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Prescription abuse may not appear to be a significant issue, but the consequences of misusing prescription medications, including opioids and stimulants, are grave.
The extent of this problem should not be underestimated. According to the 2014 NSDUH (National Survey on Drug Use and Health), among the 27.1 million Americans using illicit drugs, 6.4 million were misusing psychotherapeutic drugs. The NSDUH categorizes psychotherapeutics as a combination of prescription painkillers, stimulants, sedatives, and tranquilizers.
Among these, opioids are perhaps the most prominently discussed drugs of abuse, carrying some of the most severe associated risks. The US Centers for Disease Control and Prevention has reported a 200% increase in the rate of opioid overdose since 2000.
While these statistics may seem alarming, they are only getting worse. So, what is the current scope of this issue?
How Serious Is the Problem of Prescription Abuse?
The 2017 NSDUH revealed that 18 million Americans misused prescription medications at least once in 2017.
In that same year, 2 million Americans misused prescription painkillers for the first time. The survey also indicated that over 1 million individuals misused prescription stimulants, 1.5 million misused prescription tranquilizers, and more than a quarter-million misused sedatives for the very first time. This translates to thousands of individuals beginning to misuse their prescription medications each day, alongside millions already engaged in abuse.
As discussed in our recent study of opioid use disorder, misinformation regarding the addictive properties of opioids in the 1990s led to an increase in prescriptions for these drugs by well-meaning doctors. Coupled with the fact that prescription medications are often more accessible than street drugs, the issue is escalating.
The misuse of prescription drugs can result in serious medical consequences, including addiction and overdose.
Before delving into the primary forms of prescription abuse and misuse, it is essential to clarify the terminology. While these terms are sometimes used interchangeably, subtle distinctions exist in their meanings.
What Is Prescription Misuse?
Prescription misuse refers to the use of medications in a manner that deviates from legal or medical guidelines. This term is most commonly applied to prescription drugs.
The most frequent forms of misuse include taking a higher dosage than prescribed or using a medication that has not been prescribed for you.
While prescription misuse often leads to abuse, this is not always the case.
What Is Prescription Abuse?
Prescription abuse occurs when the illicit use of prescription drugs or the consumption of excessive amounts begins to interfere with your daily life, indicating a more serious issue.
You may have transitioned from misuse to abuse if you experience one or more of the following consequences from medication use:
- You notice health-related issues
- You begin to neglect your responsibilities
- You develop physical dependence
- You experience withdrawal symptoms when attempting to stop the medication
- You find yourself craving the medication
Although the Diagnostic and Statistical Manual of Mental Disorders (DSM) no longer employs the term “substance abuse” in the latest DSM-5, these criteria are derived from that framework and are evaluated on a continuum of severity.
Thus, misuse can easily escalate into abuse, and the risks associated with improper use of prescription medications can be substantial. These risks can vary based on the specific type of medication involved. So, what are the most common culprits?
Most Frequently Misused Medications
Prescription abuse primarily occurs with the following three types of medications:
- Opioid Painkillers: OxyContin, Vicodin, Percocet
- CNS (Central Nervous System) Depressants: Valium, Ambien, Ativan
- Stimulants: Ritalin, Adderall, Dexedrine
The methods of abuse, as well as the signs and symptoms, vary significantly among these medications, necessitating individual examination.

1) Opioid Painkiller Abuse
Opioids are commonly prescribed for managing severe pain. This class of medications interacts with opioid receptors in the brain and spinal cord to diminish the perception of pain.
Historically used as general painkillers, opioids have recently been prescribed in increasing numbers for acute pain management. Since the 1990s, however, they have also been frequently prescribed for chronic pain. There is limited evidence supporting their long-term effectiveness, and it is alarmingly easy to develop a dependency on these medications.
Tolerance can build quickly, as opioids stimulate the brain’s reward centers. In some instances, sensitivity to pain may worsen instead of improve, a phenomenon known as hyperalgesia.
So, why have opioids been increasingly prescribed for chronic pain, ultimately leading to the opioid epidemic being declared a public health emergency in 2017?
One contributing factor is the influence of pharmaceutical companies.
In 1991, a significant increase in opioid-related deaths was observed. Pharmaceutical companies and medical organizations promoted opioid painkillers for pain management, claiming there was minimal risk of addiction.
By 2010, there was also a dramatic rise in heroin-related deaths. Initial efforts to reduce opioid prescriptions inadvertently led many individuals who could no longer access prescription opioids to turn to heroin, often with fatal outcomes. Alarmingly, 80% of heroin users reported prior use of prescription painkillers.
The CDC (Centers for Disease Control and Prevention) has established detailed guidelines aimed at curbing the over-prescription of opioid painkillers, despite ongoing lobbying from pharmaceutical companies that complicates these crisis management efforts.
There is no denying that opioid misuse remains a significant issue in the United States. So, what signs should you watch for if you suspect you may be becoming overly reliant on prescription painkillers?
Signs and Symptoms
If you experience any of the following symptoms as a result of using prescription opioids, you may have crossed into the territory of misuse or even abuse:
- Confusion
- Constipation
- Drowsiness
- Euphoria
- Impaired coordination
- Increased dosage required for pain relief
- Heightened sensitivity to pain
- Nausea
- Slow breathing rate
In addition to these physical and psychological symptoms, seeking prescriptions from multiple doctors or requesting early refills indicates that you are already misusing your medication.
If you believe you are developing a problem, it is important to communicate openly and honestly with your doctor. The progression from opioid misuse to abuse and addiction can lead to severe consequences.
Consequences
When taken as prescribed, opioid painkillers are generally effective and safe for managing pain. It is uncommon for opioid use disorder to develop after just a few days of use as directed by a physician.
However, long-term use or misuse of prescriptions can quickly lead to increased tolerance and dependence. Dependence may develop in as little as four to eight weeks. Attempting to discontinue opioid use can result in withdrawal symptoms that are so uncomfortable that quitting without professional help can be difficult and even dangerous.
Abusing opioids significantly heightens the risk of overdose. A single heavy dose can cause respiratory depression, which can be fatal. These risks are further exacerbated when opioids are used in conjunction with alcohol or sedatives.
Moreover, as noted earlier, abusing prescription opioids can increase the likelihood of transitioning to heroin use. Nearly one-third of Americans who use drugs for the first time may start down the path to addiction with prescription painkillers, highlighting the grave and widespread dangers associated with opioid prescription abuse.
If you or someone you know exhibits any of the symptoms mentioned above, it is crucial to consult your doctor, even if they are the one prescribing the medication. Taking action sooner rather than later will make it easier to recover from opioid dependence. Start the process of rebuilding your life before a medication intended to help you begins to have the opposite effect.

2) CNS Depressant Abuse
Central nervous system (CNS) depressants include:
- Hypnotics
- Sedatives
- Tranquilizers
These medications work by slowing down brain activity, making them useful for treating sleep disorders and anxiety disorders.
Different classes of CNS depressants function in various ways.
The benzodiazepine family, which includes medications like Valium, Klonopin, and Xanax, can be effective for short-term management of sleep disorders. However, tolerance can develop rapidly, leading to their infrequent prescription for long-term use. Many individuals who begin using benzodiazepines may misuse their prescriptions or seek these medications on the black market.
Non-benzodiazepine sleep medications have a different chemical structure and typically present fewer side effects. However, medications such as Ambien are still commonly misused.
Tranquilizers like Nembutal pose a significantly higher risk of overdose and are more frequently prescribed for seizure disorders rather than for anxiety or sleep disorders.
While the calming and sedative effects of CNS depressants offer various medical benefits, the potential for misuse is a serious concern within this class of medication.
Signs and Symptoms
If you are taking any form of CNS depressants and begin to experience the following symptoms, you may be entering the realm of misuse:
- Confusion
- Dizziness
- Drowsiness
- Decreased concentration
- Memory issues
- Slowed breathing
- Slurred speech
- Unsteadiness while walking
Consequences
Like any prescription medication, CNS depressants should only be used as directed.
Using these medications for a longer duration than recommended by your doctor can lead to the development of tolerance, meaning you’ll need higher doses to achieve the same effects. For this reason, central nervous system depressants are seldom prescribed for more than a few days.
Continuing use beyond this point can result in dependence and withdrawal symptoms when you attempt to stop. While withdrawal from benzodiazepines can be uncomfortable, it rarely becomes life-threatening. In contrast, withdrawal from tranquilizers can lead to serious complications, which can be fatal.
If you have been misusing your prescription for CNS depressants and wish to stop, it is essential to discuss your plans with your healthcare provider instead of attempting to quit abruptly on your own.

3) Stimulant Abuse
Prescription stimulants have historically been used to treat a wide range of conditions. Currently, their primary applications are for treating ADHD (attention deficit hyperactivity disorder) and narcolepsy.
While misuse of prescription stimulants is less common due to their limited uses, it still poses a significant issue, particularly among young adults.
When taken as prescribed, these medications can enhance alertness and energy levels, as well as improve concentration by affecting dopamine signaling in the brain.
Drugs like Ritalin and Adderall are often misused by students seeking to improve focus and sustain alertness. Additionally, stimulant medications can produce feelings of euphoria, leading to their frequent misuse for recreational purposes.
How can you determine if you are beginning to abuse these prescription stimulants?
Signs and Symptoms
If you begin to notice any of the following symptoms, it’s important to consider whether you might be misusing your prescription stimulants:
- Agitation
- Anxiety
- Increased alertness
- Euphoria
- Elevated body temperature
- High blood pressure
- Insomnia
- Irregular heartbeat
- Reduced appetite
- Paranoia
If you have concerns about your use of these medications, don’t hesitate to consult your doctor. The consequences of misuse can be severe.
Consequences
Although dependence on prescription stimulants may take time to develop, once addiction occurs, withdrawal symptoms can be intense. You may experience fatigue, depression, and disrupted sleep patterns, making it challenging to stop using these medications without support.
Chronic and excessive misuse can lead to heightened hostility and significant paranoia, which, in extreme cases, can result in psychosis.
Additionally, the risk of dangerously elevated body temperature and irregular heartbeats increases. While rare, the potential for cardiovascular failure and seizures signifies a considerable overall risk associated with the abuse of prescription stimulants. With the rise in prescriptions in recent years, misuse often involves using medications intended for someone else.

What to Do If You Are Misusing Prescription Drugs
Each type of prescription drug carries specific medical risks when abused.
Regardless of the medication, misuse can lead to physical dependence and addiction. Furthermore, abusing prescription drugs increases the likelihood of accidents, may entice you to use illicit substances, and could result in engaging in criminal activities. Additionally, it can negatively affect your work performance and strain personal relationships.
Even if your initial use of prescription medication was sanctioned by a doctor and completely legal, misuse can quickly escalate to severe consequences.
If you or someone you know is misusing prescription medication, it’s crucial to speak with your doctor.
For guidance on any aspect of prescription abuse, feel free to contact Sunrise Recovery at +1 (877) 978 – 6747.