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Prescription Drug Addiction

Prescription drug medications are usually taken responsibly. Nevertheless, prescription drugs are rapidly becoming primary drugs of abuse in America and abroad. The risk for prescription drug abuse is present whenever these medications are used in ways other than as prescribed. Some people become addicted by obtaining multiple prescriptions from a number of doctors (often referred to as “doctor shopping”), forging prescriptions, or buying diverted pharmaceuticals on the illicit market. Prolonged prescription drug abuse places the addict’s physical and mental health at risk of permanent damage, and many people die each year from addiction to these drugs. While many prescription drugs can be abused or misused, there are classifications of drugs that are most often abused: opiods, CNS depressants, and stimulants.

Opiods

Opiods are commonly prescribed for their analgesic, or pain relieving, effects. Taken according to prescriptions, opiods can effectively manage pain. However, any deviation from the instructions can result in addiction and other dangerous side effects. Drugs that fall within this class—sometimes referred to as narcotics—include morphine, codeine, and related drugs. Morphine is commonly used before or after surgery to alleviate severe pain; codeine is used for milder instances of pain.

Other examples of opiods that can be prescribed as pain relievers include oxycodone (Oxycontin); propoxyphene (Darvon), hydrocodone (Vicodin), meperidine (Demerol), and hydromorphone (Dilaudid). Opiods are also used to alleviate severe diarrhea (Lomotil) or severe coughing symptoms (codeine).

Opiods act on users by attaching to opiod receptors in the brain, spinal cord, and gastrointestinal tract. Upon attaching to certain opiod receptors in the brain and spinal cord, they block the transmission of pain messages to the brain. Opiod drugs likewise affect regions of the brain that govern feelings of pleasure, leading to quick bursts of euphoria. Taken in large amounts, they can also cause drowsiness, constipations, and depress breathing. Taking a large single dose could result in severe respiratory depression and possibly death. Chronic users of opiods can build up tolerance to the drugs such that higher and higher doses are necessary for them to achieve the same initial effects. Chronic use can also lead to physical dependence for which withdrawal symptoms can occur if use is abruptly reduced. Key symptoms of withdrawal from opiods can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and involuntary leg spasms.

CNS Depressants

CNS depressants decelerate normal brain functioning. Some CNS depressants can become general anesthetics if taken in higher doses. There are two main groups of CNS depressants. Barbiturates, such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal) are used to treat anxiety, tension, and sleep disorders. Benzodiazepines, such as diazepam (Valium), chlorodiazepoxide HCl (Librium), and alprazolam (Xanax), can be used to treat anxiety, acute stress reactions, and panic attacks. Some drugs in this category have a more sedating effect and can be prescribed for short-term treatment of sleep disorders. Both barbiturates and benzodiazepines can be addictive and should only be used as prescribed.

Many kinds of CNS depressants are available, and most act on the brain by affecting the neurotransmitter gamma-aminobutvric (GABA). Though the specifics vary from drug to drug, they all increase GABA activity that causes drowsiness or calming. CNS depressants should not be taken in conjunction with any medication or substance that results in sleepiness, including prescription pain medications, certain over-the-counter cols and allergy medications, and alcohol. The effects of combining these drugs can slow breathing, or slow both the heart and respiration, which can be lethal.

If an addict discontinues using high doses of CNS depressants, he or she will likely experience withdrawal. Given that these drugs slow the brain’s activity, when an abuser stops taking a CNS depressant the brain’s activity can speed up to the point of causing seizures. Medical treatment is therefore critical for addicts thinking about discontinuing their use of a CNS depressant, or those who have stopped and are suffering withdrawal. Counseling is also advisable for people overcoming an addiction to CNS depressants. Moreover, since abuse of CNS depressants often occurs in conjunction with the abuse of another substance of drug, such as alcohol or cocaine, the treatment method chosen must address the multiple drug addictions.

Stimulants

Stimulants enhance brain activity. Drugs in this class cause increases in alertness, attention, and energy that is accompanied by raised blood pressure, heart rate, and respiration. Stimulants were traditionally prescribed to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other conditions. However, as their potential for addiction and abuse became apparent, their use began to decrease. Now, stimulants are prescribed for treating only a handful of health conditions, including narcolepsy and “attention-deficit hyperactivity disorder” (ADHD). They may also be used as short-term treatment for obesity and for patients with asthma.

Stimulants such as dextroamphetamine (Dexedrine) and methylphenidate (Ritalin) are comprised of chemical structures that are similar to brain neurotransmitters called monoamines, which include norepinephrine and dopamine. Stimulants increase the levels of these chemicals both in the brain and body, which, in turn, increases heart rate and blood pressure, constricts blood vessels, increases blood glucose, and opens up respiratory pathways. The increase in dopamine produces a strong sense of euphoria that hooks users and can lead to addiction.

Addiction to stimulants can be exceedingly dangerous. Taking high doses of a stimulant can lead to an irregular heartbeat, dangerously high body temperatures, and/or the possibility of cardiovascular failure or fatal seizures. Taking high doses of some stimulants consistently over a short time period can sometimes cause hostility or feelings of paranoia. If mixed with antidepressants, the effects of a stimulant may be enhanced. If combined with over-the-counter cold medicines containing decongestants, blood pressure can become dangerously high and irregular heart rhythms can result. Treating an addiction to prescription stimulants effectively requires intensive out-patient or in-patient treatment.

Preventing and Detecting Prescription Drug Addiction

Patients, healthcare professionals, and pharmacists can play a crucial role in preventing and detecting prescription drug addiction. There are several ways that patients can prevent themselves from developing an addiction to prescription drugs. When visiting a doctor, they should provide a comprehensive medical history and description of the reason for the visit to ensure that the doctor understands the problem and can prescribe medication accordingly. If a doctor prescribes a pain medication, stimulant, or CNS depressant, patients should follow the directions for use carefully and learn about the potential side effects and interactions with other drugs. This is easily accomplished by reading all the information provided by the pharmacist. They should refrain from increasing or decrease doses or abruptly discontinue taking a prescription without consulting a health care professional first. Also, patients should never use a drug that has been prescribed to someone else.

Physicians and health care providers are in a strong position to prevent and detect prescription drug addiction. In addition to prescribing medications appropriately, physicians and other health care providers identify drug abuse when it exists, help patients recognize the problem, assist in setting goals for recovery, and seek appropriate treatment when necessary. They should always screen for any type of substance abuse during regular history-taking. In particular, they should ask questions about what prescriptions and over-the-counter medications the patient is taking and why. Screening can also be performed if a patient has specific symptoms commonly associated with misuse of a substance. Over time, providers should make note of any rapid increases in the amount of a medication required, as this may indicate the buildup of tolerance, or requests for refills before the prescribed quantity should have run out.

Pharmacists can help prevent prescription drug abuse by providing clear information and advice about how to take a medication properly, the effects of the medications they prescribe, and any potential drug interactions. They can help avert prescription fraud or diversion by looking for false or altered prescriptions. Indeed, many pharmacies have established “hotlines” to notify other pharmacies in the region when they detect fraud.

Treating Prescription Drug Addiction

Addiction to any drug, whether illegal or prescribed, is a disease which affects the brain and can be very difficult to overcome. However, years of research indicates that these addictions can be effectively treated.

No single treatment is right for all individuals addicted to prescription drugs. Treatment must take into account the type of drug used and the specific needs of the individual. In order to determine an appropriate course of treatment, several components such as counseling in conjunction with medication may be necessary. The two main classes of drug addiction treatment are behavioral and pharmacological. The former teaches addicts how to function without drugs, deal with cravings, avoid drugs and situations that could result in drug use, prevent episodes of relapse, and handle relapse should it occur. Behavioral treatments such as individual counseling, group or family counseling, contingency management, and cognitive-behavioral therapies can also help patients improve relationships and enhance their ability to function at work and with others. Some prescription drug addictions, such as opiod addiction, can also be treated with medications. Such pharmacological treatment methods counteract the effects of the drug on the brain and behavior. They can also be used to relieve withdrawal symptoms, treat overdoses, or help fight cravings. While a behavioral or pharmacological approach alone may effectively treat drug addiction, research indicates that combining both, where possible, is most successful.

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