Delving Into the Prescription Drug Addiction and Abuse Epidemic
Millions of Americans safely use prescription medications every day. But what about those who are unable to control their use and find themselves in the territory of prescription drug abuse?
119 million Americans over the age of 12, or 1 out of 3 people, take some type of prescription drug, according to a federal survey. Today's consumer culture has lead to a "take a pill to make it go away" type of mentality, resulting in such high rates of use.
Alcohol Recovery Information
Despite the trend of treating symptoms rather than causes, millions of Americans find these prescriptions beneficial in their daily lives.
They use their medication properly and go about their business. These medications help them combat symptoms that would otherwise impact their ability to function productively.
Problems arise, though, for those who misuse or abuse their prescription drugs. 16 percent of those 119 million individuals misuse their prescription medication. Whether their use constitutes abuse or addiction, over 19 million Americans struggle with using their medication as prescribed.
What are prescription drugs? How do they function in today's society? How do people become addicted to prescription medications? Is there any way to tell if someone is abusing their medication to intervene before it's too late?
Learn more about the role prescription drugs play in the United States today. By understanding the impact they have on such a significant portion of the population, you can prepare yourself to potentially help someone struggling with addiction.
Prescription Drug Abuse and Addiction Statistics
Prescription drugs are the 4th most misused mind-altering substance in America, with 6.3 million people reporting misuse in the past month alone. According to a study conducted by the Substance Abuse and Mental Health Services Administration in 2015, misuse of prescription drugs is only beat by the misuse of alcohol, tobacco, and marijuana.
Rates of misuse for specific types of prescription medications are also significant. Painkillers, tranquilizers, stimulants, and sedatives each fall within the top 15 most misused drugs in America.
The following list shows the number of people 12 and older who report misuse of the substance in the past month alone:
- Alcohol: 138.3 million
- Tobacco: 50.9 million
- Marijuana: 22.3 million
- Prescription medications: 6.4 million
- Painkillers: 3.8 million
- Cocaine: 1.9 million
- Tranquilizers: 1.9 million
- Stimulants: 1.6 million
- Hallucinogens: 1.2 million
- Methamphetamine: 897 thousand
- Ecstasy: 557 thousand
- Inhalants: 527 thousand
- Sedatives: 446 thousand
- Crack: 394 thousand
- LSD: 352 thousand
With 1 in 50 people reporting misuse in the past month alone, it's clear that prescription medication abuse is a significant problem in the United States. Legislators continue to work actively to instate new laws to reduce the prevalence and availability of prescription drugs. Prescription drugs are especially dangerous because when the money to continue affording pills runs out, some people turn to harder alternatives.
What Are Prescription Drugs?
There are hundreds of types of prescription medications available, both brand name and generic. 1,453 different types of drugs have been approved by the Food and Drug Administration as of December 2013.
Prescription drugs are used to treat either causes or symptoms of various conditions, both physical and psychological. Depending on the drug, these chemical compounds react on different parts of the brain.
Some common types of prescription painkiller medications include:
- Oxycodone (brand names include Percodan, Percocet, Roxicet, and OxyContin)
- Hydrocodone (brand names include Norco and Vicodin)
- Meperidine (brand names include Demerol)
- Hydromorphone (brand names include Dilaudid)
Prescription painkillers, also referred to as opioids, are a synthetic opiate used to relieve moderate to severe pain. Doctors commonly prescribe painkillers after a surgical procedure or as part of a pain management plan. While they are beneficial when used on a short-term basis, many people find painkillers to be a slippery slope. They have an incredibly high potential for misuse, abuse, and addiction.
Even when used as prescribed, painkillers provide a mild "high" in the user: usually a state of calm euphoria. Many use the medications for as long as necessary then taper off once the pain has subsided. However, there are some who become addicted to the high it provides. They find themselves taking more than prescribed or for longer periods of time than they originally intended.
Prescription stimulants are most commonly known for helping people with Attention-Deficit Disorder (ADD) and Attention-Deficit/Hyperactivity Disorder (ADHD). However, stimulants are also helpful for treating narcolepsy and depression. They affect the dopamine and norepinephrine levels in the brain, causing users to be more alert and attentive.
Some types of prescription stimulants are:
- Amphetamine (brand names include Adderall and Dexedrine)
- Methylphenidate (brand names include Concerta and Ritalin)
Stimulants are popular among high school and college students as "study drugs." The energy boost and alertness help them stay up for extended periods of time in order to complete homework or study. Some discover they enjoy the euphoria and the stimulant use progresses from study use to recreational use.
Tranquilizers are used to treat those with chronic anxiety or panic disorders. Prescription tranquilizers are a central nervous system depressant, meaning they dull the receptors in the nervous system. This helps reduce anxiety and alleviate or eliminate severe panic attacks. They help people function better in their day-to-day lives rather than being controlled by their mental illness.
Types of prescription tranquilizers include:
- Diazepam (brand names include Valium)
- Alprazolam (brand names include Xanax)
- Clonazepam (brand names include Klonopin)
When taken as prescribed, tranquilizers help individuals manage their daily anxiety levels. But when taken at high, non-prescribed doses, they provide a significant sensation of relaxation and euphoria. Due to this, tranquilizers also have a high potential for misuse, abuse, or addiction. Tranquilizer addiction is serious due to the psychological complications that can arise when the user suddenly stops taking them.
Prescription sedatives are similar to tranquilizers in that they act on the central nervous system. Oftentimes the two are either confused for one another or simply grouped together. However, sedatives are used mainly to treat individuals with insomnia, irregular sleeping patterns, or other sleep disorders. They are an umbrella term for barbiturate and benzodiazepine medications.
Common types of prescription sedatives include:
- Zolpidem (brand names include Ambien)
- Lorazepam (brand names include Ativan)
- Eszopiclone (brand names include Lunesta)
Sedatives provide a relaxing high when taken in high doses, similar to tranquilizers, but they also cause extreme drowsiness. They are dangerous to use while driving to begin with; those who misuse or abuse prescription sedatives should avoid driving at all times.
Prescription barbiturates are a class of drug known as sedative-hypnotics. They function as a combination of tranquilizers and sedatives, helping both with anxiety and sleeping difficulties. They were more common in the 1960s and 1970s; prescriptions have declined dramatically since the introduction of benzodiazepines.
Prescription barbiturates still in use today include:
- Secobarbital (brand name Seconal)
- Phenobarbital (brand name Luminal)
As mentioned before, barbiturate use and abuse was more common in the 60s and 70s. They were better known by their street names such as:
- Yellow jackets
- Red devils
- Blue devils
- Pink ladies
Although use rose again in the 90s, barbiturate addiction is thankfully uncommon today. Due to the sedative-hypnotic nature of the drug they significantly impair the user. Dosages are also difficult to get right, causing quick overdoses that can result in coma or death.
Prescription benzodiazepines have mostly replaced prescription barbiturates in order to treat anxiety, panic disorders, insomnia, and sleep disorders. They relax users and also induce a state of intense drowsiness, making them dangerous to use when operating a car. The euphoria experienced at higher doses encourages some users to take more.
There are at least fifteen different types of prescription benzodiazepine medications prescribed in the United States but the most common are:
- Lorazepam (brand names include Ativan)
- Diazepam (brand names include Valium)
- Clonazepam (brand names include Klonopin)
- Alprazolam (brand names include Xanax)
Because of relaxing, euphoric nature of the drug, benzodiazepines have a high potential for addiction. They are difficult to wean off of due to not only the physical effects but the psychological effects of reducing anxiety. Benzodiazepine withdrawals are an intense period of time and some require medical detox supervision for their own safety.
Prescription antidepressants are used to treat major depressive disorder and other mental illnesses involving depression. They do not have a high potential for addiction due to most medications needing a minimum of two weeks in order to take effect. They do not provide any sort of "high." Instead, they function by regulating serotonin release to help those with depression function better in their everyday lives.
Common types of prescription antidepressants include:
- Citalopram (brand names include Celexa)
- Duloxetine (brand names include Cymbalta)
- Escitalopram (brand names include Lexapro)
- Fluoxitine (brand names include Prozac)
- Paroxetine (brand names include Paxil)
- Bupropion (brand names include Wellbutrin)
- Sertraline (brand names include Zoloft)
While there is little chance for any sort of addiction to antidepressants, users do become dependent on their doses. Skipping days or weeks, or suddenly stopping taking antidepressants, can have dangerous and even deadly results. Remaining consistent with dosages and times, as well as taking them under the supervision of a doctor, is the safest way to take prescription antidepressants.
Prescription antipsychotics are used to treat and manage symptoms in those with schizophrenia, bipolar disorder, and severe depression. Similar to antidepressants, antipsychotics have a low potential for addiction. They do not entirely eliminate psychosis but they do help reduce and control the frequency and severity of the symptoms.
Prescription antipsychotic medications include:
- Aripiprazole (brand names include Abilify)
- Clozapine (brand names include Clozaril and Denzapine)
- Haloperidol (brand names include Dozic, Haldol, and Serenance)
- Olanzapine (brand names include Zyprexa)
- Quetiapine (brand names include Atrolak, Biquelle, Seroquel, and Tenprolide)
- Risperidone (brand names include Risperidal)
Those who use antipsychotics rarely become addicted or misuse them; rather, they are dependent on these medications. Some prescription antipsychotics have incredibly short half-lives, meaning withdrawal symptoms will take hold quicker than with those that have longer half-lives.
Which Prescription Medications are Most Commonly Abused?
As mentioned above, not all prescription drugs are abused.
Medications like antidepressants and antipsychotics are not designed to induce a high in the user but meant to manage symptoms of mild to severe mental illness. They do not necessarily affect the body from a physical standpoint as many other prescription drugs do.
The most commonly abused prescription medications are:
- Painkillers (opiates)
- Sedatives (barbiturates and benzodiazepines)
The euphoric feelings produced by painkillers, stimulants, sedatives, and tranquilizers hook many people into the trap of addiction. Despite the necessity of a prescription to receive these drugs, there are "dirty" doctors who fill massive prescriptions, allowing them to trickle down into the hands of drug dealers.
What Causes Prescription Medication Addiction?
This question can delve into the bigger question, "What is the cause of addiction?" Current research has yet to pinpoint one single cause of addiction. The present understanding is that the cause of addiction tends to be a combination of biology and environment.
There is no single "addiction gene" but a number of genes that can cause a predisposition to drug abuse and addiction.
Additionally, some people raised in certain environments, such as with a family member struggling with addiction or in low-income areas, are more predisposed to addiction.
However, many people who would "never use drugs" still find themselves addicted to prescription drugs. Since they are prescribed by a doctor most people find no reason not to use their medications and do not see them as a drug. As the effects take hold, though, they may begin to enjoy the sense of ease and comfort provided by taking an extra pill every so often.
When their prescription runs out and their doctor stops refilling it, these individuals start to realize what they've gotten themselves into. They scramble to receive additional prescriptions and if they can't, they may turn to other alternatives to continue finding the high they're missing.
As mentioned before, people who take prescription antidepressants and antipsychotics develop a dependence on their medication but not an addiction. Even some who take painkillers, stimulants, tranquilizers, or sedatives for long periods of time are dependent without being addicted. But what is the difference between dependence and addiction?
Dependence refers to either physical or psychological reliance upon a medication. Prescription drugs directly affect brain chemistry and when taken on a long-term basis, the body becomes dependent upon the steady supply. If someone suddenly stops taking their prescription medication, they will experience withdrawal symptoms ranging from physical discomfort to psychological distress.
Addiction refers to the compulsive use of a drug despite the consequences that may or do occur. It is common for addicts to avoid responsibilities in favor of getting high. This can result in the loss of jobs and isolation from friends and family, along with a physical or psychological dependence.
Both those with a dependency and those with an addiction will likely experience withdrawal symptoms when removing the prescription drugs from their system. The significance of their withdrawals depends on the amount of drugs use and the length of time they were used for. When taken under a doctor's supervision, the user will taper off slowly until the drug is completely cleared from their system.
How to Know If Someone Is Addicted to Prescription Drugs
There is a caricature of what a drug addict looks like: poor, disheveled, homeless, and living under a bridge. However, especially when it comes to prescription medication addiction, this is not always what an addict looks like. Addiction can affect anyone regardless of age, gender, social rank, financial status, or physical health.
Many people addicted to prescription medications don't realize that they're addicted until their supply is cut off. Once the medication runs out, they find themselves trapped. Those who continue finding more sink to lower levels to do so. They either find dirty doctors who write illegal prescriptions or start to go through friends or high-end dealers.
As people fall further and further into their addiction, it becomes less difficult to notice the signs of addiction. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) outlines 11 criteria to diagnose a substance use disorder. You can look for some of these signs if you are concerned about someone's prescription medication use:
- Taking the medication in larger doses or for longer than originally intended.
- Wanting to cut down or quit but finding themselves unable to.
- Spending extended periods of time trying to get or using the prescription medication.
- Experiencing a strong desire or craving for the prescription drug they use.
- Finding themselves unable to carry out responsibilities at work, school, or in the home as a result of their use.
- Continuing to use the prescription drugs despite complication with employers, friends, or family.
- Cutting back on or entirely quitting activities they once enjoyed in favor of using prescription medication.
- Getting into dangerous situations (such as driving under the influence) as a direct result of use.
- Continuing to use the medications despite resulting physical or psychological complications.
- Developing a tolerance to the drug (needing to use more to achieve the desired effect).
- Experiencing withdrawal symptoms when they haven't used their prescription medication for some period of time.
The DSM-V describes 3 different levels of substance use disorder depending on the number of criteria that apply to the individual.
- Mild: 2 to 3 criteria apply
- Moderate: 4 to 5 criteria apply
- Severe: 6 or more criteria apply
Though this is not a guaranteed way to diagnose someone an addict, they are warning signs to look out for when questioning whether someone is struggling with prescription medication addiction.
Although not everyone makes the switch, the fact is that heroin acts on the same receptors as painkillers. It provides a similar high for a lower price. It is alarming to know that something prescribed legally by the medical field can be such a gateway drug. Thankfully legislators continue to work to clamp down on the frivolous prescribing of painkillers.
Prescription painkillers have the potential to create a dangerous path to harder drugs like heroin. Since pills tend to be more expensive and harder to come by, heroin provides a cheaper, more available alternative.
Mixing Alcohol and Prescription Medications
Nearly every medication, from over-the-counter Tylenol to prescription OxyContin and Valium, insists that you not mix alcohol with these drugs. Why should you not mix medications with alcohol, though?
The main reason to avoid mixing alcohol and prescription medications is their impact on the liver.
The human liver is the main processor of both medications and alcohol. When you overload your liver with both prescription drugs and alcohol on top of them, your liver must process a large number of toxins at once.
Long-term combinations of prescription medications and alcohol can lead to dangerous and even deadly liver damage. While it can somewhat repair itself, if you force it to process heavy amounts for long periods of time, your liver will develop scarring that does not go away.
Another reason to avoid mixing alcohol with prescription drugs is due to the combined effects. Alcohol already causes lowered inhibitions, slowed reaction times, and drowsiness. When you combine it with a prescription medication like painkillers, tranquilizers, or sedatives, the impact on your ability to function can be significant. For example, it is already dangerous to drive a car while drinking or taking prescription medications. When you combine the two, the effects can be disastrous.
Long-term use of prescription medications does not always lead to addiction but surely leads at least to dependence. The body becomes both physically and psychologically reliant upon the drugs. If for some reason the supply is suddenly cut off, there may be little to no alternative solution to the physical or psychological distress that the medications help alleviate.
Additionally, the body develops a tolerance to medications like painkillers, stimulants, tranquilizers, and sedatives. As tolerance grows, the amount necessary to receive the same relief grows. Taking large numbers of these drugs for an extended period of time can cause damage to internal organs.
Unless it is absolutely necessary, it is best to use prescription medications on a short-term basis. For the sake of your physical and emotional health, developing healthy coping mechanisms rather than relying only upon medication can make a positive impact on your life.
Treatment for Prescription Drug Abuse and Addiction
1 in 12 individuals ages 12 and older need treatment for a substance or alcohol use disorder. However, almost 90 percent of these people do not receive the specialty treatment they need to achieve recovery. With such high numbers of individuals misusing and abusing prescription drugs, a significant portion of those who do not receive treatment are likely addicted to prescription medications.
There are a number of treatment options available for those struggling with prescription medication addiction. The type of treatment you choose depends on the severity of the addiction, your insurance, and financial situation, and whether you want to attend treatment nearby or out of the area.
Medical detox is the process of supervising the process of the body clearing itself of all chemicals in its system. Since withdrawals are a common part of the detox process, detoxes that involve medication assisted treatment help manage withdrawal symptoms. By using other types of medications, they can alleviate or eliminate symptoms to make the detox process more tolerable and comfortable. Detox takes place on either an inpatient or outpatient basis.
Inpatient Drug Rehab
Inpatient drug rehab provides drug and alcohol treatment programming during the day and living arrangements at night. Inpatient rehab is helpful for those who feel they need the added support and accountability of residential environment during the first 30, 60, or 90 days of their recovery.
During inpatient rehab, people learn more about addiction and how to develop the coping skills necessary for long-term sobriety. Individual and group therapy are important aspects of inpatient treatment.
Intensive Outpatient Program
An intensive outpatient program (IOP) is beneficial for those who have full-time commitments they cannot get away from, such as school or work. IOP usually consists of 3 hours of programming per day, 3 to 5 days per week. Participants are not required to stay overnight and can attend their previous commitments during the day. Educational lectures, individual, and group therapy help addicts in recovery learn more about themselves and how to stay sober for the long run.
Prescription Drug Addiction is Not the End of the Story
Prescription drug addiction and abuse significantly impact millions of Americans every day. It does not have to be the end of the road, though. Through the help of loving friends and family, combined with treatment, addicts have the opportunity to get clean, to recover, and to live full, happy, and healthy lives.