How to identify prescription drug addiction

Addiction to prescription drugs is not new. But these days, given the range of mental health and emotional or behavioral diagnoses doled out to anyone and everyone, we are becoming a pill-happy culture. Abuse of doctor authorized medications is on the rise. What are the signs that a loved one is using scripts to cope with life? And how can you know the difference between proper and misuse of prescription drugs?

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Reviewed by: Dr. Dili Gonzalez, M.D. Dr. Juan Goecke, M.D.

ARTICLE OVERVIEW: Most Rx drug problems start when you are using the drug in a way not intended by the prescribing doctor. Prescription drugs most often abused include opioid painkillers, sedatives, anti-anxiety medications, and stimulants. Early identification of prescription drug abuse and intervention is very important. Addiction is a medical condition and responds successfully to medical treatment.


Common RX Drugs

There are three kinds of prescription drugs that are commonly misused:

  1. Central nervous system depressants including tranquilizers, sedatives, and hypnotics used to treat anxiety and sleep disorders (Ambien, Ativan, Xanax).
  2. Opioids that usually prescribed to treat pain (Vicodin, OxyContin, Fentanyl, Tramadol).
  3. Stimulants, most often prescribed to treat ADHD (Adderall, Ritalin, or amphetamines)

Because commonly misuse or abused prescription drugs activate the brain’s reward center, it is possible to develop physical dependence and addiction. But did you know that taking a medicine to get high can have serious medical consequences? Here are examples of serious consequences of prescription drug addiction:

Sedatives and anti-anxiety medications can cause memory problems, low blood pressure and slowed breathing. Overdose can cause coma or death. Abruptly stopping the medication may cause withdrawal symptoms that can include nervous system hyperactivity and seizures.

Opioids can cause low blood pressure, a slowed breathing rate and potential for breathing to stop, or a coma. Overdose has a significant risk of death.

Stimulants can cause dangerously high body temperature, heart problems, high blood pressure, seizures or tremors, hallucinations, aggressiveness, and paranoia.

How Do People Get Addicted?

Prescription drugs are legal when a legitimate medical provider has prescribed you the medication for the treatment of an illness or condition. However, these drugs still can be addictive when taken as prescribed. How?

Mainly, prescription drugs change the chemistry of the brain. The brain is made up of about 100 billion neurons, also known as nerve cells. Neurons communicate with each other by using chemical messengers called neurotransmitters. There are many types of neurotransmitters, and each one carries a specific message. Neurotransmitters deliver their messages by attaching to special places on nerve cells called receptors. [1]

Drugs are chemicals. When someone puts these chemicals into their body, either by smoking, injecting, inhaling, or eating them, they tap into the brain’s communication system and tamper with the way nerve cells normally send, receive, and process information. Different drugs, because of their chemical structure, work differently. We know there are at least two ways drugs work in the brain:

  • Imitating the brain’s natural chemical messengers.
  • Overstimulating the reward circuit of the brain.

Dependence Defined

Physical dependence is the body’s response to long-term use of a psychoactive drug. People who are physically dependent on a drug may need higher doses to get the same effects and may (tolerance) experience withdrawal symptoms when cutting back or abruptly stopping the drug. Physical dependence may also become evident if a drug the body becomes adjusted to over time, even without dosage change, is stopped abruptly.

But just because you’re drug-dependent doesn’t mean that you’re addicted! What’s the main difference?

People who are addicted to a drug compulsively seek a drug and continue to use it, even when that drug makes their lives worse. If you’re using a drug even in spite of problems with health, home, work, or social life…that problem goes beyond drug dependence. It is a psychological dependence…that can be treated!

Misuse Defined

Some people misuse drugs because they enjoy the feelings that they provide and thus take more of a drug than is necessary. In fact, people most often become addicted to an RX drug when they use a medication to get high. Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed. It can include:

1. Mixing it with other drugs. In some cases, if you mix your prescription drug with alcohol and certain other drugs, it is considered misuse and it can be dangerous.

2. Taking a prescription medication in a way other than prescribed. Taking your own prescription in a way that it is not meant to be taken is also misuse. This includes taking more of the medication than prescribed or changing its form, for example, breaking or crushing a pill or capsule and then snorting the powder.

3. Taking a prescription medication to get high. Some types of prescription drugs also can produce pleasurable effects. Taking the medication only for the purpose of getting high is considered prescription drug misuse.

4. Taking someone else’s prescription medication. Even when someone takes another person’s medication for its intended purposes (such as to relieve pain, to stay awake, or to fall asleep) it is considered misuse.

Risk Factors

As with any other disease, vulnerability to addiction differs from person to person, and no single factor determines whether a person will become addicted to drugs. In general, the more risk factors a person has, the greater the chance that taking drugs will lead to abuse and addiction.

Early initiation of use and a habit. Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs, the more likely he or she is to develop serious problems. This may reflect the harmful effect that drugs can have on the developing brain; it also may result from a mix of early social and biological vulnerability factors, including unstable family relationships, exposure to physical or sexual abuse, genetic susceptibility, or mental illness. The fact remains that early use is a strong indicator of problems ahead, including addiction.

Environment. The influence of the home environment, especially during childhood, is a very important factor. Parents or older family members who abuse alcohol or drugs, or who engage in criminal behavior, can increase children’s risks of developing their own drug problems.

Genes. Scientists estimate that genetic factors account for between 40 and 60 percent of a person’s vulnerability to addiction; this includes the effects of environmental factors on the function and expression of a person’s genes. A person’s stage of development and other medical conditions they may have are also factors. Adolescents and people with mental disorders are at greater risk of drug abuse and addiction than the general population.

Peer pressure. Friends and acquaintances can have an increasingly strong influence during adolescence. Drug-using peers can sway even those without risk factors to try drugs for the first time.

Social isolation. Academic failure or poor social skills can put a child at further risk for using or becoming addicted to drugs.

Am I Addicted?

There are questions people can ask themselves to gauge whether, or not, they have a prescription drug problem. Answering yes to any of these questions may suggest a developing problem, which could require follow up with a professional drug treatment specialist. The main questions to ask yourself include:

  • Do family or friends ever tell you to cut down on your use of any prescription drug?
  • Do you ever forget things you did while using any prescription drug?
  • Do you ever use any prescription drug to relax, to feel better about yourself, or to fit in?
  • Do you ever use any prescription drug when you are alone?
  • Have you ever gotten into trouble while you were using any prescription drug?
  • Have you ever ridden in a car driven by someone (including yourself) who had been using any prescription drug?

The two main categories of drug addiction treatment are behavioral treatments and medications.

Main Treatments

Years of research have shown that substance use disorders are brain disorders that can be treated effectively. Treatment must take into account the type of drug used and the needs of the person. Successful treatment may need to incorporate several components, including detoxification, counseling, and medications, when available. The two main categories of drug addiction treatment are behavioral treatments and medications.

Behavioral and Psychotherapy Treatments. These treatments help persons stop drug use by changing unhealthy patterns of thinking and behavior; teaching strategies to manage cravings and avoid cues and situations that could lead to relapse; or, in some cases, providing incentives for abstinence. Talk therapy which may take the form of person, family, or group counseling, also can help persons improve their personal relationships and their ability to function at work and in the community.

Medications. Addiction to prescription drugs, like opioids, can additionally be treated with medications including buprenorphine, methadone, and naltrexone. These drugs can counter the effects of opioids on the brain or relieve withdrawal symptoms and cravings, helping the person avoid relapse.

Treatment with Medications

Medications for the treatment of prescription drug addiction are administered in combination with psychosocial supports or behavioral treatments, known as medication-assisted treatment. The most commonly used medicines in addiction treatment are used to treat opioid addiction. This is because the medicines have had much research and investment.

Research on treating addiction to central nervous system depressants and stimulants are sparse; however, persons who are dependent on these medications should undergo medically supervised detox because the dosage they take should be tapered gradually. There are no FDA-approved medications for treating addiction to these drugs.

Main addiction medicines for opiate/opioid addiction include:

  • Buprenorphine is a partial opioid agonist, it binds to the opioid receptor but only partially activates it. Like methadone, it can reduce cravings and is well tolerated by persons.
  • Methadone is a synthetic opioid agonist that prevents withdrawal symptoms and relieves drug cravings by acting on the same brain targets as other opioids such as heroin, morphine, and opioid pain medications.
  • Naltrexone is an antagonist medication that prevents other opioids from binding to and activating opioid receptors. It is used to treat overdose and addiction.

There has been a popular misconception that medications with agonist activity, such as methadone or buprenorphine, replace one addiction with another. This is not the case. Opioid use disorder is associated with imbalances in brain circuits that mediate reward, decision-making, impulse control, learning, and other functions. These medications restore balance to these brain circuits, preventing opioid withdrawal and restoring the person to a normal affective state to allow for effective psychosocial treatment and social functioning.

Treatment with Psychotherapy

Treatment options for prescription drug abuse vary, depending on the type of drug used and your needs. However, counseling, or sometimes psychotherapy, is typically a key part of treatment.

A licensed drug counselor or other addiction specialist can provide person, group or family counseling. This can help you:

  • Determine what factors may have led to the prescription drug abuse, such as an underlying mental health problem or relationship problems.
  • Identify ways to become involved in healthy activities that are not related to drugs.
  • Learn strategies for developing positive relationships.
  • Learn the skills needed to resist cravings, avoid abuse of drugs and help prevent recurrence of prescription drug problems.
  • Learn the steps to take if a relapse happens.


Rehabilitation programs are an important part of the treatment for prescription drug addiction; the directors of these programs understand the things that motivated people to abuse prescription drugs and generate established programs to address these problems. Most programs are designed to promote the healing of the mind and body as part of the recovery process.

Outpatient clinics can provide some degree of assistance in your recovery efforts. However, a prescription drug rehabilitation program for inpatients is more likely to provide long-term success. The longer you stay in the program, the greater the chances of success.

The choice of one type of rehabilitation over the other will depend on the degree of addiction that the person has and the drug that is abusing.


The economic consequences of prescription drug abuse are substantial. It is estimated that opioid analgesic abuse results in over $72 billion in medical costs each year. [2] Other studies estimate the cost of opioid abuse to be $53 to $56 billion annually, accounting for medical and substance abuse treatment costs, lost work productivity, and criminal justice costs. [3] This is comparable to the costs related to other diseases such as asthma and HIV. In many instances, public payers are responsible for covering the costs of prescription drug abuse.

For the user, the cost of addiction treatment varies between each center. Some programs are free, while some cost hundreds of dollars a day. No matter how much money you have, there is an ideal center for you from every point of view. The opportunity to heal is accessible to everyone if they know what resources can help them.

Average costs for addiction treatment are around:

  • $135 per day for outpatient treatment.
  • $700+ per day for inpatient treatment.
  • $3-6,000 for detox.
  • Free to $150 per hour for counseling.

Insurance is one of the most common ways to pay for rehabilitation. However, not everyone has insurance, but there are still options, one way is to find a free or low-income center. The other is to look for programs that offer financing options.

The cost of rehabilitation will depend on the type of rehabilitation you choose: detoxification services ($300 to $500 per day), outpatient rehabilitation ($100 to $300 per day) or inpatient rehabilitation ($300 to $1,000) per day); the time you spend in the rehabilitation program and the state in which you seek help.

There will always be options that you can count on to find the best prescription rehabilitation for you.

Who to Ask for Help?

Finding yourself with a problem of prescription drug addiction and not knowing what to do is very stressful and overwhelming. Keep in mind that there are many people, in addition to family and friends, who are willing to help you. Here is where you can look for help:

  • Your doctor, who may be able to recommend resources.
  • A medical doctor trained in addiction medicine.
  • A licensed clinical psychologist.
  • A psychiatrist.
  • A licensed clinical social works.
  • Self-help groups.
  • Your church or faith group.
  • School counselor or nurse.
  • Support groups, either in person or from a trustworthy website.
  • Your employee assistance program, which may offer counseling services for substance abuse problems.

You are not alone; do not face this problem without help.


Prescription drug abuse is the fastest-growing drug problem in the United States, and the Centers for Disease Control and Prevention has classified prescription drug abuse as an epidemic. [3] While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly an estimated 54 million people over the age of 12 have used prescription drugs for nonmedical reasons in their lifetime. [4]

  • Painkillers 3.3 million users.
  • Tranquilizers 2 million users.
  • Stimulants 1.7 million users.
  • Sedatives 0.5 million users.

Prescription opioid drugs contribute to 40% of all United States opioid overdose deaths. In 2016, more than 46 people died each day from overdoses involving prescription opioids. Prescription opioid overdose rates are highest among people ages 25 to 54 years. [4]

The number of adults filling a benzodiazepine prescription increased 67%(from 8.1 million to 13.5 million) between 1996 and 2013, while the total quantity filled more than tripled. During this same period, the overdose death rate for benzodiazepines more than quadrupled.

Between 2006 and 2011, nonmedical use of stimulants and emergency room visits involving the drug increased significantly, while treatment visits stayed the same. Stimulants misuse rose 67%, and emergency room visits went up 156%. Young adults (age 18-25) made up 60% of those using stimulants for nonmedical reasons.

Many teens believe that prescription drugs are much safer than illegal street drugs because a doctor prescribes them. The top three prescription drugs used by high school seniors in 2017 were stimulants (5.5%), tranquilizers (4.7%) and prescription opioids (4.2%).

As you can see, you are not the only one who has a prescription drug problem…

Your Questions

Do you have any questions? Story to share? Any feelings about prescription drug addiction?  Do that here… write your comments below and will be posted and answered as soon as possible. We are here to help you.

Reference Sources: [1] NIDA: Drugs, Brains, And Behavior: The Science Of Addiction
[2] SAMHSA: Prescription Drug Misuse And Abuse
[3] CDC: Addressing Prescription Drug Abuse In The United States
[4] SAMHSA: Results From The 2016 National Survey On Drug Use And Health
CDC: Prescription Overdose Data
MAYO CLINIC: Prescription Drug Abuse
MEDLINE PLUS: Prescription Drug Abuse
NIDA: Prescription Drug Misuse
NIDA: Seeking Drug Abuse Treatment
NIDA: Vaping Popular Among Teens; Opioid Misuse At Historic Lows
NIDA FOR TEENS: Brain And Addiction
NIDA FOR TEENS: Prescription Drugs
ONDCP: Prescription Drug Abuse
SAMHSA: Efforts To Fight Prescription Drug Misuse And Abuse
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Dili Gonzalez, M.D. is a general surgeon practicing women's focused medici...
Dr. Goecke is a medical doctor and general surgeon with personal experience of...

All of the information on this page has been reviewed and verified by a licensed medical professional.

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