ALL YOU NEED TO KNOW ABOUT PRESCRIPTION DRUG ABUSE

Prescription drugs, as the name implies, are regulated drugs that require a medical prescription. They are authorized by medical professionals ranging from dentists, veterinarians and optometrists to advanced practice nurses and medical practitioners. Regulation for the use of such substances is covered by different laws depending on each country. Separate legislation takes effect in the United States, United Kingdom and Australia among others.

History of Prescription Drugs

The introduction of prescription drugs in the market was brought about by some circumstances in the past. At first, medicines were discovered to help in certain diseases and to relieve any patient who was in pain. However, it was discovered that with the solution these medicines brought to the life of many, some people have abused and misused it.

Medical prescriptions date back as far as when medicines were already available and when a writing system to write dosage and instructions for these medications were accessible. Modern prescriptions, the ones we make use of these days, are written on the spot by the medical professional depending on the ailment that was discovered during the check-up.

According to Revisiting the "origins of compulsory drug prescriptions", there is an argument that today's prescriptions were derived from the arbitrary acts of the United States Food and Drug Administration (FDA). Particularly, the compulsory drug prescription was introduced in 1938 when the FDA began issuing regulations as to the creation of the types of drugs which can be sold in the market with prescription only.

Different Types of Prescription Drugs

There are different types of prescription drugs according to their uses. There are pain relievers that are recommended for those who underwent a surgical procedure or those suffering from a traumatic injury. There are also sleep medications prescribed either to induce sleep or to keep an individual awake.

The list of the 10 Most Prescribed Drugs includes the following: (1) hydrocodone; (2) Generic Zocor, a statin drug to lower cholesterol; (3) Lisinopril for blood pressure regulation; (4) Generic Synthroid for synthetic thyroid hormones; (5) Generic Norvasc, another blood pressure drug; (6) Generic Prilosec, an antacid; (7) Azithromycin antibiotic; (8) Amoxicillin, another antibiotic; (9) Generic Glucophage for diabetes; and (10) hydrochlorothiazide to lower blood pressure.

Misconceptions About Using Prescription Drugs

There are many misconceptions with regards to the use and safety of prescription drugs. As written in Exploring the Epidemic of Prescription Drug Abuse, many people such as parents are not fully aware of the consequences of giving a prescribed drug to another person who was not the actual patient supposed to receive the medication.

As proof to this misconception, the same article noted that a study made by the US Department of Health and Human Services (HHS) mentioned that there are about 55.7% of those aged 12 and older who received dosage for pain relievers from their parents, family members or friends even if the drug was not intended for their use.

Another misconception about prescription drugs is that it is safe to use. Teens would often think that since they are prescribed by well-educated doctors and are manufactured by well-known companies, they are safe to be used by anyone. This then resulted in the misuse and abuse of such medications. Alongside that, since people think they are regulated and are legal, they use prescription drugs which are not actually intended for their consumption.

Prescription Drug Abuse Defined

It was mentioned that the main reason behind why prescription drugs came into existence is because of the use and misuse by some people of these medicines. However, during this time, even prescription drugs are being abused thus the term prescription drug abuse was coined.

Prescription drug abuse is defined as taking a prescribed drug in a way other than what has been prescribed by the medical professional. It can be pictured in different scenarios like:

(1) taking a drug that has been prescribed to another individual;

(2) taking the drug in larger doses than what was recommended;

(3) taking the prescribed drugs in a different manner like crushing or injecting or inhaling them; and

(4) taking the medicine for purposes other than curing an illness.

Effects of Prescription Drug Abuse

An Emphasis on Addiction

One of the common effects of prescription drug abuse is an addiction. This results from several reasons. For one, it can be due to use of the drug that is over what is prescribed for its potency or frequency of dosage. This can then cause addiction no matter how the drug was acquired, whether legally or not.

In another, addiction results when the body begins to have an increased tolerance to the medication. When this happens, the body will look for an increased dosage of the substance thus leading to addiction. There are also instances where a party may become addicted to the prescribed drug when the abuse occurs from an unintentional exchange of different substances between two individuals.

Other Effects

Apart from the obvious fact that prescription drug abuse can be addicting, there are yet other dangerous effects that should be noted when it comes to taking advantage of these medications. Effects of prescription drug abuse vary depending on the type of prescription drug being abused but for sure, all will have an addictive influence on the user:

  • Those taking prescription opiates like hydrocodone and morphine may lead to slowed breathing. At times, an overdose may lead not just to slowed breathing but also to death.
  • Those using central nervous system (CNS) Depressants can suffer from loss of memory, slow respiration and heart rate and seizures most especially when the drug is withdrawn from use by the patient.
  • Those abusing prescription stimulants may suffer paranoia, heart failure, hostility and irregular heartbeat.

The dangers of misused prescription drugs can also include a variety of health problems ranging from irregular menstrual cycle to changes in mood to infertility. Some drugs classified under sedatives can also result in accidents since the person under the influence of such prescription medications will tend to feel sleepy behind the steering wheel. Not to forget the legalities behind using prescription drugs thus anyone abusing it can be in legal trouble especially if he intentionally misuses the drug for other purposes.

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, an 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.

Varying Symptoms

While there are common symptoms of prescription drug abuse, it is emphasized that the signs shown by every individual vary depending on the type of prescription drug one has taken in.

For abuse of opioid painkillers, for instance, depression, low blood pressure and poor coordination can be noted. For abuse of sedatives and anti-anxiety medications, on the other hand, symptoms include dizziness, unsteady walking and poor judgment. In the case of stimulants, weight loss, irritability and agitation are common.

Opioid painkillers

  • Constipation
  • Depression
  • Low blood pressure
  • Decreased breathing rate
  • Confusion
  • Sweating
  • Poor coordination

Sedatives and anti-anxiety medications

  • Drowsiness
  • Confusion
  • Unsteady walking
  • Poor judgment
  • Involuntary and rapid movement of the eyeball
  • Dizziness

Stimulants

  • Weight loss
  • Agitation
  • Irritability
  • Insomnia
  • High blood pressure
  • Irregular heartbeat
  • Restlessness
  • Impulsive behavior

History of Abused Prescription Drugs

The history of prescription drugs includes the following facts:

  • In 1898, heroin was launched in the market. Back then it was thought to be non-addicting only to find out later that it is otherwise thus medical practitioners alongside the public called for the control or actual ban of its distribution.
  • In 1903, barbiturates were introduced as a substitute to bromides, a more toxic equivalent of the former. Bromide is noted to be in some popular products that are found over-the-counter. It was found addictive and was found in the list of discontinued products right after World War II.
  • In 1955, Tylenol introduced the pain-reliever Acetaminophen which can be used by children.
  • In the 1960s, the Food and Drug Administration formed the Bureau of Drug Abuse Control whose purpose was to control the abuse of non-narcotic medicine. Abuse of amphetamines by truck drivers was the initial result of this program. The same bureau merged with the Federal Bureau of Narcotics thus forming the Department of Justice's Bureau of Narcotics and Dangerous Drugs.
  • In 2000, the prevalence of online pharmaceutical companies that fill-up prescriptions became a growing problem. These illegal pharmacies continue to operate up to these days.
  • In 2007, abuse of prescription medicines grew in number, in fact, even greater than substance abuse. Non-medical use of such drugs was reported to be 2.2 million in children who are 12 years old and older for the year 2005.

More Facts about Prescription Drug Abuse

Prescription drug abuse is said to be more than just an addiction that results in a compulsive intake of a certain medication without the go-signal of a medical professional. The following facts will show that there is more to this condition than just that:

  • Prescription drug abuse is an increasing problem. It can affect all age groups most especially the younger generation who are into the unwarranted use of painkillers, anti-anxiety medications, stimulants and sedatives.
  • People abuse prescription drugs for recreational purposes. In the US alone, it was noted that 20% of adults use it for such a purpose. This rate increases every year thus it is such an alarming incident.
  • It is difficult to watch out for the signs of prescription drug abuse. College students are exposed to many options that lead them to experiment with prescription drugs. Add to that, as mentioned above, the signs and symptoms of abuse differ from one drug to another.
  • There are different street names used for prescription drugs. If synthetic drugs have street names, prescription drugs have their own versions as well. For opioids, "percs", "happy pills" and "vikes" are common street names. For depressants like benzodiazepines, they are called downers, slipping pills, tranks, or candy. Stimulants, on the other hand, are known by the street names beauties, roses, speeds, hearts uppers, the smart drug and skippy among others.
  • Teens get prescription drugs without their knowledge sometimes. Sometimes, teens can obtain these drugs from their relatives or friends without even knowing about it.

Signs and Symptoms of Prescription Drug Abuse

Prescription drugs are meant to help and protect, to minimize pain—physical and emotional—to calm down and comfort and to heal. When their use is not properly managed by a medical doctor, they become the source of pain, not only for the abuser but also for his/her family as a whole.

When the prescription drug abuse person involved is a young member of the family who has yet to develop into a fine adult and who has his/her whole life ahead of him/her, family life gets disrupted. With young teenagers in grade school, the home medicine cabinet could be the unwitting source of their first adventure into teenage substance abuse.

Here are some of the most infamous prescription drugs and their corresponding signs and symptoms:

Drug Abused

Signs and Symptoms

Marijuana

Physical:  Blood-shot eyes, mucus-filled cough, fast heartbeat, frequent hunger, dry mouth

Behavioral: impaired coordination, weak learning and problem solving ability, distorted perceptions, memory lapses, slow reaction time, loss of control, mood and social behavior problems

Psychological: Euphoria, relaxation; at times- anxiety, paranoia, fear

Pain Relievers (Vicodin)

Physical: Night sweats, muscle aches when supply is cut; constricted pupils, constipation, nausea, flu-like symptoms

Behavioral: Slowed reaction time, faulty balance and coordination, insomnia, drowsiness, euphoria, lethargy

Psychological:  anxiety, inability to concentrate, irritability

Fentanyl

Physical: Dizziness, dry mouth, sweating, urine retention, severe constipation, itching/hives, problem with vision, weight loss, headache, swollen extremities

Behavioral: Sleeping difficulty, loss of appetite, nausea and vomiting, shaking

Psychological: Depression, bad dreams, hallucinations

Stimulants (Adderall)

Physical: Fatigue, trembling, heartbeat changes, nausea, vomiting, stomach cramps/pain, weakness

Behavioral: Preoccupation with obtaining the drug

Psychological:  Difficulty with relationships, one-tracked mind, loss of perspective and of ambition

Tranquilizers/Depressants (Barbiturates)

Physical: Drop in blood pressure, poor body coordination, miscarriages and birth defects

Behavioral: Loss of inhibition, slurred, slow speech, uneven or staggering walk, stumbling slow, shallow breathing, lethargy, irritable, extremely deep sleep, even coma

Psychological: Lowered anxiety, thinking difficulty, poor judgment, poor memory, not aware of surroundings and of problems and dangers.

Sleeping Aids

Physical: Burning or tingling sensation in the extremities, constipation, diarrhea, feeling of imbalance, dizziness, drowsiness, headache, heartburn, stomach pain, body shakes, weakness

Behavioral: Changes in appetite, possible parasomnias (e.g., sleepwalking)

Sedatives/Anesthetics

Physical:  When abused and/or when taken with alcohol, sedatives can make the signals to the central nervous system so weak that the functioning of the heart and lungs may not be maintained, leading to death.

Behavioral: Calming effects; loss of interest in things and persons victim used to do and enjoy

Psychological: Loss of commitment and sense of responsibility

Benzodiazepines

Physical: Dizziness, breathing difficulty, drowsiness, blurred vision, poor coordination, unsteady walk, weak muscles

Behavioral: Insomnia, hostility, irritability, reduced inhibition, continuous seeking of ways to get the drug, withdrawal from social interactions

Psychological: Confusion, anorexia, amnesia, bad dreams, impaired judgment, detachment, loss of interest in life


Meanwhile, here are other drugs and their respective signs and symptoms of use:

Ativan

Ativan is a benzodiazepine and an effective depressant medication that slows down the chemical processes throughout the body. The medication is used as a sedative and prescribed to patients diagnosed with anxiety and depression.

Given that Ativan is highly addictive and has a very high dependence rate among its users, it is not recommended as a maintenance medication. Addiction to Ativan may cause someone to suffer from a memory problem, loss of concentration, control and coordination, weakening of the muscles, difficulty in breathing, hallucination and light-headedness. Severe cases may result in the user’s kidney failure, psychosis and paranoia, respiratory illnesses, and amnesia.

Darvocet

This is a prescription drug given to patients who have recently undergone major surgeries. Darvocet is an opioid that contains propoxyphene and acetaminophen. Just like painkillers, Darvocet has the ability to immediately lessen physical pain. This is usually the reason why people begin to develop their addiction to the medicine—the numbness saves them from any type of pain they are struggling with.

Addiction to Darvocet may cause a person to have chest pains, nausea, and swelling of body parts, jaundice, skin rashes, and seizures. It may also cause mood swings, anxiety, depression and paranoia. Because of the strong effects of the drug, the person addicted may have a very difficult time going through withdrawal because dependence on Darvocet easily and quickly develops.

Demerol

A narcotic prescription analgesic, Demerol is used as a pain reliever and is often given to women who are in labor or after childbirth. Similar to other pain management medication, this drug changes the brain’s perception of pain by acting on the central nervous system.

Usually, addiction to Demerol is developed from a person’s desire to escape from any physical or emotional pain he or she is struggling with. Addiction to the drug may cause intense mood swings, depression, agitation and irritability. Risks also include liver failure, hypotension, kidney failure, heart attack, and difficulty breathing.

Orphenadrine

Also known as Norgesic and Norflex, this drug is used for the specific treatment of Parkinson's Disease, as it is an effective skeletal muscle relaxant in cases of severe muscle strain.

Percocet

Percocet is a combination of oxycodone and acetaminophen. It is prescribed to patients suffering from severe pain, by changing the way the brain perceives pain.

Percocet addiction is similar to heroin addiction wherein the user experiences a euphoric feeling after taking the drug. Side effects of Percocet use include light-headedness, sleepiness, constipation, confusion, nausea, and difficulty breathing.

As Percocet is a very strong medication, those who develop addiction or dependence on the drug may develop liver failure and other illnesses of internal organs. A Percocet addict may also feel flu-like symptoms, dizziness, and panic attacks. Addiction to Percocet also usually results in drug overdose, especially because of its acetaminophen content.

Statistics on Prescription Drug Abuse

In the year 2010, there are approximately 7 million individuals who were noted as users of non-medical psychotherapeutic drugs and the most commonly abused drugs are as follows: pain relievers with 5.1 million non-medical users; tranquilizers with 2.2 non-medical million users; stimulants with 1.1 million non-medical users; and sedatives with 0.4 million non-medical users.

For high school seniors, the most commonly used illicit drug comes from over-the-counter and prescription forms. Non-medical use of the drug Vicodin was reported in 1 of 12 high school senior students for 2010 while 1 of 20 was noted to have used Oxycontin. Out of all those surveyed, 70% vouched that the non-medical intake of these prescription drugs resulted from the advice of a family member or a friend.

There is an increased number of prescriptions disposed of for these medications between the years 1991 and 2010. For stimulants, prescriptions increased from 5 million in 1991 to about 45 million in 2010. For opioid analgesics, on the other hand, an increase to 209.5 million in 2010 from 75.5 million prescriptions in 1991 was also noted.

International Statistics for the US shows that there are 2,500 teenagers aged between 12 and 17 who abuse prescription drugs every day for the first time.

Prevalence of prescription drug addiction in the US was noted as follows: about 2.7% in adults or around 15 million being addicted to the use of prescription drugs; 6% for those aged between 17 and 25 years old; and 3.5% for those within the 12 to 17 age brackets.

Teenagers between the ages 12 and 17 years old abuse prescription drugs more than they do abuse the likes of ecstasy, heroin, methamphetamines and cocaine. This is according to the 2011 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration.

Two-thirds of those belonging to the teenager bracket reported that they abused prescription drugs even before they reach the age of 16. This is according to the 2010 Partnership Attitude Tracking Study.

The US Center for Disease Control and Prevention has declared that prescription drug abuse is already an epidemic in the country. The following statistics were noted alongside this declaration as reported in the Center for Lawful Access and Abuse Deterrence:

As of 2012, 17,000 yearly deaths have been noted from the use of the pain prescription opioid analgesics.

In the year 2013, it was realized that only 16% of Americans have firmly believed that the US government is making an effort to reduce the incidence of prescription drug abuse.

In 2012 alone, it was found out that there are about 493,000 teenagers between the ages 12 and 17 who were noted to use pain prescriptions non-medically for the first time.

A quarter of those who started abusing drugs in 2012 resulted from non-medical intake of prescription drugs.

The 2013 Monitoring the Future survey concluded that next to marijuana, prescription drugs account for the top-most abused drugs. Survey results show 7.4% use of Adderall, 5.3% use of Vicodin, 5.0% use of Cold medicines, 4.6% use of tranquilizers, 3.6% use of OxyContin and 2.3% use of Ritalin. The statistics were a result of a study conducted on 12th graders and they were noted to have taken the aforementioned drugs without consent or non-medically.

These figures are quite alarming, considering that the abuse of synthetic drugs somehow went down over the past year. There is a reason to worry and to scrutinize the high prevalence of prescription drug abuse-related cases.

Factors that Explain the High Prevalence of Prescription Drug Abuse

What can possibly explain the figures associated with prescription drug abuse and addiction to prescription drugs? 

Misconception

This misconception is about the safety of prescription drugs. Many people believe that since these substances are prescribed by medical professionals, it is perfect to use it for a particular ailment it is intended for in any circumstance.

Increasing market availability

Facts have shown that availability of prescription drugs have already increased throughout the years. This being said, access to it is easier than before and sadly that access opens rooms for abuse in many individuals.

Specific reasons for abuse

Prevalence of prescription drug abuse comes from several reasons that users usually justify. These reasons include countering pain and anxiety, increasing mental health and getting a natural high.

Main Drugs That Can Be Abused and Tested

Under the Commonly Abused Prescription Drugs Chart of the National Institute on Drug Abuse, the following drugs were noted to be used for non-medical reasons in the year 2010:

  • Depressants like barbiturates, benzodiazepines, sleep medications;
  • Opioids and morphine derivatives like codeine, morphine, methadone, fentanyl and analogs and other opioid pain relievers;
  • Stimulants like amphetamines and methylphenidate; and
  • Other compounds like dextromethorphan.

Among the list of prescription drugs, opioids were most abused having 5.1 million users out of the total 7 million users in 2010. Sedatives and tranquilizers come next with a total of 2.6 million users back then. Stimulants, on the other hand, tracked 1.1 million users.

Opioids

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.

There are many types of trademarked prescription opiates, including:

Generic Opiate Names Trademarked Opiate Names Description
Codeine Phosphate Pediatric BP Codeine (INN) is an opioid used for its analgesic, antitussive and antidiarrhoeal properties. It is commonly marketed as the phosphate sale codeine phosphate.
Dihydrocodeine Remedeine Pain relief after enduring moderate to severe physical trauma
Ethylmorphine Dionine, Indalgin Ethylmorphine is a drug in the class of both opiates (representing a minor synthetic change from morphine) and opioids (being effective in the CNS opioid receptor system). Its effects in humans mainly stem from its metabolic conversion to morphine.
Morphine Morcap Major sedative and pain-relieving drug found in opium, being approximately 10% of the crude opium exudate.


Some of the side effects of 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 the use of the drugs are reduced or stopped altogether.

Opioid misuse and abuse continue to be major public health problems in the United States. From 1999 to 2013, the rate of death from opioid pain reliever overdose nearly quadrupled.

Propoxyphene

Propoxyphene, which is trademarked as Darvon N and Dolene, is used for the treatment of mild to moderate pain symptoms. Whether taken by itself or in combination with other drugs, high doses of propoxyphene are associated with many cases of preventable overdose deaths.

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 types of drugs are susceptible to overdose and can cause potentially dangerous effects. Among frequently used depressants are benzodiazepines, barbiturates, and quetiapine:

Amobarbital (trademarked as Amytal and Tuinal) and butabarbital (trademarked as Soneryl) are the most commonly prescribed barbiturate drugs. Amobarbital and butabarbital are used for their sedative and hypnotic properties. Sometimes, two or more barbituates can be combined into one, as in Tuinal, which contains equal amounts of amobarbital and secobarbital.

Flurazepam, one of the most commonly occurring benzodiazepines trademarked as Dalmane, is used to treat insomnia and other sleep-related ailments by slowing brain activity.

Barbiturate and benzodiazepine drugs effect on neural function induces 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.

Stimulants

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 inappropriately can produce feelings of 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

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 muscle 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 the 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. Promethazine, marketed as Anergan, is one such antihistamine with a Tricyclic Antidepressant base used to treat allergies. Promethazine is also used as an antiemetic to ease motion sickness symptoms.

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.

Fast Facts About Prescription Drugs

Here are some important information about specific prescription drugs:

Depressants

Name

Examples of Commercial & Street Names

How Administered*

Barbiturates

Amytal, Nembutal, Seconal, Phenobarbital; barbs, reds, red birds, phennies, tooies, yellows, yellow jackets

injected, swallowed

Benzodiazepines

Ativan, Halcion, Librium, Valium, Xanax; candy, downers, sleeping pills, tranks

swallowed

Sleep Medications Ambien (zolpidem), Sonata (zaleplon), Lunesta (eszopiclone); forget-me pill, Mexican Valium, R2, Roche, roofies, roofinol, rope, rophies swallowed, snorted

Tricyclic Antidepressants

Amitriptyline, Elavil, Triptafen-M; used in small doses to treat depression and pain related to nerve damage.

swallowed

 

Opioids and Morphine Derivatives

Name

Examples of Commercial & Street Names

How Administered*

Codeine

Empirin with Codeine, Fiorinal with Codeine, Robitussin A-C, Tylenol with Codeine; Captain Cody, Cody, schoolboy; (with glutethimide: doors & fours, loads, pancakes and syrup)

injected, swallowed

Morphine

Roxanol, Duramorph; M, Miss Emma, monkey, white stuff

injected, swallowed, smoked

Methadone

Methadose, Dolophine; fizzies, amidone, (with MDMA: chocolate chip cookies)

swallowed, injected

Fentanyl & analogs

Actiq, Duragesic, Sublimaze; Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, Tango and Cash

injected, smoked, snorted

Other opioid pain relievers: Oxycodone HCL, Hydrocodone Bitartrate Hydromorphone, Oxymorphone, Meperidine, Propoxyphene

Tylox, Oxycontin, Percodan, Percocet: Oxy, O.C., oxycotton, oxycet, hillbilly heroin, percs Vicodin, Lortab, Lorcet; Vike, Watson-387 Dilaudid; juice, smack, D, footballs, dillies Opana, Numporphan, Numorphone; biscuits, blue heaven, blues, Mrs. O, octagons, stop signs, O bomb Demerol, meperidine hydrochloride; demmies, pain killer Darvon, Darvocet

chewed, swallowed, snorted, injected, suppositories

 

Stimulants

Name

Examples of Commercial & Street Names

How Administered*

Amphetamines

Biphetamine, Dexedrine, Adderall; bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers

injected, swallowed, smoked, snorted

Methylphenidate

Concerta, Ritalin; JIF, MPH, R-ball, Skippy, the smart drug, vitamin R

injected, swallowed, snorted

 

Other Compounds

Name

Examples of Commercial & Street Names

How Administered*

Dextromethorphan (DXM)

Found in some cough and cold medicines; Robotripping, Robo, Triple C

swallowed

Metronidazole (Anabact) A drug used to treat bacterial, fungal and parasitic infections. It is also being studied in the treatment of some cancers. topical gel applied to skin

 

Study Drugs

Study drugs are stimulants that are used inappropriately to help enhance mental focus such as memory, motivation, alertness, attention, concentration and productivity that helps in studying.

These drugs – also known as “smart drugs”, “cognitive enhancers” and “neuro enhancers” – are designed to treat Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). When these drugs are used without any prescription, these can pose danger to an individual’s health. In fact, any substance that is taken without a medical advice or prescription is considered illegal and dangerous.

These drugs are referred to as “nootropic”, which translates to “mind affecting”. This term was coined by a Romanian psychologist, Corneliu E. Giurgea back in 1972.

How Study Drugs Affect the Brain

Stimulants have chemical structures that are similar to some neurotransmitters. When an individual takes this kind of drug, it boosts the effect of the neurotransmitters in the body and brain. Once this happens, brain activity increases which include increased focus and concentration.

The “feel good” phase persists for only a few hours. Once the effect wears off, the individual may feel disconnected, sluggish or depressed.

Statistics on Study Drug Use

According to a 2015 study, about 17% of students are taking these ADHD drugs.  Such medications include Adderall and Ritalin, both categorized under Schedule II of the Controlled Substances which clearly shows that these drugs are within the range of substances like methamphetamine and cocaine.

These smart drugs were developed to primarily treat people with ADHD for the purpose of helping them to stay focused to be able to understand better. Being a stimulant, it has a calming and focusing effect on people having ADHD especially when prescribed to be used in a daily basis. This comes in two forms: capsules or tablets.  As the ADHD symptoms improved, people taking these drugs will show an increase in self-esteem and social interactions.

A 2011 report showed that an estimated 5% of Americans illegally used prescription psychotherapeutic drugs between the ages 18-25. While it may appear that we should not be too alarmed considering that it was just 5%, it is significantly higher than those individually illegally using cocaine and hallucinogens combined.

A survey by the Partnership for Drug-Free Kids in 2014 reported that there were at least 20% among college students are engaged in prescription stimulants abuse. The most popular drug in the survey was Adderall that is used by 60% among those taking stimulants. Half of the students surveyed said that the reason why they used the drugs was for improving their academic performance.

Why Are Study Drugs Abused?

Misuse of these drugs are either taking them without prescription or taking the drugs more than what has been prescribed. The main reason why these are misused by some individuals is because of its supposed “positive effect” in improving academic performance.

Recreational use of ADHD medications along with alcohol prolongs the ability of an individual to tolerate alcohol, thus, making the individual drink more alcohol that he can actually handle. In doing so, the individual may not be aware that he is crossing a very dangerous line.

It was reported that the most common source of ADHD stimulants was among friends who are members of a fraternity or sorority which makes it very popular in different campuses.

Since college students may be too stressed to cope up with so many things that they need to do, that they have resorted to ADHD medications with the hope that they can easily absorb everything that they need to study.

First time users may not have the intention of getting hooked on the drug but rather just wanting to be able to cope with demands in school. However, using the drug without supervision poses a high risk of developing a problem.

The pressure that college students feel may be the reason why they resort to using these drugs. They may not be aware of its long-term effects but are just rather focused on what their current need in using the drug.

Adverse Effects of Study Drugs Abuse

According to the National Institute on Drug Abuse (NIDA), the abuse of these stimulants may lead to:

  • Anxiety
  • Cardiovascular complications, such as stroke
  • Dizziness
  • Headache
  • Hostility
  • Impotence or changes in sex drive
  • Increased blood pressure
  • Insomnia
  • Irregular heartbeat
  • Malnutrition
  • Mouth dryness
  • Nervousness
  • Paranoia
  • Restlessness
  • Suppressed appetite

Individuals who may have just occasionally used these drugs may experience exhaustion and depression once the effect of the drug has worn off.

Consequences of Taking Unprescribed ADHD Medications

Apart from the health consequences that one may suffer from taking these drugs, the individual could face serious legal consequences such as fines, serving jail time and consequently suspension from school. In addition to taking of the drug is the increased possibility of committing a crime.

The long-term risk of taking these drugs is dependency and addiction which can lead to various health conditions and eventually can be the cause of death.

The reality in taking these drugs as an aid to enhance attention and mental focus is that those individuals who used them had lower GPAs.

Common Study Drugs

When we talk about drugs, we would often associate them to party drugs or club drugs. But now, there are various prescription drugs that are misused hoping that it can be their solution of having concentration to boost their grades.

Adderall

This is the most famous of all study drugs. It is prescribed to individuals with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). This drug is a combination of amphetamine and dextroamphetamine that directly affects the chemicals in the brain and nerves.

Ritalin

Its chemical name is methylphenidate. It similarly acts like Adderall. It is a drug that can help increase attention span and to keep an individual more focused.

Caffeine Pills

These pills can also help boost energy that taking a cup of coffee may not be enough. It was discovered to boost long term memory and pattern separation.

Concerta

Just like Adderall and Ritalin, it is a prescription drug that is used to manage ADD and ADHD and can help increase attention and absorb information for long hours. It chemical is methylphenidate.

Adrafinil

This drug increases blood flow in the brain thereby increasing neurotransmitter activity that enhances attention and focus.

It is currently banned in France but remain unregulated in the US.

Focalin

Its chemical name is dexmethylphenidate. It is a mild stimulant that can affect hyperactivity of the brain thereby increase focus and attention similarly as Adderall and Ritalin.

Modafinil

This drug is specifically prescribed to individuals who are suffering from narcolepsy. This drug helps in increasing blood flow to the brain and makes the user alert as long as 12 hours.

Nicotine

Nicotine, trademarked as Nicoderm, can be found in quit smoking aids such as patches and gum. Nicotine is the addictive drug contained in tobacco products which activates a specific type of acetylcholine receptor.

Penalties Imposed on Study Drug Abuse

Since ADHD drugs are controlled substances, those people who distribute, handle prescription drugs should secure a government license and to keep records of the drugs. Possession without a valid prescription is considered illegal.

  • 1st offense of possession – up to 1 year in prison, a $1000 fine, or both with escalating, with escalating offenses for subsequent offenses.
  • Distributing Schedule II substances, like study drugs – a fine up to $5 Million and up to 20 years in prison for first offenders.
  • Distributing drugs in or near schools and colleges could double distribution penalties.

Drug Testing Methods to Test Prescription Drugs

One of the most popular ways to test prescription drugs is through urine testing. Like when testing for illegal drugs using this method, this type of test indicates whether one or more prescription drugs are present in the urine. It tests for medical drugs such as benzodiazepines, barbiturates, methadone and tricyclic antidepressant among others.

Here are the detection windows of commonly abused prescription drugs:

Drug

Class

Detection Time in Urine

Amphetamine

Stimulant

Up to 2 days

Barbiturates

depressants / sedatives / hypnotics

short-acting: 2 days long-acting: 1-3 weeks (based on half-life)

Benzodiazepines

depressants / sedatives / hypnotics

therapeutic dose: 3 days chronic use: 4-6 weeks or longer

Cocaine (benzoyl ecgonine metabolite)

Stimulant

Up to 4 days

Codeine

Analgesic / Opiate

2 days

Ethyl alcohol, ethanol

depressants / sedatives / hypnotics

urine: 2 to 12 hours serum/plasma: 1 to 12 hours

Heroin

Analgesic / Opiate

2 days

Marijuana, Cannabinoids

Hallucinogen

Single use: 2 to 7 days Prolonged, chronic use: 1 to 2 months or longer

Methadone

Analgesic / Opiate

3 days

Methamphetamine

Stimulant

Up to 2 days

Methaqualone

depressants / sedatives / hypnotics

Up to 14 days

MDMA / Ecstasy

Stimulant

Up to 2 days

Morphine

Analgesic / Opiate

2 days

Phencyclidine

Hallucinogen

8-14 days, but up to 30 days in chronic users

 

Treatment Approaches for Prescription Drug Abuse

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 legislators are still trying to combat. These efforts include implementation of several regulations, monitoring, treatment, and prevention measures.

However, successful treatment and prevention begin 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.

Common Drugs Used for Prescription Drug Abuse Treatment

Although there are many options for drug abuse treatment, one of the commonly used techniques is pharmacological treatment. This may sound preposterous, but some drugs are designed to help in the treatment of prescription drug abuse.

Here are three common drugs used for the pharmacological treatment of drug abuse and addiction:

Methadone

Methadone is a synthetic opioid analgesic synthesized in 1937 by German scientists Max Bockmühl and Gustav Ehrhart at IG Farben (Hoechst-Am-Main) who were searching for an analgesic that would be easier to use during surgery and also have low addiction potential. Also known by its trademarked name, Dolophine, Methadone is a Schedule I drug under the Single Convention on Narcotic Drug.

This narcotic drug is used to reduce withdrawal symptoms in individuals who have been addicted to heroin or other narcotic drugs. It is designed for pain relief and has become a safe alternative to more addictive prescription opioids. In fact, methadone is being used as part of drug addiction detoxification and maintenance programs.

Precautions when using Methadone

Here are some necessary measures to be taken prior to prescribing Methadone to an individual:

  • It should not be used by patients with asthma or bowel obstruction.
  • It can slow up breathing.
  • It should not be used in large amounts for a long time because taking it can be habit-forming.
  • It should only be given to the patient that has been prescribed with it and should not be shared with others.

Misuse of Methadone

Abusing this drug may lead to health risks, some of which are:

  • Chest pains
  • Dizziness
  • Headache
  • Life-threatening heart rhythm disorder

It should be noted that alcohol and methadone can be a dangerous combination.

Side Effects of Methadone

There are certain adverse reactions that a patient may experience when taking Methadone. Not all described below, however, can be experienced by the patient at the same time.

  • Impotence or lower sex drive
  • Infertility or missed periods
  • Life-threatening heart rhythm disorder
  • Light-headedness
  • Nausea, vomiting, dizziness, loss of appetite
  • Severe constipation
  • Shallow breathing

Buprenorphine

This narcotic analgesic — which is also known as naloxone or the brand name Suboxone — works on the brain and the central nervous system to help decrease pain.

Precautions when using Buprenorphine

Patients should always provide the necessary information to their physicians so that they can be given the right kind of medication to ensure their complete recovery from a condition.

For instance, you should mention potential sensitivity to any ingredient in Buprenorphine. It’s also advised to mention to your doctor if you are taking sodium oxybate.

Conditions affected by Buprenorphine use

Extreme caution should be undertaken when prescribing Buprenorphine as it can affect several conditions, which may worsen the situation instead of helping in the treatment. Here are some conditions where Buprenorphine may have some impact:

  • Currently taking other prescription medication
  • History of any recent head injury or brain growth
  • History of blood problems, lung problems, adrenal gland problems, liver or kidney problems, blockage of bladder, gallbladder problems, or stomach problems
  • History of mental problems, as well as drug or alcohol abuse
  • Medications that can interact with Buprenorphine
  • Pregnancy
  • Sensitivity or allergy to medicine, food or other substances

Buprenorphine should be prescribed and taken with utmost care. Complete patient history should be provided so that doctors may be aware of any medications that can cause untoward reactions to Buprenorphine. Here are some of them:

  • Azole antifungals
  • Methadone (may decrease the effect of Buprenorphine)
  • Naltrexone

Side Effects of Buprenorphine

Expect a number of adverse effects when taking Buprenorphine. These side effects include:

  • Breathing problems
  • Constipation
  • Drowsiness or dizziness
  • Headache
  • Nausea
  • Seizures
  • Sweating
  • Vomiting

Naltrexone

Generic Name: Naltrexone

Trade Name: Nalorex

Description: A long-lasting opiate antagonist used for the treatment of heroin addiction, and more recently used for the treatment of alcohol addiction.

This drug blocks the effects of any opioid medication that can lead to opioid abuse. This drug is used as part of a treatment program for drug or alcohol dependence. It helps in keeping a drug dependent away from the feeling of having the urge to use the opioid.

Precautions when using Naltrexone

The following precautionary measures should be undertaken prior to using Naltrexone:

  • This should not be used by people who experience withdrawal symptoms from alcohol or drug addiction.
  • This should not be used if there was any opioid medication used for the past 10 days.
  • This should not be used with Methadone or Buprenorphine.
  • This should not be used by individuals below 18 years old.

Side effects of Naltrexone

Just like other drugs, Naltrexone may produce side effects that an individual may experience. Not all of the mentioned signs and symptoms below can be experienced all at the same time by a single patient.

  • Clay-colored stools
  • Dark urine
  • Depression (thoughts about suicide)
  • Feeling anxious
  • Insomnia
  • Jaundice
  • Loss of appetite
  • Mood changes
  • Muscle or joint pains
  • Nausea, vomiting, or diarrhea
  • Upper stomach pain

Drugs that may interact with Naltrexone

Your doctor should be aware of other medications that you are taking prior to prescribing Naltrexone. This ensures that the optimum efficacy of the drug can be achieved.

The following drugs may interact with Naltrexone and affect its effectiveness:

  • Herbal supplements
  • Over-the-counter medicines
  • Vitamins

Long-term use of naltrexone is considered to be effective. In other words, it is safe to use for months without the fear of being addicted to it. Naltrexone also does not pose any danger when taken with alcohol.

Prescription Take-Back Programs and Initiatives in the U.S.

The National Prescription Drug Take-Back Day in the U.S. started on September 25, 2010 following an approved legislation from Congress amending the Controlled Substances Act. On October 12 of the same year, President Obama signed the program called Safe and Secure Drug Disposal Act of 2010 pushing the DEA to work on regulations that will offer more permanent solutions.

The primary aim of the take-back initiative is to ensure safe, responsible and convenient means for prescription drug disposal. It also includes dissemination of information to educate the public about prescription drug abuse and its potential effects. The program involves several law enforcement agencies from each state in the US.

The program entices the public to have its own participation in the promotion of the National Prescription Drug Take-Back Day. In fact, it encourages individuals to download materials, posters and handouts that are crucially significant in informing the public of what they can do to prevent prescription drug abuse. A Partnership Toolbox is available.

Likewise, the Office of Diversion Control under the Department of Justice's Drug Enforcement Administration, the office in charge of the take-back, provides the public with access to Drug Disposal Information.

States with Prescription Drug Take-Back Programs

Apart from the National Prescription Drug Take-Back day, there are states in the USA that started statewide initiatives to regulate prescription drug disposal. Among the states included in the list are:

Pennsylvania. Pennsylvania's Department of Drug and Alcohol Programs have included prescription drug take-back on its list of activities.

Virginia. Virginia's Attorney General Mark R. Herring has explained that there are different benefits to the take-back including but not limited to more organized and closer monitoring of prescription drug disposal.

Idaho. Idaho's prescription drug take-back programs include distributing forms via the Idaho Prescription Drug Abuse Handout downloadable from the Idaho Office of Drug Policy.

New York. Monthly collection of non-controlled prescription drugs as well as over-the-counter medicines is made by Kinney Pharmacies every last Saturday of the month. There are also various scheduled events for the said take-back program.

North Dakota. The state's Attorney General Wayne Stenehjem, together with all other law enforcement agencies within the state has provided a list of take-back program locations.

Washington. Through the help of the Science and Management of Addiction (SAMA), the state was able to implement and continue implementing medicine return programs.

Effectiveness of Prescription Drug Abuse Take-Back Programs

With the prescription drug abuse take-back programs in place in the different states of the country, many wonder how effective the initiative is. Before going deep into that, there should be a better understanding of what the program is all about. The purpose is divided into two according to Energy and Environment Counsel Paula Cotter. In the article Drug Takeback Programs – National Day Planned, Cotter emphasized that one of the purposes served by these programs is to reduce the risks of having prescription drugs in both human water and marine life. The second one is to reduce the risks of consuming prescription drugs inappropriately. Of course, the other purpose is considered most important of the two.

Since the program's launch in 2010, a total of 4.1 million pounds or 2,123 tons of unused and unneeded medications were already collected. What does this mean? It simply implies that the DEA Nationwide Drug Take-Back efforts pay-off thus leading to controlling misuse and abuse of prescription drugs. The efforts have been held twice a year and by far resulted to a legal and safe disposition of prescription medications.

As proof to its effectiveness, the Food and Drug Administration together with the National Drug Control Policy of the White House combined forces to develop federal guidelines that will govern take-back programs. These guidelines have been introduced in order to convince every agency involved to take advantage of the existence of such initiatives. Luckily, the initiatives attracted different states to be one with the program.

Conclusion

The Centers for Disease Control and Prevention (CDC) has classified prescription drug abuse as an epidemic in the United States. Various agencies and community partners have contributed initiatives to address the growing crisis.

More than developing treatment methods, intervention and prevention measures in homes and schools must also be strengthened to preclude further escalation of the problem. Those who are aware of loved ones, co-workers, or peers who are taking prescription drugs whether medically or non-medically must assist in monitoring their symptoms or habits in case intervention is necessary. Early detection could save a life and prevent addiction.


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