I. What Are Prescription Drugs?

There are two types of drugs common in the prevention, treatment, or cure of diseases and medical conditions – prescription drugs and over-the-counter (OTC) drugs. Over-the-counter drugs can be purchased off the shelf in pharmacies, grocery stores, convenience stores, without a doctor’s prescription. They are regulated by the Food and Drug Administration (FDA), but not as closely as prescription drugs, as they are not as powerful and don’t have the same potential for abuse as prescription drugs.

In order to purchase a prescription drug, you need a prescription from a licensed doctor or physician. You can only legally get prescription drugs through a pharmacy, and the prescription is only intended for the person for whom it was written, and the drugs should be taken only in the recommended dosage and for the recommended time period.

There are two types of prescription drugs – name-brand and generic. Generic drugs are designed to work exactly the same as their name-brand counterparts, just for a lower cost. When a doctor writes a prescription, they will usually indicate if it is acceptable for the patient to take the generic brand, if one exists.

Medications work in a variety of ways, and fall into several different categories, typically based on the system or disorder they treat. The three most commonly abused types of prescription drugs – stimulants, opioids, and depressants – all significantly impact the brain’s chemistry, specifically those areas of the brain controlling reward, pleasure, and satisfaction.

Stimulants

Prescription stimulants are designed to increase energy and alertness, and are a common treatment for psychological or sleep disorders like Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy. They typically come in pill form, although there are some stimulants that can be taken as a skin patch or in liquid form.

One of the key differences among stimulants is how long they last. Stimulants are divided into short-acting, intermediate-acting, and long-acting classification. Common short-acting stimulants include:

  • Adderall
  • Ritalin
  • ProCentra
  • Dexedrine
  • Focalin
  • Zenzedi

Intermediate-acting stimulant drugs will last longer, but still need to be taken at regular intervals to be effective. Some common intermediate-acting stimulants are:

  • Ritalin SR
  • Methylin ER
  • Metadate ER
  • Evekeo

Long-acting stimulants are effective for hours or even days, so they do not need to be taken in regular doses. Common long-acting stimulants include:

  • Adderall XR
  • Metadate CD
  • Focalin XR
  • Adzenys XR-ODT
  • Concerta
  • Mydayis
  • Ritalin LA
  • Daytrana
  • Quillivant XR

Opioids

Opioids are synthetically created drugs that mimic the effects of naturally-occurring opiates derived from the opium poppy plant. They provide pain relief and sedation be working on the brain’s pain receptors, and are commonly prescribed to individuals with moderate to severe pain following surgical procedures or injuries. Because opioids are very addictive, they are generally not considered for long-term use. The usually come in pill form, but some can be administered through transdermal patches.

Some common opioids include:

  • Morphine (Brand names: Avinza, Kadian, MS Contin)
  • Oxycodone (Oxycontin, Percocet, Percodan)
  • Hydrocodone (Lorcet, Vicodin, Lortab)
  • Codeine
  • Fentanyl (Duragesic)
  • Methadone (Dolphine)
  • Diphenoxylate (Lomotil)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)

Depressants

Depressants, also called sedatives or tranquilizers, are essentially the opposite of stimulants. They inhibit the function of the central nervous system, leading to feelings of relaxation, calmness, drowsiness, and pain relief. These drugs are commonly prescribed to individuals suffering from anxiety or sleep disorders, although because they are habit-forming, they may not be a good option for treating long-term or chronic conditions. Depressants usually come in pill form, and are categorized as short-acting or long-acting.

Depressants usually fall into one of three categories:

  • Benzodiazepines, such as
    • Alprazolam (Xanax)
    • Diazepam (Valium)
    • Estazolam (ProSom)
    • Triazolam (Halcion)
  • Non-benzodiazepine sleep medications
    • Zolpidem (Ambien)
    • Eszopiclone (Lunesta)
    • Zalepon (Sonata)
  • Barbiturates, such as
    • Phenobarbital (Luminal Sodium)
    • Pentobarnital sodium (Nembutal)
    • Mephobarbital (Mebaral)

II. Causes of Prescription Drug Abuse and Addiction

Depressants, stimulants, and opioids are commonly abused because they affect the brain’s chemistry. These changes to brain function may be beneficial – for example, benzodiazepines can produce feelings of calm and relaxation that help those suffering from anxiety function normally. However, when taken long-term, in higher doses than prescribed, or recreationally by individuals who do not have a treatable disorder, they can alter the brain so that it cannot function without the drugs.

Opioids bind to receptors in the brain, and trigger the release of endorphins. This blocks pain, which is why opioids are often used for severe pain relief. It also creates a rush of pleasure and satisfaction.

Over time, the brain will stop producing its own endorphins, creating a dependence on opioids to create pleasure feelings. The brain also quickly develops a tolerance to opioids, so increasingly stronger doses are needed to create the same effect. Once the brain starts relying on the endorphin rush produced by opioids, an individual can experience physical and mental withdrawal symptoms if they stop taking opioids. At this point, an individual may continue taking opioids even though they no longer need them for pain relief, or will turn to illegal opiates like heroin to continue their addiction.

Depressants affect the brain by stimulating gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits the excitability of neurons and produces a calming effect. As with opioids, individuals taking depressants can become dependent on the drugs to produce happy, calming feelings. They will also develop a tolerance, and require more of the drug to produce similar effects.

Stimulants increase energy, alertness, and attention, which is why they are a popular treatment for individuals coping with attention and sleep disorders. They also trigger the release of the brain chemicals dopamine and norepinephrine, which are related to pleasure and rewards. Individuals abusing stimulants will come to rely on the drugs to help them focus, give them energy, and trigger pleasurable feelings. If prescription stimulants are no longer available, they may turn to illegal stimulants like cocaine or methamphetamine.

There are some factors that can increase the likelihood of developing a prescription drug addiction, such as personal history, the nature of the disorder or issue being treated, and co-occuring disorders. Additionally, individuals who begin taking prescription medications without a doctor’s supervision may be more prone to abuse and addiction. To lower the risk of abuse and addiction, only take prescription medications as advised by a doctor or physician, in the appropriate dosage and only for the length of time prescribed.

III. Prescription Drug Abuse Signs, Symptoms, and Side Effects

There are a number of physical, psychological, and behavioral signs and symptoms that can indicate an addiction to prescription drugs. Some of them may vary depending on the type of drug being abused.

Physical Abuse Symptoms

  • Nausea and vomiting
  • Drowsiness and fatigue
  • Insomnia
  • Weight loss
  • Increased heart rate
  • Tremors
  • Sweating
  • Clammy skin
  • Slurred speech
  • Impaired coordination
  • Shallow breathing
  • Dizziness

Psychological Abuse Symptoms

  • Anxiety
  • Depression
  • Irritability
  • Impaired memory
  • Mood swings
  • Paranoia
  • Agitation

Behavioral Abuse Symptoms

  • Seeing multiple physicians to obtain more prescriptions, or lying about one’s condition to extend a prescription
  • Neglecting personal and professional responsibilities to hide drug use, or by prioritizing drug use
  • Losing interest in activities and responsibilities not related to drugs
  • Stealing money, or committing other illegal acts, to obtain drugs or money for drugs
  • Forging prescriptions
  • Displaying poor judgement and impulse control
  • Changing circles of friends to avoid judgement for using drugs, or to be closer to those with access to drugs
  • Switching from prescription drugs to illegal drugs, such as cocaine or heroin

Long-term Effects and Overdose

One of the most serious risks of drug abuse is the potential for overdose. While prescription overdoses most typically involve opioids, it is possible to overdose on stimulants or depressants, especially if they are mixed with other drugs or alcohol.

Stimulants, depressants, and opioids all affect an individual’s cardiovascular and respiratory systems. In the event of an overdose, a person can experience low blood pressure, seizures, respiratory failure, heart attack, heart failure, or stroke.

Long-term drug abuse can have severe negative impacts on a person’s health, and can include:

  • Weakened immune system
  • Increased risk of HIV, hepatitis, and other bloodborne diseases, if drugs are being injected intravenously
  • Increased risk of dementia and Alzheimer’s disease
  • Paranoia and psychosis
  • Health and respiratory problems
  • Memory loss
  • Kidney and liver failure
  • Depression
  • Anxiety
  • Suicidal thoughts

If you or someone you know exhibits any of the signs of prescription drug abuse or addiction, it’s important to speak to a doctor and seek help.

IV. Prescription Drug Detox, Withdrawal, and Treatment

The first step in the treatment and recovery process is detoxification, in which the individual stops taking the drug, and allows the body to fully remove the drugs from its system. During this time, the person will usually experience withdrawal, while the body and brain seek the chemicals to which they are now accustomed. Depending on they type of drug, and the length of addiction, withdrawal symptoms and how long they last will vary.

Stimulant Withdrawal Symptoms:

  • Tremors
  • Abdominal pain
  • Sweating
  • Fever
  • Anxiety
  • Depression
  • Difficulty sleeping
  • Suicidal thoughts
  • Aggression
  • Intense dreaming

Opioid Withdrawal Symptoms

  • Nausea and vomiting
  • Insomnia
  • Muscle aches and spasms
  • Abdominal cramps
  • Fatigue
  • Excessive sweating
  • Anxiety
  • Paranoia
  • Rapid heartbeat
  • High blood pressure
  • Irritability

Depressant Withdrawal Symptoms

  • Mood swings
  • Anxiety
  • Depression
  • Fatigue
  • Loss of coordination
  • Headache
  • Dizziness
  • Tremors
  • Nausea and vomiting
  • Restlessness
  • Muscle spasms

Because some of these withdrawal symptoms can be dangerous, it’s best to undergo detoxification under the care of a trained medical professional. Many rehabilitation facilities have detoxification centers on-site where patients can safely undergo detox and withdrawal before beginning treatment.

There are some drugs that can be used to ease withdrawal symptoms, particularly for opioid addiction, including methadone and buprenorphine, although they are also opioids, and carry some risk. Do not use these drugs unless under the supervision of a trained medical professional.

There are a number of treatment options available for individuals recovering from prescription drug abuse and addiction, including:

The best option for treatment will depend on the patient’s specific needs, and should be decided in consultation with a doctor, counselor, and trusted family and friends. If an individual undergoes inpatient treatment, they may move to a sober living house after completing rehabilitation, to help transition back to sobriety. Individuals may also need additional treatment for underlying psychological or physical issues that contributed to the addiction.

Although recovery can be challenging, individuals should remain confident and continue working towards a healthy, sober life.

Disclaimer: The information contained on Help.org is for informational and educational purposes only and should not be relied upon for any medical or diagnostic purpose. The information on Help.org should not be used for the treatment of any condition or symptom. None of the material or information provided on Help.org is not intended to serve as a substitute for consultation, diagnosis, and/or treatment from a qualified healthcare provider.