Death from a Bottle: Guide to Prescription Drug Abuse
Prescription Drug Abuse Non-medical prescription drug use is extremely common in the United States. According to the National Institute on Drug Abuse, a full 20 percent of Americans age 12 and older have used a prescription drug for a non-medical reason at least once. That’s 53 million people, and most of them are young.
The most commonly abused prescription drugs are opioids given for pain management, depressants prescribed for anxiety and sleep promotion, and stimulants used to control conditions like ADHD. Common brands include:
Effects of Commonly Abused Prescription Drugs
Most people have heard of drugs like Vicodin, Xanax, and Ritalin. Many people across the world are prescribed these drugs for short-term pain, sleep disorders, and learning disabilities. They can be very effective, but each drug comes with its own risk of abuse and addiction due to the pleasant effects they have on the brain and body.
Opioids like Vicodin and OxyContin create a fairly intense body high. A pleasant, relaxed feeling throughout the body is common. The drugs often cause drowsiness and lightheadedness as well as feelings of euphoria. The effects are similar to those associated with morphine and heroine. All of this makes prescription opioids incredibly effective and incredibly addictive. An estimated 2.1 million people in the US are addicted to opiate painkillers, according to the Senate Caucus on International Narcotics Control.
Opioids also come with a high risk of overdose. If too much is taken, heart rate and breathing may slow to the point that users can slip into a coma or even suffocate.
Common side effects of these drugs include:
- Loss of appetite
- Dry mouth
- Mood changes
If a person becomes extremely drowsy, is having trouble breathing, or has an irregular heartbeat after consumption, an overdose may be occurring, and the person should be rushed to the emergency room immediately.
Sedatives and benzodiazepines (benzos) like Valium and Xanax can be very beneficial when used as prescribed by a medical professional. Valium is often used before surgery or in other medical situations in which the patient is likely to be experiencing significant anxiety and needs help calming down. Xanax is prescribed for short-term use for people with anxiety disorders or who are experiencing acute anxiety related to temporary life situations. It helps people sleep and deal with whatever is causing the stress, at which point they can get on with their lives. This is a particularly popular drug. As of 2015, Xanax was the 9th best selling drug in the nation.
The reason these drugs are meant for short-term use is because they can be highly addictive. The relaxing effects are very pleasant, much like those of the painkillers listed above. Because of this, many people use these drugs recreationally for the high or use them without a prescription because they can’t sleep or function without them. The sleep aid Ambien is also commonly used because it can produce psychoactive effects if users force themselves to stay awake after taking it.
As with any sedative, an overdose of Valium, Xanax, or Ambien, or taking these drugs with other substances like alcohol, can cause a dangerous depression of the respiratory system, which can lead to suffocation and death.
Stimulants Ritalin and Adderall, on the other hand, are stimulants used to help people focus. They’re best known for treating ADHD (attention deficit hyperactivity disorder) and are also often used to treat narcolepsy. Because these drugs give users energy and promote intense focus on whatever task is being performed, they are often used by those without ADHD or narcolepsy, in an effort to help them work or study.
These drugs are becoming increasingly popular among young people as workloads in high school and college increase. Many high school students are expected to engage in multiple extracurricular activities and work or volunteer, all while maintaining a high GPA in order to get into a good college. In addition, more college students are having to work long hours to pay for high tuition and textbook costs. The pressure and the lack of free time can quickly cause anyone to burn out, so students may turn to stimulants to get them through the day. Ritalin and Adderall can make users feel powerful, even invincible, and like they can accomplish anything – similar to the high experienced when taking cocaine.
These substances can be just as addictive as depressants, especially as people come to rely on them to get anything done. They also come with negative side effects, including:
- Dry mouth
- Difficulty sleeping
- Loss of appetite
- High blood pressure
- Cardiac arrhythmia
While death from an overdose of Ritalin and Adderall isn’t as common as with other commonly misused prescription drugs, even healthy young people have been known to die from sudden heart failure during periods of abuse. It’s also especially dangerous to mix stimulants like these with alcohol, as they can disguise the symptoms of alcohol poisoning.
How Does Addiction Happen?
People misuse prescription drugs for a wide variety of reasons, including simple peer pressure and the demands of keeping up with life. However, addiction most often occurs when these substances are taken at higher doses than recommended. This can happen if someone obtains the drug illegally and doesn’t know the correct dosage and/or the dangers of taking more than recommended, or if someone takes the drug for too long and needs to take more to get the same effect.
Rates of prescription drug abuse and addiction are also increased by misconceptions about the safety and addictive potential of these substances. Because they’re prescribed by doctors, many people think that they’re substantially safer and less addictive than illegal drugs like heroine or cocaine. Depending on the nature of the abuse, and the individual’s genetic predispositions and ability to process certain drugs, they can easily be just as dangerous and just as habit-forming as street drugs like heroin and cocaine. It doesn’t help that they’re sometimes easier and cheaper to obtain than illegal drugs, and there’s much less of a stigma associated with their use. In 2011, 70 percent of youths who abused prescription drugs reported getting the prescription medications from friends and family members.
Basically, any use of a prescription opioid, sedative, benzodiazepine, or stimulant outside of what is recommended by a medical professional substantially increases the chances of addiction. This in turn increases the chances of health problems and deadly overdose from any of these drugs.
Prescription Drug Abuse Statistics
As the abuse of prescription drugs has become more and more common in the US, research has increased. Studies often focus on recreational use, addiction rates, short-term and long-term effects of abuse, health and societal costs, and rates of recovery from addiction.
According to the 2014 National Survey on Drug Use and Health, 15 million people age 12 or older had engaged in nonmedical use of a psychotherapeutic drug in the past year, and 6.5 million had done so in the past month. This recreational usage has been on the rise for some time due to misconceptions about the safety of these drugs and the increase in availability. According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids like Vicodin in 2010 were four times what they were in 1999.
Unfortunately, the increase in use has come with a similar increase in deaths due to misuse. Each day, 44 people die from an overdose of a prescription painkiller. Deaths from benzodiazepine overdose are less common, but have increased fivefold since 1999. Drug overdose in general is a huge problem in the US, being the leading cause of injury death in 2013, outpacing even traffic accidents. Over half of all these deaths were related to the use of prescription drugs.
Most of the people who died from prescription drug overdose from 1999-2013 were between the ages of 25 and 54, and the 55-64 age group experienced a sharp increase in overdose death rates during this time. The majority of these individuals were non-Hispanic white people. Men are more likely to die from overdose than women, though that gender gap is quickly closing.
According to the Drug Abuse Warning Network (DAWN), there were over 1.4 million emergency room visits in 2011 that were related to the use of prescription drugs. Interestingly, more of these involved the use of anxiety medications and sleep aids than prescription painkillers. Many emergency room visits involved the use of benzos even if they weren’t the primary cause of the emergency.
For prescription opioid abuse alone, the costs from loss of workplace productivity, burden on the healthcare system, and criminal justice proceedings amounted to about $55.7 billion in 2007.
Dangers of Long-Term Abuse
All drugs cause damage to parts of the body when they’re used heavily over long periods of time. How quickly the damage accumulates and begins to threaten the user’s life depends on many factors, including the type of drug, how heavy the use is, and if the individual has any other health problems.
Opioids like Vicodin and OxyContin contain high levels of acetaminophen – a drug also found in common painkillers like Tylenol. Too much acetaminophen is hard on the liver, and regular use of this substance will eventually cause liver damage and possibly cirrhosis of the liver. If the abuse continues, the individual may go into liver failure and need a transplant to live.
Scientists are discovering more about the long-term effects of opioids on the brain. Because these drugs activate the brain’s pleasure center, that area can become less sensitive or even damaged over time, subjecting the addicted individual to depression, anxiety, mood swings, paranoia, and psychosis.
When it comes to benzos, there are both physical and mental risks with long-term use. However, not everyone who uses these substances will develop adverse symptoms. Numerous studies have suggested that long-term use can cause cognitive impairment, including memory problems, reduced attention span, impaired motor skills, and reduced spatial abilities.
In 2011, there was something of a scandal among the medical community when 30-year-old documents were released that showed brain shrinkage in some patients who were prescribed benzos. This observation led the Medical Research Council to recommend large-scale studies into drugs like Valium to find out more about their long-term effects. However, these studies never happened, and the drugs were prescribed to people anyway. To this day, studies on the long-term effects of benzos on the brain remain sparse.
The most dangerous thing about benzos is the fact that people tend to develop a tolerance to them so easily, and after little more than a month, they will often need to increase the dosage to maintain the same effects. This also tends to be the point at which people become addicted to these drugs. Eventually, doctors will not be able to increase the dosage due to the risk of serious damage and overdose. At that point, individuals who are addicted may begin to obtain benzos illegally and risk serious health problems by increasing dosages.
Long-term effects of the abuse of prescribed stimulants like Adderall have not yet been well established by controlled studies that follow users over many years. Because of this, it’s hard to say for sure what the effects will be. However, studies on animals have shown a possibility of neurotoxicity, which happens when a substance causes changes in the way the brain behaves, leading to damage of neural tissue. Prolonged exposure to high doses of amphetamines in rodents caused damage to dopamine transporters in the brain and created serotonin deficits. This damage was long-term, persisting for years after exposure to the drug stopped.
One of the biggest concerns about these prescription stimulants is their role as “gateway drugs.” A survey of 9,000 college students found that those who had been prescribed stimulants for ADHD were three times as likely to abuse prescription medications as those who had not, and those who abused them reported more extensive use of alcohol, marijuana, cocaine, and other illegal substances.
With all of these drugs, people may alter the way in which they are ingested in order to produce a faster and more euphoric high. The pills may be crushed so they can be snorted, which can cause damage to the nasal passages over time, leading to a loss of the sense of smell, chronic inflammation, difficulty swallowing, and hoarseness. Injecting drugs comes with a risk of infection at the injection site and contraction of HIV and hepatitis B and C.
Treatment and Therapies
Treatment for prescription drug addiction and dependence is different, depending on the type of drug to which the individual has become addicted. Those who suspect they may be dependent on a substance and may experience withdrawal symptoms if they stop taking it should always seek professional medical advice before doing so.
For opioids, there are medication options that can help an addicted individual quit and that can manage withdrawal symptoms. There are antagonist medications that stop opioids from activating the receptors in the brain that cause the high. A new version of this medication lasts for weeks at a time, greatly increasing the effectiveness, as those in recovery do not have to worry about remembering to take the medication or the temptation to stop voluntarily so they can get high again. There are also medication options to reduce cravings and even eliminate withdrawal symptoms.
Treatment for benzos can be a bit trickier. It’s extremely important that anyone who wants to stop taking a benzodiazepine do so under medical supervision. The dosage must be reduced gradually to prevent potentially life-threatening symptoms, including intense suicidal urges. About 10-15 percent of those addicted to a benzodiazepine will develop what is called post-acute withdrawal syndrome or benzodiazepine withdrawal syndrome. This condition can last for months or years, and is thought to be due to the fact that benzodiazepines treat anxiety and depression, which can reappear when drug use is stopped.
Because of this, doctors will often recommend switching to a non-addictive medication like an SSRI antidepressant. Therapy is also recommended to help the individual deal with the stress and anxiety that might have caused the need for a medication like Xanax in the first place. Cognitive Behavioral Therapy in particular teaches coping skills and works to change thought patterns and behaviors that can lead to drug abuse.
When it comes to stimulants, there are no medications that can effectively eliminate withdrawal or block receptors. Other medications, such as SSRI antidepressants, can be used to make withdrawal more bearable. Tapering off the drug may be recommended to make it easier to deal with unpleasant symptoms and avoid intense cravings that come with stopping intake all at once.
Addiction has long been classified as a brain disease, and addiction to prescription medication is no different. In fact, many have fallen into addiction and dependence on these drugs because they were long marketed as harmless “wonder drugs” without letting people know about their addictive qualities. There’s no shame in suffering from an addiction, and only good can come from understanding how these drugs work, what leads to addiction, and what you can do to get on the road to recovery. A medical professional can provide anyone interested with further information on prescription drug abuse and addiction. With comprehensive addiction treatment, those struggling with prescription drug abuse and addiction can get on the road to recovery.