ARTICLE OVERVIEW: Prescription drug addiction is a common but treatable condition. Americans misuse painkillers, sedatives, and stimulants. Evidence-based treatments include a combination of medications and psychotherapy. These treatments are generally successful and long-lasting.
TABLE OF CONTENTS:
- The Facts and Statistics
- Use vs. Abuse
- Types of Rx Drugs Abused
- Do I Have a Problem?
- What is the Evidence-Based Treatment?
- Where to Go For Help
- Am I Alone?
The Facts and Statistics
Prescription drug addiction is a major public health concern in the U.S. In fact, prescription drugs are second only to marijuana use as the nation’s most commonly used illicit drug. The 2016 National Survey on Drug Use and Health reported that an estimated 6.2 million Americans aged 12 or older misused psychotherapeutic drugs at least once in the past month, which represents 2.3 percent of the population. In fact, both the Obama and Trump administrations have declared that our country is facing an “Opioid Epidemic” to highlight addiction to pain killers.
Here are some basic stats.
In 2016, approximately:
- 20.1 million people aged 12+ could be diagnosed with addiction.
- 1.8 million people could be diagnosed with a prescription pain reliever use disorder.
- 389,000 12-17 year olds misused psychotherapeutic drugs at least once in the past month, about 1 in 60 adolescents (1.6 percent).
- 1.6 million young adults aged 18 to 25 were current misusers of psychotherapeutic drugs (4.6 percent of young adults).
- 4.2 million adults aged 26 or older were current misusers of psychotherapeutic drugs (2.0 percent of adults in this age group).
So, how do you identify prescription drug addiction or abuse and how are these conditions treated? We review here. Save your question(s) for the end, as we try to respond to all legitimate questions with a personal and prompt response.
Use vs. Abuse
It’s sometimes difficult to clinically separate prescription use from abuse. Generally, Rx drug misuse is defined as:
Using a medication without a prescription.
Using a medication more often than prescribed.
Using a medication at higher dosages than prescribed.
Using a medication in ways other than prescribed (snorting, chewing, smoking, or injecting).
Types of Rx Drugs Abused
So, what drugs are part of the problems? The main prescription drugs abused by Americans in order of most popular or least popular are:
1. Pain relievers
1. Pain Relievers. This class of medication is called “opiates” and/or “opioids”. In general, the opiate and opioid class of medications are prescribed to treat pain. These pain relievers work directly by interacting with pain receptors in the brain to change the way the brain perceives pain. However, they also come with a very strong side effect: euphoria. Euphoria is an extreme sense of well-being.
Because pain relievers also make people feel good, they can become habit forming. Not only do people become physically dependent on them, regular use can manifest specific symptoms of pain killer abuse. Opioids also cause the sense of euphoria by affecting pleasure centers. The most commonly used brand name prescriptions in this class of drug are morphine (Kadian, Avinza), codeine, oxycodone (OxyContin, Percodan, Percocet), hydrocodone (Lortab, Lorcet, Vicodin), propoxyphene (Darvon), fentanyl (Duragesic), morphine, methadone, and hydromorphone (Dilaudid).
This CDC Vital Signs report speaks to the real dangers, especially to women.
2. Tranquilizers. Prescription tranquilizers are psychoactive drugs often prescribed for anxiety or muscle spasm relief. This includes benzodiazepine drugs such as alprazolam (Xanax), lorazepam, (Ativan), diazepam (Valium) as well as muscle relaxants such as Soma, and others. The most common reasons for the misuse were to relax or relieve tension.
The 2015 NSDUH Report on drug use shows tranquilizers to be problem drugs:
3. Stimulants. Stimulants, including dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta), are used primarily to treat attention deficit hyperactivity disorder, attention deficit disorder, and narcolepsy. Stimulants increase the amount of certain chemicals in the brain and peripheral nervous system.
How do they work?
Stimulants are central nervous system medications that affect dopamine levels by blocking reuptake, the reabsorption of dopamine by cells in the brain and central nervous system. These medications may also block some of the metabolic enzymes that absorb loose dopamine. This can lead to increased blood pressure and heart rate, and increased blood glucose. People main abuse stimulants to help lose weight, to concentrate, to be alert or stay awake, to help study, to experiment, or for euphoric effect.
The 2015 NSDUH outlines how stimulants are the third most abused class of drugs in the U.S.:
4. Sedatives. Central nervous system depressants commonly are prescribed to treat sleep disorders. These medications have the ability to slow the brain functions in normal conditions. Common medications include barbiturates, such as mephobarbital (Mebaral), pentobarbital sodium (Nembutal), butalbital (Fioricet), and hypnotics like Ambien (zolpidem). People commonly misuse these medications in order to sleep better.
The 2015 NSDUH also shows an overlap of people diagnosed with mental illness and their misuse of sedative drugs:
NOTE: The most commonly misused prescription drugs in the world are antibiotics. Although they are rarely addictive, their consumption is related to other addictive drugs. Other drugs that are commonly misused are NSAIDs and steroids, both of which are actively used in pain management and to reduce inflammation. Steroids are also used by body builders.
Do I Have a Problem?
Prescription medications are very useful treatments, especially when supporting outpatient treatment of medical conditions. However, pain relievers, tranquilizers, stimulants, and sedatives can also be abused. And many cases of drug abuse result in prescription drug addiction. Dosage can increase over time, therapeutic use can shift to seeking euphoric effect, or a therapy timeline is rescheduled without a doctor’s opinion.
So when does prescription drug use become a problem? Non-medical use of prescription medications is the first indicator of prescription drug abuse. Using drugs to get high or for euphoric effect and using Rx drugs OTHER THAN PRESCRIBED indicates a drug problem. On the other hand, prescription drug addiction is characterized by four specific (psychological) symptoms.
1. Drug craving.
2. Obsessive or compulsive thinking about a drug.
3. Continued drug use despite negative consequences to home, social, or work life.
4. Loss of control of drug use (using more of a drug than intended, using a drug more frequently than intended, or the inability to stop using a drug).
In order to be able to identify a prescription drug addiction and then address it, you need to double check the presence of any of these medications at your home for a longer period of time (usually consecutive use over the course of three (3) months or more). Further, the most common general physical signs of prescription drug addiction include:
- euphoria during drug use
- loss of appetite
- mood changes
- trouble sleeping
What is the Evidence-Based Treatment?
Prescription drug addiction usually requires professional intervention. In fact, many different types of healthcare providers can play a significant role in discovering and addressing drug abuse. Depending on the medication abused as well as individual needs, treatment can vary. Treatment often combines techniques in order to cover the complexity of the health condition. Generally, a combination of behavioral and pharmacological treatments are usually practiced.
1. Behavioral Therapy
Talk therapy is the foundation for prescription drug addiction recovery. The goal of behavioral and psychological treatments are to support emerging positive responses to environmental cues, turning them into habits. Cognitive Behavioral Therapy, individual, group, and family counseling have the potential to help people re-learn how to live a normal, healthy life.
The Matrix Model is good example of a well structured and simplified approach including cognitive behavioral principles, individual and family therapy, 12 step program and weekly urine monitoring for drug use. Other kinds of behavioral treatment include contingency management, motivational interviewing, and support groups.
2. Medications or Pharmacological Treatment
Pharmacological treatment is a fancy word for the use of medications during addiction treatment. In fact, medicines can be extremely useful, especially in the first few months after quitting a prescription drug. Medicines work mainly to:
2.1. Address symptoms of withdrawal.
2.2. Treat possible mood disorders.
2.3. Mitigate or reduce drug cravings.
Still, the risk that the substitute drug becomes the next medication abused is also present. The bottom line is that the use of drugs varies for different types of prescription drug addition. For example, opioid addiction has been clinically tested to respond to the use of methadone, buprenorphine, and/or naltrexone. Other than the use of antidepressants, there is no current use of medications in the treatment of tranquilizer, stimulant, or sedative addiction. Clinical trials are ongoing and are listed here: Substance Related Disorders clinical studies.
Where to Go For Help
So where can you go to receive treatment for prescription drug addiction?
1. Treatment centers. Addiction treatment centers are facilities that offer the full scope of both behavioral and pharmacological treatment, and are supervised by some of the the most experienced professionals in the field. Treatment centers are most often recommended for the treatment of addiction simply because they can monitor, treat and facilitate follow up for each patient and his family. Residential treatment of 90 days or more is highly effective, as are therapeutic communities that rehabilitate people for 3-9 months, or longer.
2. Detox clinics. Drug detox clinics have the capacity to assist in the case of intoxication, detoxication, or overdose. These clinics process hundreds or thousands of visits per year through their emergency departments. Staff supervise the medical removal of prescription drugs from the system, at the same time providing pharmacological and psycho-emotional support. Medical interventions and medications are provided when needed, ensuring the safe removal of prescription drugs from the body. Tapering protocols are also used in the medical detox from Rx drugs.
3.Physicians. A physician can help you identify and diagnose prescription drug addiction. Physicians are informed about patient’s medications, health history, and can easily track the refill dates. Furthermore, physicians can assess your case using a brief intervention and then refer you to local resources according to your needs.
4. Psychiatrists. Psychiatrists can be another good place to receive solid advice for prescription drug addiction. Some psychiatrists specialize in drug addiction and can easily unveil addictive behavior, even at the earliest stages. Furthermore, psychiatrists can help explore possible co-occurring disorders and/or prescribe medications, when necessary.
5. Psychologists. Licensed clinical psychologists are trained to identify and treat drug addiction using psychotherapy and behavioral treatments. They can provide you with a safe environment in which to explore the reasons why you use drugs. Counseling can take place in individual sessions, in a group, or with your family. Addiction counselors have many tools that help you deal with the mental and emotional reasons that compel drug use. Without talk therapy, it is difficult to remain abstinent from drugs for an extended period of time.
6. Support groups. Prescription drug addiction support groups are non-formal, patient-based groups that organize private meetings to share experiences and offer support. This form of mutual aid benefits both former addicts and those new to recovery through empathy. Examples of support groups include SMART Recovery, S.O.S., Narcotics Anonymous, and Narc-Anon (for families).
7. Social workers. Licensed clinical social workers often have a different perspective when addressing addiction. Social workers can assist you in the selection of a financially suitable treatment center and refer you to state programs to support yourself or family members during and after treatment.
Am I Alone?
In 2016, an estimated 21.0 million people aged 12 or older needed addiction treatment. This translates to about 1 in 13 American. However, in 2016, only 1.4 percent of people aged 12 or older (3.8 million people) received any substance use treatment in the past year. Less than 1% – 0.8 percent – or 2.2 million people – received substance use treatment at a specialty facility.
In sum, 1 in 10 people aged 12 or older who need help get it. Be a part of the growing recovery movement!
You can do it.
Prescription drugs do not need to take over your life. Help is available. The condition is medical. Please let us know if we can help you along the way.
Still have questions about the treatment of prescription drug addiction? Please feel free to post your question(s) in the comments section below. We try to respond to all legitimate concerns with a personal and prompt answer.
References Sources: NIDA: Principles of Drug Addiction Treatment
Utah Department of Human Resources
National Institute of Drug Abuse: Prescription Drug Alert
SAMHSA: Why Do Adults Misuse Prescription Drugs?
2016 NSDUH Survey Findings
2016 Complete NSDUH Survey
NIDA: Senate Caucus on International Narcotics Control Testimony to Congress
NIDA: What is the Scope of Misuse of Prescription Drugs?
All of the information on this page has been reviewed and verified by a licensed medical professional.