Prescription drug abuse is a major health issue in the United States. Data from the National Survey on Drug Use and Health indicate that around 16 million people aged 12 and older reported misusing prescription medications in the past year. This figure highlights a significant issue with prescription drug misuse across the United States.
Understanding Prescription Drug Abuse
Prescription drug abuse occurs when someone uses medication in a way that deviates from medical guidelines, often exceeding prescribed dosages or using it for recreational purposes. This misuse can stem from leftover medications after treating an injury or from developing an addiction to the euphoric effects of these drugs. Many prescription drug abusers initially obtain these medications from friends or relatives, which serves as a common entry point.
The most frequently abused prescription drugs include:
Prescription drug abuse has become an increasingly dangerous trend over the last two decades, driven in part by rising diagnosis and prescription rates, as well as misconceptions about the risks associated with these medications. The most at-risk populations include youth, seniors, and women.
Why Prescription Drug Abuse is So Dangerous
Prescription drug abuse often begins under the guise of legitimate medical treatment, leading many users to believe these medications are safer than illicit drugs. Addiction can develop gradually, with users often unaware that they are becoming dependent on an addictive substance. The dangers of prescription drug abuse are evident in the rising number of emergency room visits and overdoses linked to these medications. According to the National Survey on Drug Use and Health, nearly 12% of those who reported non-medical use of prescription drugs in the past year met the criteria for addiction. Opioids, the most hazardous of these drugs, have seen a fourfold increase in overdose deaths since 1999.
Prescription Drug Abuse Among Youth
In the U.S., nearly 5% of adults aged 18 to 25 reported misusing prescription medications in the past year, a rate higher than any other age group surveyed. Among youths aged 12 to 17, the figure dropped to 1.6%. According to the National Institute on Drug Abuse’s Monitoring the Future Survey, prescription drugs are the most commonly used recreational substances after tobacco, alcohol, and marijuana.
The survey revealed a slight decline in the abuse of opioid painkillers and central nervous system depressants in recent years, while stimulant misuse has risen. This increase may be due to limited public awareness of the addictive nature of stimulants compared to the extensive media coverage of the opioid crisis. Many respondents also reported obtaining these drugs from friends or relatives.
Prescription Drug Abuse Among Older Adults
As people age, the likelihood of regularly taking prescription medications increases significantly. For instance, over 80% of older adults aged 56 to 86 use at least one prescription medication daily, with more than 50% taking multiple medications each day. Due to the high prevalence of chronic illnesses among seniors and the associated health risks of prescription drug misuse, this population is particularly vulnerable. It is crucial for seniors to limit their medication use to those prescribed by their primary healthcare provider. Additionally, they should store and secure their medications to prevent them from being diverted. A small percentage of prescription drug abusers obtain their supply by stealing from the medicine cabinets of older adults.
Prescription Drug Abuse Among Women
Women represents another vulnerable group when it comes to prescription drug abuse. Although overall, more men than women misuse prescription drugs, adolescent females have higher rates of usage across all categories, including painkillers, sedatives, and stimulants. This age group is also more likely to meet the criteria for substance use disorders. Additionally, the rate of opioid overdose among women has risen more rapidly than that of men.
The Dangers of Prescription Drug Abuse
According to the Drug Abuse Warning Network (DAWN), in 2011, over 1.2 million emergency room visits were related to the recreational use of prescription medications, accounting for approximately 50% of all ER visits that year. Opioids were involved in nearly 40% of these visits, representing a threefold increase from 2005 to 2011. During the same period, ER visits related to central nervous system depressants also quadrupled. In 85% of these cases, the depressants involved were benzodiazepines, such as Xanax, Librium, and zolpidem, a prescription sleep aid.
Prescription medications are particularly hazardous when combined with other substances, despite the false sense of safety and relative ease of access. While many users know they shouldn’t mix medications with other substances, they may not fully understand the specific risks. Some patients face significantly higher dangers from certain drug combinations. Even mixing prescription drugs with over-the-counter medications, tobacco, or alcohol can lead to dangerous side effects. For instance, combining central nervous system depressants can be fatal, as their effects are intensified when taken together. Mixing opioids with alcohol can result in respiratory depression while combining stimulants with over-the-counter cold medicine can cause spikes in blood pressure or irregular heart rhythms.
Prescription Opioids
Opioid medications are commonly prescribed to help patients manage the physical pain associated with traumatic injuries or chronic illnesses. Ironically, these drugs can lead to even greater long-term suffering due to their highly addictive nature. Common prescription opioids include:
Hydrocodone is among the most frequently prescribed medications in the U.S., used for various types of pain, including dental and injury-related discomfort. Oxycodone and oxymorphone are also widely prescribed for moderate to severe pain relief. Morphine is commonly used in surgical settings, while codeine and diphenoxylate are used to relieve coughs or severe diarrhea.
When taken as prescribed by a physician, opioids can be effective in safely managing pain. However, this does not eliminate the risk of developing a debilitating addiction, nor does it entirely prevent the danger of taking too large a dose and risking severe respiratory depression. Using opioid medications daily for more than a week can lead to withdrawal symptoms and increase the risk of addiction if the drug is suddenly stopped. Tolerance to opioids develops quickly, and withdrawal symptoms can begin within hours of the last dose, depending on the user’s circumstances. Early signs of withdrawal include watery eyes, runny nose, yawning, and sweating, followed by restlessness, irritability, and loss of appetite. As withdrawal intensifies, symptoms may include diarrhea, shivering, muscle cramps, increased sensitivity to light and pain, insomnia, and a general sense of malaise. These symptoms, often likened to the flu, can last from a few days to a week. Beyond the painful withdrawal experience, there’s also the risk of transitioning to heroin, as misuse of prescription opioids is a significant risk factor for heroin addiction.
Healthcare providers face challenges in managing opioid prescriptions. On one hand, opioids are the most effective means available for temporarily alleviating physical pain, and most patients who use them do not develop addictive habits. However, research on the percentage of the population that becomes addicted to prescription opioids remains inconclusive, with estimates ranging from 3% to 26%, depending on study size, demographics, and duration.
To safely prescribe opioids, doctors must assess pain levels and evaluate the patient’s risk of addiction before prescribing. Following the CDC Guidelines for Prescribing Opioids for Chronic Pain can help mitigate the risk of addiction by providing clinicians with clear rules for appropriate administration. Doctors should prescribe the lowest effective dose for the shortest necessary duration, and patients should undergo routine monitoring to ensure they do not become dependent on the medication.
Prescription Central Nervous System Depressants
Central nervous system (CNS) depressants are a class of drugs used to alleviate anxiety, reduce stress, and slow brain activity. They are particularly effective in treating mood disorders and insomnia. However, similar to opioids, long-term use of these drugs can worsen the conditions they are meant to treat. The most common types of CNS depressants include:
CNS depressants are particularly dangerous because they impair a person’s ability to make safe decisions and function physically. With prolonged use, higher doses are required to achieve the same therapeutic effects, increasing the risk of overdose, though it is less likely than with opioids. Withdrawal from CNS depressants can be intensely painful and challenging.
Prescription Stimulants
Stimulant medications serve various medical and recreational purposes. Medically, they are primarily prescribed to treat attention deficit hyperactivity disorder (ADHD) and are intended to enhance alertness, and attention, and increase blood pressure, heart rate, and breathing. Recreationally, stimulants are used to achieve heightened alertness, energy, and a pleasurable sense of well-being. When injected or smoked, they can produce intense euphoria. Common forms of stimulants include amphetamines, cocaine, methamphetamines, pseudoephedrine, and more. The most widely used prescription stimulants are amphetamine (e.g., Adderall, Dexedrine) and methylphenidate (e.g., Ritalin).
Stimulants are frequently prescribed to young adults and adolescents, making them highly susceptible to abuse within this age group. These drugs enhance wakefulness, focus, and energy, which can be particularly appealing to students and professionals seeking a competitive edge. Historically, military personnel have also abused prescription stimulants to improve their performance and alertness. This drive for an advantage in academics and the workforce often leads individuals to view these drugs as essential. However, prolonged use and dependence can lead to significant adverse effects. Withdrawal symptoms from stimulants include lethargy, anxiety, persistent fatigue, and difficulty concentrating.
Next Steps
Prescription drug abuse may impact millions of Americans, but there are strategies to prevent misuse and reduce the risk of progressing to more dangerous substances. Physicians play a crucial role in diagnosing and monitoring patients who require prescription medications as part of their treatment plan. State governments can enhance their efforts by implementing prescription drug monitoring programs to track better and identify instances of abuse. For those struggling with prescription medication addiction, drug rehabilitation centers offer hope and recovery. At Sunrise Recovery, we are dedicated to providing a supportive network and access to resources designed to help you overcome addiction. Visit our website to learn more about our drug and alcohol addiction treatment in Indiana.
