What are the most abused prescription drugs?
The most abused prescription drugs include three classifications of medications: opiate painkillers, sedatives or benzodiazepines, and stimulant drugs. Each is very different in effect and prescribed for different disorders, but all can be devastating when a person abuses the medication.
: Opiate painkillers are the most frequently abused type of prescription drug in the United States. An estimated 5.1 million people abuse the drugs each year. Prescribed to treat acute or chronic pain, they also create a high in the user when taken in large amounts. Examples include OxyContin, Vicodin, Percocet, and others. Abuse of these medications can cause overdose characterized by extreme respiratory depression that can result in coma, brain damage, and death.
: Benzodiazepines are prescribed to patients struggling with anxiety and panic disorders and/or insomnia. An estimated 2.6 million people in the US abuse these medications each year seeking out the sedation and high that they create when taken in large doses. High-dose abuse can result in a lowered breathing rate and lowered blood pressure that can be deadly; risks of overdose increase significantly when combined with alcohol. Examples of benzodiazepines include Xanax, Valium, Atavan, and others.
: Stimulant medications are prescribed to increase alertness, focus, and mood in patients who struggle with attention deficit and hyperactivity disorder (ADHD), anxiety, and other issues. People often abuse these drugs in an effort to accomplish more in a day or to lose weight. Abuse can cause paranoia, hallucinations, psychosis, erratic behavior, stroke, seizures, heart attack, and death. Examples of stimulants include Ritalin, Vyvanse, Adderall, and others.
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What makes a prescription drug addictive?
Prescription drugs are so addictive in part due to the fact that they trigger the pleasure pathway in the brain. Because taking the drug can cause a “high” in users who are unused to the drug and its effects, taking these meds can be uniquely pleasurable. Some people will begin to crave that feeling and seek it out, wanting it all the time. Continued use of these drugs for this purpose, however, often means that a low dose is no longer effective in creating the high, forcing the user to take a higher dose in order to experience the pleasurable symptoms.
Increased tolerance plus the cravings to experience the high add up to addiction – but not everyone has this experience or develops this problem when taking addictive prescription drugs. Why? There are a number of reasons. Some people may be prone to the development of addiction while others are not. Genetics, biology, trauma, environment, and other factors can contribute to the likelihood that one person will develop an addiction while another will not.
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Are there alternatives to prescription medications to treat mental Illness?
There are alternatives to prescription drugs when it comes to treating mental health symptoms. In fact, almost no one advocates for the use of medications alone for mental health disorder management; most mental health treatment professionals advise patients to attend therapy, group sessions, and take advantage of complementary and alternative methods (CAM) of treatment in addition to taking medication.
Is it possible to rely on therapy and CAM treatment without use of medications? Possibly. Each patient is different, and in some cases, the goal is to eventually stop using medications after initial stabilization and depend solely on the coping skills, reduction in stress, and changes in perspective provided by alternative therapeutic intervention.
Some possible alternatives to medication in mental health treatment include:
- Peer support groups
- Self-help plans
- Nutrition changes
- Exercise plan
- Holistic treatments (e.g., meditation, yoga, acupuncture, acupressure, etc.)
- Herbal supplements
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What exactly is an opiate and how does it work?
Opiates are narcotic painkillers (e.g., hydrocodone, codeine, oxycodone) that are prescribed to treat moderate to severe pain. They work by attaching to opioid receptors in the brain, spinal cord, and other organs, and they cause a reduction in the experience of pain by the user. They also cause a host of side effects, including:
- Mental confusion
In high doses, opiates can also cause depressed respiration, slowed heart rate, and other potentially problematic physiological changes that result in medical emergency, including overdose and death.
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What is a benzodiazepine and how does it work?
Benzodiazepines (e.g., alprazolam, diazepam, clonazepam, etc.) are an addictive class of prescription medications and one of the most commonly prescribed medications for the treatment of mental health conditions and symptoms. They can be prescribed as anti-anxiety medications, anticonvulsants, sleep aids, muscle relaxants, and sedatives.
They work by binding to the GABA receptor in the brain and essentially allow dopamine to be released without interference from inhibiting neurons. In the process, however, they produce a high in the user akin to the effect of drinking alcohol. Though they are prescribed to be taken as needed in many cases, the nature of the disorders triggering the prescription often means that patients self-medicate and take too high of a dose of the drugs. As a result, they inadvertently develop prescription drug abuse problems and ultimately addictions.
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What dosages are there for prescription painkillers?
Depending on the active ingredient in the prescription painkiller (e.g., oxycodone, codeine, hydrocodone, etc.) and the amount of the active ingredient in specific formulation, different doses will be available and have different effects in the user. For certain medical issues, a specific formulation or dosage may be more common (e.g., a low dose of Percocet for the treatment of acute pain after a dental surgery), but the effect of the drug, and whether or not it works to help the patient reduce his experience of pain, may be impacted by:
- Underlying medical issues that affect process and elimination of the active ingredient in the drug
- The use of other medications and their impact on the bioavailability of the painkiller
- Metabolism of the patient
- Foods eaten and/or nutrient levels in the body
- Age of the patient
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What is a drug half-life?
The term “half-life” refers to the length of time that it takes the body to process a prescription drug and clear it from the body. Some are metabolized quickly and process through the body rapidly. These often come with a rapid onset of effect, and they are effective in treating acute issues.
For example, Xanax is a rapid onset benzodiazepine with a short half-life so it is often prescribed to people who struggle with acute symptoms related to anxiety and panic with a dosing schedule that allows for taking multiple doses throughout the course of the day. However, Ativan is also a rapid onset benzodiazepine but it has an intermediate half-life, so while it may be effective for the treatment of anxiety, it is also prescribed to aid with sleep when insomnia is an issue because it stays in the body a little bit longer than Xanax.
It is important to know the half-life of a given medication because stepping up the dosing schedule, taking more of a medication, or combining its use with other medications with different half-lives can result in overdose.
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What are the signs and symptoms of prescription drug abuse?
There are a number of behaviors that can indicate the abuse of prescription drugs, including:
- Taking any amount of a prescription medication without a prescription from a doctor
- Taking a prescription drug in a way that is not prescribed (e.g., taking a higher dose or taking the pills more often than recommended)
- Taking prescription pills specifically to get high
- Altering the pills before ingesting them (e.g., crushing them before snorting, swallowing, or injecting them)
- Taking other prescription medications or mind-altering substances to augment the effects of the prescription
- Filling a prescription for an addictive medication at multiple pharmacies
- “Doctor shopping” or seeking multiple prescriptions for similar drugs for the same purpose from different doctors without their knowledge
Although the signs of use of stimulant drugs will be very different from the signs of use of sedatives or painkillers, chronic drug abuse of any kind takes a toll on a person’s life and personality. Ongoing abuse of any prescription medication will usually result in any combination of the following:
- Financial loss and struggles
- Job loss and/or difficulty getting a new job
- Personality shifts, including mood swings, isolation, and disinterest in spending time with longtime friends and family
- Extreme weight loss or gain
- Extreme changes in sleep patterns
- The beginning of mental or physical health problems or the worsening of underlying issues
- Defensive and/or dishonest response to questions or concerns about drug use
- Hiding drugs or lying about being under the influence
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What effect does crushing medications have?
Crushing pills before ingesting than be a deadly practice. If the pill is an extended-release version of the medication, containing multiple doses that are designed to be released over a period of hours rather than all at once, the practice of pill crushing can be even more dangerous. In an effort to experience all the doses at the same time, some may crush the medication and then snort the resulting powder, taking in multiple doses simultaneously. This can lead to a drug overdose that is deadly, and if done regularly, it can contribute to the development or maintenance of an addiction.
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How long do prescription drugs stay in your system?
Depending upon the half-life of a substance, the length of time that a drug is active and in effect in a person’s system will vary. The half-life is defined as the length of time that it takes for a drug to reduce by half and be processed out of the body. Though there is still technically some level of the drug in the system, it may not be at a therapeutic level.
For many prescription drugs, it will be possible to detect traces of the substance in the person’s system using a drug test for weeks after it was last ingested.
Additionally, it is important to note that a number of factors can impact how quickly a drug is processed out of someone’s system – and those factors may shift and change over time. Age, metabolism, drug-condition interactions, multiple drug interactions, and more can impact how long a medication stays in the system of the user.
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What prescription drugs will cause withdrawal symptoms?
All addictive prescription drugs will trigger withdrawal symptoms in the user if that person suddenly stops taking their drug of choice after a long period of high-dose use and physical/psychological dependency. The specific withdrawal symptoms experienced will vary depending upon:
- The type of prescription medication taken (e.g., withdrawal symptoms caused by benzodiazepine detox will be far different from withdrawal symptoms caused by stimulant drug withdrawal)
- The daily dose of the drug of choice at the time of cessation of use
- The use (or not) of other addictive substances, including marijuana, other prescription drugs, and alcohol
- Underlying mental health disorder(s) or symptoms
- Underlying medical disorder(s) or symptoms
- The use (or not) of medications designed to assist in alleviating the experience of some withdrawal symptoms
Some common symptoms may include:
- Stomach cramping
- Bone and muscle pain
- Heavy sweating, shaking, runny nose, tremors, etc.
- Nausea and vomiting
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What happens when a prescription drug overdose occurs?
A prescription drug overdose can occur when a person takes a high dose of their drug of choice that is overwhelming to their system. For example, too much of a stimulant prescription drug can result in heart attack or stroke that can be fatal, and too much of an opiate painkiller or benzodiazepine can result in a suppressed respiratory system that stops breathing and the heart that can be deadly.
The possibility of overdose is not necessarily something that is a high risk for those new to using substances. Though inadvertently taking too much as a novice drug user is a possibility, so too is having too much of the drug in the system already, taking a “normal” dose additionally, and having it add up to be too much – or combining substances and creating a synergistic effect in the body that is overwhelming to the senses.
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