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Addictions

What is prescription drug addiction?

Prescription drug addiction often starts by misusing a legally prescribed drug. Misuse of a prescribed drug simply means using a medication in a way that is inconsistent with the prescribing instructions. Examples of this can be taking more of a medication, such as two pills instead of one, or increasing the frequency at which you take a medication without a doctor’s approval. It can also mean you’ve taken medications that aren’t prescribed to you, such as using someone’s Adderall to focus and study for a big test. This in itself is not indicative of a problem, but the start of an addiction to prescription drugs begins with misuse.

The National Institute on Drug Abuse defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.” This means that you may be aware of the impact of misusing prescription drugs on your day-to-day life and the lives of those around you, and you find yourself unable to stop. Addiction happens as you adapt to the drug’s physical and pleasurable effects, and you continue to use it to sustain the feelings and stop withdrawals if you are physically dependent.

The behavioral changes and the continued use of a substance despite negative consequences are common to all substance use disorders. Prescription drug addiction is further complicated by issues of tolerance, dependence, and behavioral symptoms, in addition to pre-existing conditions which may still need to be treated without the use of potentially addictive medications. If you are unsure whether you are addicted to prescription drugs, contact your prescribing doctor or an addiction specialist to discuss your concerns.

Prescription Drug Abuse and Misuse Statistics

According to the National Institute on Drug Abuse, an estimated 18 million people misused prescription drugs in 2017. This doesn’t mean that they are addicted, but it does mean that they used drugs in a method their doctors did not prescribe them. Two million of those individuals misused pain relievers, a particularly dangerous drug to misuse, and 1.5 million people misused sedatives.

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Prescription drug abuse hits some demographics harder than others. According to one study, every day, 2,500 teenagers abuse prescription drugs for the first time. A total of 5% of this group misused prescription drugs within the past year, and 6% of high school seniors misused Adderall. Ease of access is a contributing factor for young people to try prescription drugs. These medications can be found by opening most medicine cabinets.

However, the demographic with the highest levels of prescription drug abuse are those aged 18-25. For young adults, prescription misuse is the fourth largest commonly used drug, following alcohol, marijuana, and tobacco. Within this age group, 14.4% of respondents reported misusing prescription drugs at least once.

Why do people take prescription drugs?

Prescription drug use, of course, is nothing out of the ordinary. Doctors or other authorized medical professionals will prescribe medication for many reasons, including managing chronic conditions, pain, managing mental health disorders, or more. Most prescription drugs come with side effects or ancillary benefits, but these medications are considered safe when taken as prescribed.

When prescribing opioids, stimulants, or other potentially addictive medications, there is no way for your prescriber to know if you will become addicted. This is why it is vital that you take any medications exactly as prescribed and contact your doctor if you have any side effects. When you take these drugs in a manner not dictated by medical professionals or for recreational purposes, there is a risk of addiction.

It’s tempting to believe doctors and pharmaceutical companies are solely responsible for prescription addiction. This is short-sighted because when used as prescribed, these medications can be safe. Examples of these include opioid-based painkillers, such as Vicodin, stimulants such as Adderall, and benzodiazepines such as Xanax. These all have legitimate medical purposes; however, when misused can lead to addiction.

The role of medical and pharmaceutical professionals is just a part of the larger societal problem of addiction. The reality is that prescription misuse is part of the complex, multi-faceted disease of addiction, with many causes, including biological, environmental, and psychological.

A 2017 report from National Survey on Drug Use and Health identified multiple reasons why people begin to misuse prescription drugs. These include:

Prescription Pain Relievers

Vicodin (Hydrocodone), Percocet, OxyContin (Oxycodone), Fentanyl, or Codeine

  • Physical pain
  • Relax
  • Experimentation
  • Euphoric feelings from the drug
  • Insomnia
  • Physical dependence

Central Nervous System (CNS) Depressants

Include three classes of medications:
Benzodiazepines: Valium (diazepam), Klonopin (clonazepam), Xanax (alprazolam)
Sedatives: Ambien (zolpidem), Lunesta (eszopiclone), Sonata (zaleplon)
Barbiturates: Meberal (mephobarbital), Luminal (phenobarbital), Nembutal (pentobarbital sodium)

  • Relax
  • Insomnia
  • Euphoric feelings
  • Experimentation
  • Cope with difficult emotions

Prescription stimulants

Adderall (Dextroamphetamine-Amphetamine), Ritalin (Methylphenidate), Concerta (Methylphenidate), Vyvanse (Lisdexamfetamine) or Didrex (Benzphetamine)

  • Stay awake
  • Concentration
  • Studying
  • Euphoric feelings
  • Experimentation

Controlling the Problem

The most common way to obtain prescription drugs is through a doctor or other prescriber. However, certain medications, such as opioids, are increasingly challenging to get by prescription due to the opioid epidemic. Currently, forty-nine states participate in statewide Prescription Drug Monitoring Programs (PDMP), which track prescription prescribing patterns for opioids, benzodiazepines, and other medications. These programs monitor patient prescriptions and can be an early warning system that someone is receiving multiple prescriptions or trying to fill prescriptions too frequently. These programs seek to curtail the practice of “doctor-shopping,” where people addicted to prescription medications see numerous doctors to obtain prescriptions. They also cut down on “pill mills,” which can include pain clinics or doctors who will prescribe large quantities of addictive drugs for cash.

There is a downside to programs such as these as some people will turn to illicit drugs or buying prescriptions on the street. Both practices are extremely dangerous, as you may purchase fake prescription drugs, which another person or company has manufactured to replicate the original drug. Counterfeit prescription drugs, including benzos, are often manufactured with other substances such as fentanyl, increasing your risk of overdose. The same holds true for purchasing opiates such as heroin. In both cases, you are at high risk for overdose and even death as there is no way to determine what the substance contains.

How does prescription drug addiction develop?

Prescription drug addiction is unique because you may have started misusing medications with a high potential for abuse and were prescribed to you for legitimate medical purposes. For instance, it is not uncommon to be prescribed an opiate for a medical reason, such as after a surgery or for an injury. Adderall and Vyvanse are regularly prescribed for attention deficit disorders, and benzodiazepines are a common medication used for treating anxiety and panic disorders. The length of time you take a medication and the dosage you are taking may also help develop an addiction.

The route of administration of a drug can also lead to someone becoming addicted to a substance. Drugs that produce “highs,” or euphoria, are more likely to lead to addiction than drugs that do not. This is why drugs that release slower and over a more extended time are less likely to cause dependence and why many drugs are built in ways that make them harder to smoke, snort, or inject. These methods are typically associated with abuse, as they are more likely to get an individual high.

What are the risk factors for prescription drug addiction?

Biological factors can increase the risk of addiction. Genetics can make up between 40-60% of the risk of becoming addicted to prescription drugs. In addition to genetics, brain development is believed to play a critical role in addiction, with addictive behaviors tied to developmental challenges.

Environmental and psychological factors can also increase these odds. Numerous studies have pointed out that certain risk factors can make someone more likely to become addicted to drugs. These include aggressive behavior as a child, an overly permissive upbringing, poverty, and close exposure to drugs as a child. The reverse is also true: Self-control, engaged parents, and access to sufficient resources can be protective factors against addiction later in life.

Other factors include access to prescription medications. Exposure to drugs at a young age and easy access to drugs are believed to be tied to increased addictive behaviors. Research has shown that high school athletes who participate in high-impact sports are at a greater risk of being prescribed opioid-based medications. A 2014 University of Michigan researcher determined that 11% of student-athletes have misused prescription pain medications by their senior year.

Recognizing the Signs of Prescription Drug Abuse or Intoxication

It is difficult to categorize every sign of prescription drug intoxication or use. As you can see below, there are a wide array of drugs, all of which have different impacts and side effects depending on the drug’s classification. For instance:

Drug Type

Physical Symptoms

Opioids

  • Constricted pupils
  • Track marks (if IV user)
  • Flu-like symptoms such as aches, fever, nausea when unable to get opioids (withdrawal)

Stimulants

  • Dilated pupils
  • Weight loss
  • Restlessness, change in sleep pattern
  • Hyperactivity
  • Elevated heart rate
  • Increased blood pressure

CNS Depressants

  • Shallow breathing
  • Dilated pupils
  • Decreased heart rate and respiration
  • Confusion
  • Mood changes

Behavioral Symptoms

While each drug has differing physical symptoms of use, the behavioral symptoms are common to all and can include:

  • Continued use of the drug, despite personal, legal, or financial consequences
  • Cravings
  • Changes in sleep patterns
  • Stealing
  • Purchasing drugs on the street or turning to illicit drugs (e.g., heroin)
  • New friends who are also using
  • Loss of job, friends, or family due to substance use
  • Poor hygiene
  • Risky behavior
  • Poor judgment
  • Seeing multiple doctors for access to prescriptions
  • Seeking drugs from friends or family
  • Running out of medications before refill dates

What prescription drugs are addictive?

Prescription and illicit drugs are classified by the United States Drug Enforcement Administration (DEA) into five schedules which reflect the drug’s accepted medical use and its potential for addiction. Narcotics and opioids appear within multiple schedules. The schedule is determined by the amount of the narcotic/opioid present in the medication.

The DEA uses the same classifications for illicit and prescription drugs, as a drug’s legal status does not define addictiveness. Some examples are:

Schedule
Description
Class
Examples
Schedule I
No medical use within the US and high-risk for addiction
Opiates
Opium Derivatives
Hallucinogens
Depressants
Stimulants
Cannabinoids
Heroin
Marijuana
LSD
PCP
Bath Salts
GHB
Crack Cocaine
Schedule II
Accepted medical uses in the US and high abuse risk
Narcotic/Opioids
Stimulant
Depressants
Methamphetamine
Oxycodone (Percocet, OxyContin)
Vicodin (hydrocodone)
Fentanyl
Methadone
Ritalin
Adderall
Concerta
Crystal Meth
Cocaine
Schedule III
Accepted medical uses in the use and lower risk for abuse
Stimulants
Depressants
Narcotic/Opioids combined with acetaminophen
Buprenorphine (Suboxone)
Tylenol with Codeine
Lorcet, Lortab (hydrocodone with acetaminophen)
Ketamine
Didrex
Schedule IV
Accepted medical uses and very low risk of developing a substance use disorder
Depressants
Xanax (Alprazolam)
Klonopin (Clonazepam)
Valium (Diazepam)
Ativan (Lorazepam)
Schedule V
Accepted medical uses and minimal risk of developing an addiction
Narcotic (very low amount)
Cough medicines with codeine

Short and Long-term Effects of Prescription Drug Use

One of the challenges of prescription drugs is that there is such a wide array of types of drugs. Because of this, the short- and long-term effects of prescription drugs can be grouped into specific drug classes, as the drugs within each class act in a similar manner.

Opioids

Opioids are among the most likely drugs to be abused. These drugs – often used as painkillers – are ripe for abuse because of their unique chemical composition that can relieve pain, provide a euphoric high, and are easy to become physically dependent upon. Opioids are also responsible for many overdose deaths within the United States.

CNS Depressants

Anti-anxiety: Anti-anxiety drugs are drugs meant to calm anxiety. There are many types of anti-anxiety drugs, including benzodiazepines. These drugs include medications like Klonopin or Xanax. In addition to their tranquilizing effects, these drugs can produce a relaxing euphoria that can increase the likelihood of addiction.

Barbiturates: Barbiturates are a class of drugs used to treat various disorders, operating as a Central Nervous System Depressant. They can treat sleeping issues, seizures, and more. These drugs can be abused as they can cause euphoria and relaxation while also slowing your heart rate or breathing. Mixing barbiturates with alcohol is extremely risky and can lead to death.

Stimulants

Stimulants are drugs that make your body work faster, speed up various systems, and enhance focus and attention. Among the drugs in this class are Ritalin or Concerta. These are often misused to increase focus, study, or stay awake.

These changes can also lead to substantial long-term challenges. Prescription drug abuse can lead to a loss of employment and make it more likely that someone will fall into poverty. This, in turn, can make you highly depressed or anxious, which can increase how often you use.

In this state, long-term relationships, including with spouses and other family members, will often crumble, as a person cares only about getting their drugs as soon as possible. Prescription drug abuse also leads to long-term health challenges, as someone who is addicted to drugs faces a very high risk of death from an overdose or painful withdrawal symptoms. Furthermore, evidence suggests that addiction to prescription drugs causes an array of long-term physical challenges, including an elevated risk of kidney, heart, and liver malfunction.

There is also evidence to suggest that prescription drug addiction can have a long-term impact on the brain’s functioning. The effect varies based on the class of drugs:

  • Opioids can block feelings of pain and stress while creating their euphoric benefits. However, they can also harm brain development and overall function.
  • CNS Depressants can result in lower levels of awareness and depressed activity in the central nervous system. This can make everything slower, including thought patterns and reaction time.
  • Stimulants will cause the brain to produce higher levels of certain chemicals, including dopamine. This results in increased mood and motivation, helping someone to focus more and be more productive while using the drug. However, extended use of stimulants may result in depression, long-lasting fatigue and an inability to feel pleasure without the drug.

Dangers of Prescription Drug Addiction

Prescription drug misuse can be deadly. In particular, mixing alcohol and prescription drugs can lead to an overdose. Specific interactions include:

Alcohol and CNS Depressants

Mixing these can cause your breathing and heart rate to drop dramatically, which increases the likelihood of overdosing.

Alcohol and Stimulants

Using alcohol with a stimulant such as Adderall can initially block the stimulant’s effects, and you may be at risk of alcohol poisoning. This is because the stimulant’s rush masks the relaxant effect of alcohol, and it may lead to an increase in the amount of alcohol you may drink.

Stimulants and Opiates

This is often called speed-balling and is very risky. Your body will use more oxygen because of the stimulant, and the opioid will reduce breathing rates.

If you suspect someone is overdosing, call 911 immediately

If Narcan (or naloxone), an opioid overdose reversal drug, is available, it should be administered directly after calling 911. Most states have Good Samaritan Laws, which can protect you when you call 911 for an overdose if you have drugs or paraphernalia when you call.Narcan only reverses the effects of opioids and will not reverse a CNS depressant or other overdose. However, if you are unsure of what someone has taken and have access to Narcan, you should administer it. While it won’t reverse a CNS depressant or alcohol overdose, it will not harm the person and may save their life. Because it is difficult to know what someone may have taken, it is vital to call 911 in all suspected overdoses.

Does prescription drug use cause other mental disorders or vice versa?

This question is difficult to answer, as it is very similar to the “chicken and the egg” question. The truth is that the answer tends to vary from individual to individual.

On the one hand, many people start using prescription drugs in legitimate and standard ways, using these drugs under a medical professional’s care. These include opioids for pain relief, benzodiazepines for anxiety, or stimulants for Attention Deficit Hyperactivity Disorder. However, under the wrong set of circumstances, an individual may become addicted to these substances. On the other hand, people with existing emotional or mental health problems may self-medicate and abuse these substances.

At the same time, it is also notable that many people who become addicted to prescription drugs do not have any mental health problems until their addiction. They may then develop any number of disorders, like depression.

There is, sadly, no question that addiction and mental illness are frequently co-occurring disorders. Surveys have found that roughly half of all people who have a mental illness will also experience some sort of addiction, including prescription drug addiction. In instances like this, individuals must enroll in treatment programs that address mental illness and addiction.

How do I know if I’m addicted to prescription drugs?

There are some questions you can ask yourself if you think you have an addiction to prescriptions:

  • Do you use more each time (tolerance)?
  • Have you had physical or mental cravings for the drug when you don’t have it?
  • When you aren’t using, have you had withdrawal symptoms, such as shaking or sweating (dependence)?
  • Has your use resulted in negative consequences, such as losing a job, friends, or legal troubles? Do you continue using despite these consequences?
  • Do you struggle to control your use, such as when and how much you use?
  • Have you done things that you usually wouldn’t, such as stealing from friends or family or lying about what you do or your drug use?
  • Is it difficult to take care of yourself, such as eating, showering, or sleep?
  • Do you see multiple doctors to obtain prescriptions?
  • Have you stolen from or asked friends or family for their prescriptions?
  • Have you started buying illicit drugs or prescription drugs on the street?

What are Tolerance and Dependence?

While the type of physical effects you experience while using a prescription drug may vary, three things are common to most substance use disorders. These are:

Tolerance

If you are addicted, you may have an increased tolerance to the drug. This means your body has ingested so much of a substance that you need to take more and more of the drug to get the same effect. To be clear, tolerance, in and of itself, does not automatically mean that someone has an addiction.

Dependence

Dependence means that you need a drug to function. Many people take many medications that they are “dependent” on to live – for example, many people with diabetes would die without their insulin. However, in this case, dependence means that you cannot function in your day-to-day life without experiencing the euphoria or tranquilizing effects brought on by whatever prescription drug you are taking.

Withdrawal

Withdrawal means that someone will experience negative symptoms when they stop taking a drug. These symptoms can vary but will likely exist on many physical and emotional levels. Many prescription drugs can cause dangerous or even deadly withdrawal symptoms if they are abruptly stopped. These include numerous types of opioids or benzodiazepines. Fortunately, there are treatments available to manage withdrawal symptoms, which can consist of medications and treatment.

How do I stop using prescription drugs?

Prescription drugs can be extremely difficult to stop, particularly if you try to stop using them on your own. It can also be dangerous to stop benzodiazepines without being medically monitored, such as in a detox or treatment program. Withdrawal is unpredictable and can lead to seizures which may result in death. A call to one of our skilled admissions representatives can help you take the first step in stopping prescription drug abuse.

The Substance Abuse and Mental Health Services Administration (SAMHSA) also has a national helpline to find information on treatment options. They will provide referrals to treatment facilities, support groups such as Alcoholics Anonymous and community-based organizations.

The Affordable Care Act requires that health insurance companies in the Marketplace offer addiction and mental health coverage. The coverage levels vary, and there may be restrictions on which inpatient facilities one can select for treatment.

Finding Treatment for Prescription Drug Addiction

Finding treatment can begin with a call to Crystal Lake. There are many treatment options available to you when you are ready. Substance use disorders, including prescription drug addiction, are considered treatable medical conditions, and most insurance companies will cover treatment services for you.

Options include detoxification, inpatient treatment, or outpatient treatment. There are also partial hospitalization programs (PHP) and intensive outpatient programs (IOP), which can help and outpatient treatment, such as meeting with a therapist and attending a support group. If you are unsure about treatment, it’s helpful to speak with an addiction specialist, your primary care physician, or a therapist who can help you understand whether treatment is a good fit for you.

Programs will usually provide a combination of group and individual therapy, so you can start understanding your addiction and develop new coping strategies. Group sessions can benefit you as you build healthier connections with people centered on your recovery rather than substance use. One-on-one therapy can help you address trauma, anxiety, and other conditions contributing to your substance use disorder.

Most treatment programs will also introduce you to 12-step or other mutual support meetings. This will help you begin meeting people in recovery and building the connections and support that will help you when you leave treatment.

When you do find a treatment center, there are several things to look for:

  • What level of treatment is offered, such as detox, inpatient, IOP, etc.?
  • How long will I be in treatment?
  • Will I be prescribed medications for pain or co-occurring disorders?
  • Is treatment available for me if I have a dual diagnosis?
  • What kinds of behavioral therapies are available?

Effective treatment programs are grounded in evidence-based practices and will provide treatment for co-occurring disorders. Our team of professionals will develop a careful treatment plan for you, which will be assessed and adapted as your treatment needs change. Crystal Lake is grounded in evidence-based practices, and our unique approach to treatment can start your recovery.

Crystal Lake Healing offers:

  • “Talk Therapy” or behavioral counseling in groups or one-on-one.
  • Medication management
  • Evaluation for co-occurring disorders.
  • Treatment for conditions such as anxiety, depression, or trauma
  • Long-term planning and follow-up to prevent relapse.

If you began using prescriptions for a medical condition, such as chronic pain, we will work with you to find the right medical team to help manage your pain without using substances.

How to Help a Friend or Family Member

It’s difficult to see a loved one who is struggling with a substance use disorder. Many people who are addicted to drugs don’t know the harm they are causing themselves and others. Ultimately, they will be the ones to decide that they are ready for help. However, you can talk to them to let them know you are worried.

When you talk to your loved one, speaking to them privately when they are not high or feeling withdrawals is helpful. Try and use “I” statements about how their drug use is impacting you. If they are receptive, have the name and number of a doctor or facility to speak to about treatment options.

If you are seeking help for a loved one, our admissions representatives are available to talk to you any time. It helps to have the insurance information available for your loved one, as our admissions will verify insurance coverage.