• Information for choosing an appropriate treatment center

Feel free to get all the information you want. Don’t be afraid to ask questions or get clarification if there is something you don’t understand. The call may be emotional due to all the feelings you’ve been holding inside. That is okay. The hotline specialist understands how difficult these calls can be and will provide emotional support.

Finally, make sure you have something nearby to take notes. You will get a lot of valuable information that will be easier to remember if you write it down.

Last updated: March 30, 2024