When some people think about drug abuse, they often picture a person roaming the streets to purchase illegal drugs. In fact, more and more people are turning to their own medicine cabinets to get high. Prescription drug abuse affects people of all ages and walks of life. Those who misuse prescriptions risk serious health issues and addiction. Also, taking medications not prescribed to you may cause dangerous interactions with any other medications or substances you are using. Prescription drug abuse includes:
- Using a larger dose than prescribed.
- Taking someone else’s prescription medications.
- Using medicine to get high.
- Taking medicine in ways not prescribed. For example, crushing pills then snorting them.
Some of the most common prescription drugs that people abuse are opioid painkillers, sedatives, stimulants, and anti-anxiety medications. These prescriptions could be habit-forming, especially if someone has a history of addictive behaviors like smoking or alcohol use.
What Is Prescription Drug Addiction?
Prescription drug addiction occurs when a person who is taking a prescribed medication becomes physically or psychologically dependent on it. This can happen when a person takes an addictive drug 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.
Commonly Misused Prescription Drugs
Most 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 addictions to prescription drugs that have valid medical uses but are considered dangerous because of a high potential for abuse and addiction, including: 
- Opioid pain relievers 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 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) 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. 
Prescription Drug Abuse in the United States
Over the last few decades, 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%.  This dramatic increase in prescription drug addiction prompted the need for urgent action.
Clinicians were encouraged to balance access to prescription drugs among 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. 
According to the 2017 NSDUH survey, roughly 2 million Americans misused prescription pain pills for the first time in the past year. That’s an average of nearly 5,500 people initiating pain pill misuse every day. Also, more than 1 million Americans initiated prescription stimulant misuse, 1.5 million misused tranquilizers, and 270,000 misused sedatives for the first time. Roughly 6% of high-school seniors reported Adderall (prescription stimulant) misuse. Also, 2% of teenagers reported Vicodin (prescription pain reliever) misuse in 2017.
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:
- 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%).
- 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. 
- Admissions for prescription opioid addiction represented 16% of all primary opiate admissions in 2003. This number increased to 33% in 2013. 
- From 2004 to 2011, there was a significant increase in ED visits and overdose deaths from the combined use of opioids and benzodiazepines. 
- Between 2000 and 2016, there was a 200% increase in overdose deaths involving opioids (prescription opioids plus heroin). 
- Pain-reliever abuse was the second most common type of drug abuse in the US in 2018, with 3.6% of the population misusing. 
- In 2017, there were almost 58 opioid prescriptions written for every 100 Americans.
- In 2018, an average of 41 Americans died every day from prescription opioid overdoses, with roughly 15,000 deaths per year.
Reasons for Misusing Prescription Drugs
People misuse and abuse prescription drugs for various reasons. Many may begin using the medication only as prescribed and may begin taking more because they develop a tolerance. Others will begin using the medication more often than they are recommended to because of the effects of the drug.
Different prescription medications cause different effects and may be abused by people who desire the specific effects of the medication.
Some people take these medications to improve academic or work performance, as “study drugs”, or to gain a competitive edge at work or school. Older adults may misuse prescription stimulants to improve concentration and memory.  Appetite suppression is a common side effect of prescription stimulants. About 12% of young adults surveyed by a group of researchers reported that they used prescription stimulant drugs for weight loss. 
Opioids make people feel relaxed and euphoric. Some people use them 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. 
Prescription Sedatives, Hypnotics, and Tranquilizers
These drugs are often abused by people who struggle with anxiety or insomnia. Once a person becomes addicted, these can be symptoms of withdrawal, which makes it harder for the person to avoid relapse. 
Who Is at Risk of Prescription Drug Addiction?
Whenever a prescription medication is taken other than as prescribed or for a non-medical reason, there is a risk of developing an addiction. Many people mistakenly believe that prescription drugs are safer than illegal street drugs. Also, some people are misinformed or do not realize the addictive potential of prescription drugs.
Certain people are at higher risk of developing an addiction to prescription medications like sedatives, opioids, and stimulants. Family members and friends of such people 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. Also, the combination of alcohol and some prescription medications like opioid pain pills can result in a dangerous slowing of breathing, and other health effects.
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. 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 high risk of prescription drug addiction are those with chronic medical conditions, such as severe, longstanding pain. Prescription drug abuse and addiction is reported in up to 45% of patients with chronic pain by some researchers. 
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. 
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:
- Poor reflexes
- 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
- Slurred speech
- Slowed breathing
- Increased alertness
- Increased body temperature
- Increased blood pressure
- Irregular heartbeat
- Reduced appetite
- Anxiety, agitation, paranoia
Besides the above-mentioned physical signs, it’s important to be vigilant for behavioral evidence of 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 over-the-counter medications, illegal or recreational drugs, or alcohol.
Mixing Prescription Drugs with Other Substances
Any medication can have adverse reactions with other drugs, including alcohol and caffeine. It is always recommended to inform the prescribing doctor about any other drugs, supplements, alcohol, or illicit substances you are using. This can prevent dangerous interactions between prescription medications and other substances.
An estimated 10 million Americans misuse prescription opioids each year, with 2 million people misusing these drugs for the first time. The consequences of opioid misuse can be particularly dangerous when prescription pain relievers are misused in combination with alcohol. Mixing the two can result in slower disposal of these substances from the body and higher toxicity. 
Drugs that slow down breathing, such as opioids, alcohol, and CNS depressants, should not be taken together. In more than half of overdose cases in which opioid drugs are implicated, concomitant use of alcohol plays a prominent role. 
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, when taken by a pregnant woman can lead to opioid addiction in the baby, who gets exposed to the drugs through the mother. The baby, when born, can have a condition called neonatal abstinence syndrome (NAS). Babies with NAS experience opioid withdrawal symptoms because they are no longer getting the opioid drug from the mother. Treatment for NAS may require a prolonged stay in the neonatal intensive care unit, and healthcare workers are mandated reporters, which means that child protective services (CPS) will be notified. CPS workers can remove a child from the custody of their parent 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. 
Preventing Prescription Drug Addiction
Many people take prescription drugs like opioid painkillers, stimulants, or sedatives for various medical conditions. Most can obtain the benefit 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: 
- Following your doctor’s directions carefully concerning the dose and method of use.
- Telling your doctor about all your other prescription medicines, over-the-counter medicines, and herbal supplements, as well as any illegal drugs or alcohol use.
- Checking with your doctor regularly to report symptoms and make changes in dose.
- Never using another person’s prescription medication, even if they have very similar symptoms.
- Never ordering prescription medications from unauthorized sources, since the drugs could be counterfeit and may cause you harm.
- Asking your doctor about long-term risks (including addiction) for any prescribed medication.
- Taking “drug holidays” or skipping days (with 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 under lock 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 an overdose of 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. 
Opioid pain pill withdrawal symptoms: Sleeping problems, muscle and bone pain, vomiting, diarrhea, cold flashes, uncontrolled leg movements. 
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. Behavioral therapies can effectively help people to stop misusing 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 counseling for 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 that reduce the effects of opioids, lessen cravings, and control withdrawal symptoms, including methadone and suboxone.
What to Expect when Calling A Prescription Drug Helpline
When you call a prescription drug addiction hotline, you connect with someone focused on helping people struggling with substance abuse. They will not judge you or make you feel bad about what you’ve been through. Instead, they are ready to listen to your story and help with your questions. They helped countless others dealing with prescription pill abuse to find the information and resources to finally get help.
During your call, you can talk about whatever is on your mind. The prescription drug abuse helpline specialists are there to help. Here are some topics often discussed during prescription drug addiction helpline calls:
- 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 their drug use
- Treatment options available
- Preventing prescription drug abuse
- Information for choosing an appropriate treatment center if necessary
Feel free to use all the time you need to get the information you want. Don’t be afraid to ask questions or ask for 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 written down.
Last updated: March 8, 2023
Hailey Shafir, M.Ed., LCMHCS, LCAS, CCS
Hailey Shafir is a licensed addiction specialist and mental health counselor. She graduated from North Carolina State University with a master of education in clinical mental health counseling in 2012, and has developed deep expertise in the areas of mental health, behavioral addictions and substance abuse. She is passionate about using this knowledge to raise awareness, provide clear and accurate information, and to improve the quality of treatment for these disorders.
Hailey is an LCMHCS (license number: S9539) under the North Carolina Board of Mental Health Counselors, and an LCAS (ID: LCAS-21333) and CSS (ID: CCS-20721) under the North Carolina Addictions Specialist Professional Practice Board.
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