The drug abuse problem in the United States isn’t limited to the category of illicit drugs. Legal medicines such as prescription and over-the-counter drugs are also a huge component of the drug abuse epidemic.
Prescription drugs are among the most frequently abused substances in the country, along with marijuana and alcohol. In fact, the 2014 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that about 15 million people from the age of 12 used prescription drugs for non-medical reasons in the past year. It also reports that an estimate of 6.5 million people of the same age used psychotherapeutic drugs non-medically in the past month.
The prevalence of prescription drug abuse is attributed to the accessibility of the products and to the popular misconception among abusers that these drugs are safer to use compared to illicit substances. In truth, the risk for developing drug dependence and addiction is high.
The use of these drugs is regulated in the sense that they should not be taken without prior medical consultation. Medication usage and dosage should also to be supervised by a physician or health care professional. Taking these drugs for non-medical reasons can lead to health complications, overdose, and death. Prescription drug abuse accounts for 60% of overdose-related deaths and for about 1.4 million emergency room visits each year, according to this article.
Misuse or abuse of prescription drugs occurs in three possible ways: by using the medication without a doctor’s prescription or prior medical advice such as by taking a friend or relative’s prescribed medication; taking it in higher doses or administering it in a way other than as prescribed by the physician such as by crushing the tablets and snorting or injecting the powder; or using it for the purpose of experiencing the feelings that the drug elicits.
Prescription Drugs Commonly Abused And Their Effects
The drugs most commonly abused include opioid pain relievers, central nervous system depressants, stimulants, and over-the-counter drugs. Here is a brief description of each type and a discussion of the effects of drug abuse:
Opioids are prescribed to relieve and manage acute or chronic pain. These medications work by reducing the intensity of pain signals sent to the brain. Some examples of opioids are hydrocodone, acetaminophen, oxycodone, fentanyl, methadone, codeine, and morphine.
Some of the side effects from taking opioids are drowsiness, nausea, constipation, and disorientation. Taken in larger doses, the drugs can produce a sense of euphoria. Those who abuse the drugs primarily seek to experience increased levels of elation and to further intensify their experience, they may inject or snort the drugs rather than take them orally, as intended. This manner of abuse can lead to several complications including overdose, severe respiratory depression, and death.
Taking the medications for longer periods than prescribed can lead to physical dependence and increased tolerance for the drugs. Eventually, dependence leads to addiction and the user will experience withdrawal symptoms when use of the drugs are reduced or stopped altogether.
Opioid misuse and abuse continues to be a major public health problem in the United States. From 1999 to 2013, the rate of death from opioid pain reliever overdose nearly quadrupled.
Central Nervous System Depressants
Tranquilizers and sedatives fall under the general classification called central nervous system depressants. These are used to treat common conditions such as anxiety, and insomnia as well as more complicated psychiatric disorders such as depression, schizophrenia, bipolar disorder, and other related illnesses.
These medications should be prescribed by a physician only after careful evaluation of the patient’s symptoms. They must be administered with utmost caution and their use must be supervised by a doctor. These type of drugs are susceptible to overdose and can cause potentially dangerous effects. Among frequently used depressants are benzodiazepines, barbiturates, and quetiapine.
These drugs slow down brain activity and induce drowsiness and a sense of calm. They are popularly known as “downers” and are used non-medically by abusers who seek sleep as a form of escape from the reality of their troubles.
Abuse of tranquilizers and sedatives can cause lethargy, nausea, confusion, respiratory depression, and death.
Both tranquilizers and sedatives should not be taken with other medications unless under a physician’s supervision. Taking them with other substances, especially alcohol, can cause dangerous and life-threatening complications.
These drugs are prescribed to treat or manage conditions such attention deficit hyperactivity disorder (ADHD) and narcolepsy. Taking these medications help patients with the said conditions stay calm and focused. Examples of these drugs are methylphenidate, dextroamphetamine, and amphetamines.
Stimulants are known to increase alertness and energy levels. They can also cause an increase in heart rate, blood pressure, and blood sugar. Because these drugs affect the brain’s dopamine levels, taking them in appropriately can produce feelings of elevated euphoria.
Some drug abusers take stimulants in the belief that doing so would improve their cognitive performance because of the drugs’ known effects of increasing energy levels. Stimulant abuse is common among students who take the drugs to improve alertness during examinations and rigorous academic activities.
Taking stimulants non-medically increases risks of addiction, cardiovascular diseases, seizures, and strokes. Repeated use of stimulants can cause paranoia, hostility, and psychosis.
Anabolic steroids are synthetic substances that are associated with the male sex hormones. They are used to treat conditions such as delayed puberty in male adolescents, impotence in men, breast cancer in women, anemia, endometriosis, and other hormonal imbalance conditions. These medications include methandrostenolone, methyltestosterone, danazol, stanozolol, and oxandrolone.
Most anabolic steroids are administered orally while some are injected intramuscularly. Some come in gel or cream form and are used by applying the substances on the skin.
In the United States, these drugs are categorized as Schedule III Controlled Substances because of the probability of harmful adverse effects brought about by the alteration in hormonal production.
Abuse of anabolic steroids is common among those who want to “bulk up” their muscles’ size and reduce body fat. Athletes use anabolic steroids to enhance performance and prolong endurance.
Anabolic steroid abuse can cause severe acne, hair loss and baldness, altered mood, irritability, aggression, depression, infertility, liver disease, kidney disease, cardiovascular disease, hypertension, and cancer. Female steroid abusers may experience irregular menstrual cycle and develop male features such as excess facial hair or deepening of voice.
Over-the-counter (OTC) Medications
These are drugs that are readily available at supermarkets, convenience stores, retail shops, and drug stores. They can be purchased even without presenting a physician’s prescription.
The problem isn’t really the drugs but the addictive substances they contain. For instance, cough and cold medications often contain the component called dextromethorphan (DXM) which is intended to suppress cough. However, when taken in higher doses, the ingredient in the drugs cause an “out-of-body” experience, a feeling of being “high”, and can trigger hallucination. Thus, cough medications are the most commonly abused OTC drugs.
Among the effects of cough medication overdose are vomiting, rapid heartbeat, dizziness, nausea, hallucination, high blood pressure, and liver damage.
Antihistamines that are sold over-the-counter are also subject to abuse. Some users take these substances for their calming and sleep-inducing effects.
Use of diet supplements are abused for their slimming and fat reducing effects. Most weight-loss products, including herbal preparations, contain a dangerous ingredient called ephedrine. The side effects of ephedrine include insomnia, restlessness, nausea, headache, vomiting, diarrhea, palpitations, and hallucinations.
As with diet supplements, laxatives and diuretics are also chosen for their properties that help promote weight loss. The use is prevalent among teens and young adults who are weight and figure-conscious. Abuse of these substances can cause serious dehydration, electrolyte and mineral imbalance.
Caffeine pills and energy drinks are also frequently abused OTC products. They are taken to achieve higher energy levels and improve performance. Abuse of these substances is common among students and professionals. Large doses can cause adverse effects such as palpitations, anxiety, insomnia, gastric reflux, and increased blood pressure.
While over-the-counter drugs are safe for medical purposes and are beneficial when taken in moderation, they can be harmful when taken in larger doses. They are especially injurious when use is combined with alcohol and illicit drugs.
Signs and Symptoms
Spotting the signs of prescriptive drug abuse can be challenging because the symptoms vary according to the substance taken. Also, some people are more predisposed to addiction than others due to several factors such as genetics, biological make-up, social environment, and age. These presence of these factors also influence the rate and manner at which the signs become manifest. The more number of risk factors, the greater the chances for a person to develop substance addiction.
Among the common symptoms of abuse include confusion, loss of coordination, nausea, sleeping disorders, mood swings, headaches, dizziness, and vomiting.
Some signs of prescription drug abuse among teens and young adults may involve behavioral changes. These include withdrawal from family and friends, change in hobbies and interests, hostile or aggressive behavior, abrupt change in academic performance, mood swings, and changes in sleeping patterns.
When parents, relatives or friends observe these behaviors in teens and adolescents, it is best that they seek professional advice immediately and implement the appropriate intervention methods to prevent prolonged abuse that can be potentially damaging to their health.
Prescription drug abuse can be treated effectively. For better chances of recovery, the patient’s treatment plan should be customized according to the substance subject of abuse. In many instances, a combination of approaches is necessary to achieve long-term detoxification and rehabilitation goals.
One popular prescription drug abuse treatment approach is behavioral therapy. This is implemented through individual, group, and family counseling sessions. During these sessions, patients are taught strategies to avoid drug use, and to function normally without need for the substances. Effective counseling helps the patients develop improved interpersonal relationships and work functionality.
Some addictions, particularly those where there is significant physiological dependence on the substance, require pharmacological treatments. Medications may be necessary to manage or prevent cravings, as well as to cope with withdrawal symptoms.
As mentioned, it is best that the patient’s treatment plan integrates a combination of these methods to achieve optimum recovery.
Prescription drug abuse is a persistent public health threat in the country that various federal agencies and state legislation are still trying to combat. These efforts include implementation of several regulation, monitoring, treatment, and prevention measures.
However, successful treatment and prevention begins with the individual and within the home. Individuals should not take medications or alter dosages without first seeking a physician or health care professional’s advice. Neither should they pass on these medications to their family members or friends. Personal monitoring and prevention is still the best way to fight this growing crisis.