There is almost no ailment that exists that does not have the option of a pharmacological solution. Whether in combination with alternative, physical, and/or behavioral therapies, prescription drugs can be a beneficial part of a comprehensive treatment program for medical and mental health issues.

For most patients, the use of prescription drugs is helpful, not harmful. However, if those medications are taken outside of the bounds of a doctor’s orders or if someone abuses those drugs without a prescription for recreational purposes, addiction can develop – and a slew of legal, social, financial, and health problems may result as well.

The more you understand about how prescription drugs work and the potential risks that come with abuse, the better able you will be to identify a drug abuse problem in yourself or a loved one that requires treatment. Here’s what you need to know.

Dangers of Long-Term Abuse

While the short-term risks of prescription drug abuse (e.g., accident, overdose, other medical emergencies, etc.) are serious, the long-term risks of continued prescription drug abuse are just as deadly. Some risks include:

  • Physical dependence: Building a tolerance to a prescription drug can happen to anyone, and while it is normal, physical dependence can make it more difficult to stop using the medication. It can also trigger withdrawal symptoms that are uncomfortable or even life-threatening in some cases.
  • Psychological dependence: A psychological dependency upon a medication is usually defined by cravings for the drug. Obsessing over how many pills are left, how to get more, or how to get the most high every time can all characterize a psychological dependence upon a prescription drug.
  • Addiction: Physical dependence and psychological dependence together create an addiction, and when addiction is diagnosed, treatment is necessary. Otherwise, the negative impact of drug abuse harms every aspect of a person’s life: social connections, job prospects, legal standing, health, and more. Without treatment, few are able to stop using prescription drugs safely.
  • Accidents: When under the influence of any mind-altering drug, the risk of accidents increases significantly. Car accidents, drowning, burns, falls, and more are a higher risk when someone is taking prescription drugs.
  • Illegal choices: Addiction is defined by compulsive use of prescription drugs, and new laws and regulations have made it difficult to get enough to maintain an addiction legally. This means that many people who are dependent upon prescription medications are taking action that is illegal. That is, they may commit fraud and alter a written prescription or attempt to get that prescription filled at multiple pharmacies. Others may go to multiple doctors (even crossing state lines to avoid detection), seek out illegal pain clinics, or buy pills on the black market to augment their supply.
  • Decreased cognitive functioning: Studies show that long-term use of prescription drugs cause long-term changes to the brain. The size and structure of neurons may change, which in turn can impact a person’s ability to function physically and emotionally without their drug of choice. While some of the damage may heal with time, not all the problems caused by ongoing prescription drug abuse can be reversed.
  • Health issues and chronic disorders: Drugs of any kind are toxic to the body in high doses and over a long period of time. Opiate painkillers and benzodiazepines, for example, heavily impact the respiratory system, while ongoing abuse of stimulant drugs negatively impact the heart. Continued use of any of these substances can cause the kidneys to deteriorate, as well.
  • Social issues: When addiction is the primary focus of someone’s life, it is difficult for them to have positive interactions with others. From friends and family members to coworkers and neighbors – it is rare for someone to be able to manage healthy relationships with anyone. As a result, isolation, frequent arguments, job loss, and divorce are all common.
  • Financial struggles: Ongoing addiction makes it difficult to function at work – even if the person abuses stimulant drugs with the goal of increasing their ability to work long shifts or burn the midnight oil on a regular basis. Additionally, use of any substance, including prescribed medications, can interfere with a person’s ability to do their job safely, which in turn can impact the safety of their coworkers and/or the company’s bottom line.

Job loss and the inability to find a new job or maintain work for any length of time can lead to financial hardship. Foreclosure, bankruptcy, and even homelessness and poverty can result from an ongoing, untreated addiction.

Similarly, those who are addicted to prescription stimulant (e.g., Adderall, Vyvanse) may trade in their pill habit for abuse of cheaper street drugs like crystal meth.

  • Legal difficulties: Whether addicts engage in illegal behaviors and abuse their prescription or someone else’s, or abuse black market street drugs, they put their freedom at risk. Heavy fines, jail time, and parole/probation appointments and check-ins are all common among people who live with a drug addiction for the long-term.
  • Overdose: Though a number of medical emergencies are potential problems for people who abuse prescription drugs for the short-term or long-term, overdose is perhaps the most feared, and rightfully so. Opiate painkiller or sedative overdose may cause breathing and the heart to simply stop – and never start again. Stimulant prescription drug overdose may trigger a cardiac arrest that is fatal.

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Addiction treatment works best when it’s personalized

Therapies That Effectively Treat Prescription Drug Addiction

Prescription drug addiction can sneak up on those who have a legitimate prescription and those who intended only to abuse the medications recreationally. No matter how it began, there are a number of therapies and treatments that can help anyone to stop using prescription drugs safely and start thriving in recovery. Most patients will utilize a combination of treatments based on their past history of drug abuse and treatment attempts as well as their goals for treatment and recovery. Some options include:

  • Medicated detox: Whether the patient opts for maintenance medications (e.g., buprenorphine or methadone for the treatment of opiate addiction) or takes non-addictive medications to assist with the discomfort associated with withdrawal symptoms from other prescription drugs, professional detox is an important first step in recovery. Psychological withdrawal symptoms will also need to be addressed, and for this purpose, some patients benefit from antidepressants and/or anti-anxiety drugs.
  • Evaluation and assessment: Treatment should address all the issues facing the patient in recovery, and this begins with a complete evaluation and assessment. Determining diagnoses from mental health disorders to behavioral disorders to learning disabilities and medical health issues will help the therapeutic team to assess the best possible combination of treatments and therapies to help the patient stabilize in recovery. From there, treatment goals can be created and updated as they are reached through treatment.
  • Mental health treatment: If the process of evaluation determines that a mental health disorder is an issue, it is essential that the patient get treatment for that disorder while addressing addiction issues. Often, the mental health symptoms trigger the urge to use prescription drugs; similarly, use of prescription substances can contribute to or worsen mental health symptoms. Because of this, it is difficult to effectively address either disorder without dealing with the other disorder at the same time.
  • Behavioral therapies: When a patient learns how to make changes to the perspectives and behaviors that are harming them, it can significantly and positively impact their experience in recovery and make relapse prevention far easier. Usually a one-on-one experience with a therapist who specializes in substance abuse treatment and behavioral therapy is an essential component of comprehensive care.
  • Support groups: A range of group therapy sessions, including 12-step treatment, can help patients to become stronger in their communication skills, share their experience, and benefit from the experience and support of others. Connecting with other people who have been through similar struggles and who are facing the same road ahead in recovery can be empowering in addition to the topics covered and skills learned from the therapist.
  • Alternative treatments: Non-talk therapies can be hugely beneficial for patients who need alternative avenues of understanding their experience in addiction, their co-occurring mental health issues, and family circumstances, as well as any other issues including trauma that may be difficult to discuss.

Additionally, alternative therapies can help a patient to focus on one specific issue that may be contributing to the abuse of prescription drugs. For example, if someone is struggling with finding employment and part of the use of prescription drugs stemmed from the need to escape the pressure to find meaningful work, then working with a life coach to identify career goals and interests may be beneficial.

  • Holistic treatment: Almost every patient will benefit from incorporating a range of holistic treatment options into their treatment plan. These can help to lower overall levels of stress, providing stress-reducing coping mechanisms for the patient to utilize in the moment, and deepen one’s spiritual and emotional connection with the world around them. Some common options include aromatherapy, acupuncture, yoga, massage and bodywork, and others.
  • Aftercare options: When treatment is complete, some patients are ready to return home and start their lives in recovery while others prefer to take a slower step, such as moving into a sober living home or choosing to take part in outpatient treatment. No matter what choice is made, all patients are encouraged to actively continue their therapeutic growth in recovery in the months and years following treatment. Few will be able to withstand the triggers that can end in relapse without ongoing support and therapeutic growth.

Statistics and Research

  • About 52 million people older than 12 report having abused prescription medications at some point in their life.
  • About 2.7 percent of the US population, or about 7 million people, abuse a prescription medication every year.
  • Pamela Hyde, SAMHSA Administrator, said in a November 2011 CDC press release that an estimated 5,500 people abuse a prescription medication for the first time every day on average.
number abused prescription drugs
abuse by drug type
  • NIDA reports that in 2010 an estimated 5.1 million people reported abuse of opiate painkillers, 2.2 million people said that they had abused tranquilizers, 1.1 million people reported the abuse of stimulant medications, and almost half a million people said that they struggled with the abuse of sedatives.
  • The 2010 DAWN Findings on Drug-Related Emergency Department Visits released in July 2012 found that more than a half-million visits to the ER were caused by the misuse or abuse of prescription medications.
  • Alcohol and marijuana are the first and second most commonly abused drugs in the US, respectively, but prescription and over-the-counter drugs come in third as the most commonly abused substances by people over the age of 14.
common drugs abused
  • Though some people develop a prescription drug addiction problem after they are prescribed an addictive medication for legitimate use, many develop a dependence upon these drugs when they use “leftover” medications stored at home for recreational purposes.
  • One of the best ways to alleviate the issue of “leftover” medication abuse is to take advantage of prescription drug “take back” days. These are sponsored by various businesses and government agencies, and they provide a drop-off point for people who would like to safely dispose of unwanted medications – no questions asked.
  • Though it may seem that prescription drug use is inherently safe, the fact is that the prescribing doctor only prescribes these drugs in certain situations after careful consideration of past medical history, symptoms, other medications, and other issues. Taking these drugs without a doctor’s care or taking more than prescribed by the physician can lead to serious medical consequences, including death.
  • People abuse prescription drugs for a variety of reasons. For example, some people may abuse sedatives or painkillers in order to “escape” or self-medicate difficult mental health symptoms. Others may abuse stimulant drugs because they help them to focus, lose weight, or accomplish a great deal in a short amount of time. As a result, the signs of prescription drug abuse will vary considerably based on the drug of choice.
  • It is possible to overdose on a prescription drug while taking the drug as directed by the doctor. In most cases, this occurs when the patient inadvertently takes two doses too close together, combines medications, or drinks alcohol while their medication is still in their system.
car accident deaths and drugs
  • Drinking and driving is well known to be a dangerous practice, but lesser known is the fact that taking certain medications can similarly impair a person’s ability to drive. Accidents under the influence of prescription medications – even when taken at therapeutic doses – are exceedingly common. In fact, about one in three drivers who died in a car accident tested positive for drug use in 2009.
  • Though some teens did and still do abuse prescription drugs found around the house for recreational purposes, the most common types of prescription medication abused by teens are stimulant drugs prescribed for the purposes of treating ADHD. According to the Monitoring the Future study, about 13.9 percent of 12th graders said that they had used a prescription drug in the past year. The study found that ADHD medications were the primary drug of choice and that more than 8 percent of 12th graders, more than 7.5 percent of 10th graders, and more than 4 percent of 8th graders all reported abuse of amphetamines in the past year. Adderall, specifically, was cited as a drug of abuse in the past year by almost 7 percent of 12th graders, almost 5 percent of 10th graders, and more than 1 percent of 8th graders.

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Additional Treatment Manuals

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Why do some drugs require a prescription?

The Food and Drug Administration (FDA) is in charge of the regulation of over-the-counter medications and prescription medications in the United States. All medications are meant to be used to treat or prevent a disease or disorder, and medications include both over-the-counter and prescription drugs. According to the FDA, prescription drugs are:

  • Prescribed by a physician to a single person for a specific purpose
  • Purchased at a certified pharmacy
  • Regulated via the FDA’s formal New Drug Application process that requires proof that the drug works as they say it will as well as details on how it is manufactured

Over-the-counter drugs, comparatively, are:

  • Purchased by anyone online and/or off the shelf
  • Medications that do not require a prescription
  • Regulated through monographs that include ingredients, dosing information, labeling specifics, and formulations or through the New Drug Approval System

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What prescription drug categories are there?

There are a number of different drug categories. According to the FDA, general drug categories include:

  • Analgesics
  • Antacids
  • Anti-anxiety drugs
  • Anti-arrhythmic drugs
  • Anti-bacterial drugs
  • Antibiotics
  • Anticoagulants
  • Anticonvulsants
  • Antidepressants
  • Anti-diarrheal drugs
  • Anti-emetics
  • Anti-fungal drugs
  • Antihistamines
  • Anti-hypertensive drugs
  • Anti-inflammatories
  • Anti-neoplastic drugs
  • Antipsychotics
  • Antipyretics
  • Antivirals
  • Barbiturates
  • Beta blockers
  • Bronchodilators
  • Corticosteroids
  • Cough suppressants (narcotic)
  • Cytotoxic drugs
  • Diuretics
  • Hormones
  • Hypoglycemic drugs
  • Immunosuppressive drugs
  • Laxatives
  • Muscle relaxants
  • Sedatives
  • Sex hormones (male and female)
  • Sleep medications
  • Tranquilizers
  • Vitamins

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How are prescription drug scheduled?

The Drug Enforcement Administration (DEA) classifies certain chemicals, substances, and drugs into schedules based upon the drugs medical use and the risk of abuse and/or potential for addiction. Ranging from Schedule I to Schedule V, these classifications are defined by the following:

  • Schedule I: These substances are not approved for any medical use and have a high potential for abuse and addiction. Examples include heroin, marijuana, ecstasy, peyote, LSD, and others.
  • Schedule II: These substances and chemicals are dangerous drugs that have a high potential for abuse. They may also have medicinal purpose. Examples include methamphetamine, oxycodone, Adderall, Ritalin, cocaine, and others.
  • Schedule III: These drugs are considered to have a moderate to low potential for abuse and dependence and also have medicinal use. Examples include prescriptions that have less than 90 milligrams of codeine per dosing unit, testosterone, anabolic steroids, ketamine, and others.
  • Schedule IV: These substances and chemicals are considered to have a low potential for abuse and addiction. Examples include Ativan, Tramadol, Xanax, Valium, and others.
  • Schedule V: Of the five classifications of drugs, these are considered to have the least potential for abuse and addiction but with a limited amount of certain narcotics. Examples include Robitussin AC, Motofen, Parepectolin, Lyrica, and others.

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How do prescription drugs come to the market?

The FDA’s Center for Drug Evaluation and Research (CDER) is responsible for making sure that over-the-counter medications and prescription drugs that are sold in the US are safe and effective. They do not test drugs – that is the responsibility of the company that puts the drug on the market – but they do review the research that is provided to them that demonstrates quality and efficacy for the intended purpose when a company submits a new drug application.

A CDER team of professionals that includes chemists, physicians, statisticians, pharmacologists, and other scientists will review the applications to determine whether or not the new drug can and should be approved for the marketplace.

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What prescription drugs are addictive?

Some addictive prescription drugs include:

  • Narcotic analgesics
  • Anti-anxiety drugs (also called sedatives, tranquilizers, muscle relaxants, or anxiolytics)
  • Barbiturates (also known as sleep aids)
  • Narcotic cough suppressants
  • Stimulant drugs

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What are the most addictive prescription drugs?

According to the National Institute on Drug Abuse (NIDA), some of the most commonly abused addictive prescription drugs include:

Prescription painkillers

  • Use of these drugs creates a high in the user.
  • They are prescribed to treat moderate to severe pain.
  • Abuse leads to overdose, addiction, and accident.
  • The drugs are abused by taking too much; crushing the pills before swallowing, snorting, or injecting them; and/or taking the drugs with alcohol or other mind-altering substances.
  • Examples include codeine, oxycodone, hydrocodone, morphine, methadone, and others.
  • Street names vary depending on the specific drug.
  • Short-term health problems caused by use of the drug may include nausea, respiratory depression, confusion, miscarriage, overdose, and more.
  • Withdrawal symptoms can include bone and muscle pain, sweating, vomiting, diarrhea, agitation, and more.
  • Medications are available to treat opiate prescription drug addiction, including Suboxone and Subutex (e.g., buprenorphine), methadone, and Vivitrol.
  • Medication alone is not enough to treat prescription drug dependence; behavioral therapies are recommended as well as long-term aftercare and support.

Prescription sedatives

Prescribed to treat anxiety and sleep disruption, sedatives slow the brain’s activity and can be highly addictive.

  • Barbiturates, benzodiazepines, and sleep medications are all sedatives.
  • Examples of barbiturates include pentobarbital and phenobarbital. Street names include barbs, yellows, yellow jackets, reds, and others.
  • Examples of benzodiazepines include Xanax, Valium, Ativan, and others. Street names include downers, tranks, and candy, among others.
  • Examples of sleep medications include Lunesta, Ambien, and Sonata. Street names include roofies, rope, forget me pill, and others.
  • Short-term health issues caused by abuse of sedatives include confusion, low blood pressure, drowsiness, and slowed breathing.
  • Withdrawal symptoms include rebound anxiety, seizures, and a serious abstinence syndrome.
  • No medications are available to treat benzodiazepine withdrawal symptoms, but medical care is recommended in case of complications. Behavioral therapies can help the patient to remain drug-free for the long-term.

Prescription stimulants

Prescription stimulant drugs are commonly prescribed to address the symptoms related to attention deficit and hyperactivity disorder (ADHD).

  • Increased heart rate, breathing rate, and blood pressure are common results of use.
  • Pills may be swallowed as is or crushed and snorted or injected after being dissolved in water.
  • Examples of amphetamines (e.g., stimulants) include Adderall and Benzedrine. Street names include bennies, crosses, truck, hearts, and black beauties.
  • Methylphenidate is another type of prescription stimulant (e.g., Concerta, Ritalin). Street names include skippy, r-ball, MPH, “the smart drug,” and others.
  • High doses can result in seizures, heart attack, and other medical emergencies.
  • Long-term abuse of the drugs can lead to cardiac problems, paranoia, anger management issues, and/or psychosis.
  • Withdrawal symptoms may include insomnia, intense fatigue, depression, and/or suicidal thoughts or actions.
  • Long-term behavioral therapies and relapse prevention are recommended treatment options to those ready to overcome stimulant drug dependence.

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When does “use” become “abuse”?

Use of prescription drugs according to a doctor’s direction is deemed “use” of the drug and should be safe. As long as the doctor is aware of all other medications being taken, the person avoids alcohol, and any adverse side effects are immediately reported, most people will be able to take their prescription without developing an addiction issue.

Any use of prescription drugs outside of a doctor’s prescription is termed “abuse.” This can include any of the following:

  • Taking prescription drugs without a prescription
  • Taking more than prescribed or taking the prescribed dose more often than recommended
  • Drinking alcohol or using other drugs while taking the prescription medication
  • Crushing pills before snorting, swallowing, or dissolving them in water and injecting them
  • Getting multiple prescriptions for the same or similar pills from different doctors
  • Filling the same prescription at multiple pharmacies

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Are there health concerns of mixing prescription medications?

Absolutely. Even if a patient is taking multiple, non-prescription drugs, it is important to ensure that there will be no complications from mixing the substances. Similarly, it is important that patients disclose all the substances they are taking to their prescribing physician – including vitamins, supplements, and over-the-counter medications. In some cases, certain foods may even cause an issue, and in many cases, alcohol can cause problems when taking prescription medications.

Some possible health issues that come from mixing prescription medications with other prescription drugs, over-the-counter medications, alcohol, supplements, and certain foods include:

  • Side effects
  • The prescription drug being rendered less effective or ineffective
  • Medical emergency
  • Death

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What are pain clinics?

Pain clinics are medical centers that focus primarily on helping people to manage chronic and/or severe pain. In the past, many pain clinics illegally prescribed high doses of addictive medications to anyone who walked through the door with little medical investigation and no follow-up. These so-called “pill mills” were simply in the business of enabling people who would abuse the prescription medications – usually painkillers – until the federal government began cracking down. Laws were instituted in a number of states strictly regulating such issues as:

  • What organizations can define themselves as pain clinics
  • Who can own pain clinics
  • How owners must be trained in the management of pain clinics
  • The accreditation of prescribing physicians employed in pain clinics (e.g., completing an accredited pain management fellowship or being certified in pain medicine)
  • What medications can be prescribed at the pain clinic
  • How states can investigate these pain clinics to make sure they are following regulations and are up to standard

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What is doctor shopping?

Doctor shopping is the practice of seeking prescription medications that are similar in type from multiple doctors with the intent of maintaining a prescription drug addiction, according to the journal Innovations in Clinical Neuroscience. This practice has been curbed in part by the implementation of statewide prescription drug monitoring databases. Doctors and pharmacists utilize these systems by inputting the prescription information for patients and/or checking the prescriptions currently in use by a patient in the system. In this way, they can identify patients who may be struggling with addiction and, rather than enabling them to continue in that addiction by giving them more addictive medications, they can intervene and help to connect them with treatment.

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Are there alternatives to addictive painkillers?

Each patient’s experience is different when it comes to pain and what methods of pain management will be most effective. In some cases, it may be possible to completely eradicate the use of all addictive painkillers by utilizing a range of holistic and alternative treatments. In most cases, however, when pain is chronic and severe, medication doses may be diminished by use of these alternative treatment services. Some treatment possibilities include:

  • Dietary changes
  • Losing weight if obesity is contributing to pain in the joints and back
  • Use of supplements like alpha lipoic acid and acetyl-L-carnitine
  • Use of nerve blocks
  • Use of epidural steroids
  • High-strength capsaicin use
  • Mindfulness-based techniques (e.g., meditation, yoga)
  • Educational programs
  • Group therapy and support
  • Cognitive behavioral therapy
  • Exercise regimens
  • Device-based techniques (e.g., use of pumps, stimulators, etc.)
  • Massage and bodywork
  • Holistic treatments like acupressure and/or acupuncture, especially in combination with aromatherapy

Not all of these will be appropriate in every case, but in almost every situation more than one of these alternative options in combination can help to limit the use of addictive painkillers and potentially alleviate the need for them entirely.

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What is drug tolerance?

Tolerance to any medication can develop with regular use over time. Essentially, to build a tolerance to a drug means that the initial dose ultimately becomes unable to create the original effects experienced. Thus, a higher dose is needed to achieve those initial effects – until the person develops a tolerance to that dose as well and the dosage again must be raised.

A tolerance may signify a physical dependence upon a drug, but it does not signify a psychological dependence, which means that it does not necessarily indicate an addiction.

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What is tapering?

The practice of tapering the dose of a medication is done when a patient has a tolerance to their medication (e.g., a physical dependence) but they are not addicted to their drug of choice. Under a doctor’s supervision, a patient can just cut back on their dose incrementally over time until they are completely free of use of the drug.

In general, a 10 percent decrease in dose each week is relatively tolerable and does not trigger significant withdrawal symptoms. However, should the patient become uncomfortable, there is always the option to bump the dose back up or spend more time at a given dose (a month or more) until the patient is ready to move forward.

In some cases, especially among patients tapering from an opiate painkiller, mild opioid withdrawal symptoms may persist for as long as six months after the cessation of use of the drugs. Counseling can be helpful, and it is recommended especially if behavioral issues develop.

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What is medication management?

During detox for certain prescription drugs, especially opiate drugs, medications may be used to assist the patient in dealing effectively with the significant withdrawal symptoms that can result. Some of the most commonly prescribed medications for the purpose of medication management in detox for opiate prescription drugs include:

  • Methadone: When used for the purposes of medication maintenance, methadone is dispensed daily in-person in liquid form. A full opioid agonist, it is often referred to as the gold standard in opiate addiction treatment because it has been used successfully for the purpose for decades.
  • Buprenorphine: In the form of Subutex and Suboxone, buprenorphine is a sublingual tablet that patients take every few days on an outpatient basis. This drug is the one most recently approved for the treatment of opiate addiction.
  • Naltrexone: Though it can be prescribed in tablet form, it has been proven most effective when used on a once-a-month basis as an injection.

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Learn More About Prescription Drug Addiction Treatment Options

Each patient’s experience in addiction – and prior to addiction – is unique. Thus, the treatment program and services chosen to help the patient enter a life in recovery should be unique as well. A personalized treatment plan is recommended, especially for patients who are seeking to overcome opiate addiction. With the assistance of a therapeutic team, the patient can identify all issues that must be addressed in treatment and then take part in therapies chosen based on their ability to empower the patient to learn how to successfully manage those issues.

Though detox and rehab are important steps in the recovery process, recovery is a lifetime event. There is no cure for drug addiction of any kind, including prescription drug addiction, and patients are encouraged to make a concerted effort to continually grow in their recovery in order to avoid relapse and a potential return to active addiction.

You can help someone you love to begin the process of recovery today or take the first steps toward comprehensive and effective treatment. Contact The Recovery Village at Palmer Lake at the phone number listed above, and ask any questions you may have about how you and your family can begin to heal through treatment after prescription drug dependence.