Prescription Drugs and Pain Medications

There is little doubt that prescription medications have saved countless lives, relieved incalculable amounts of pain, and improved the quality of life for millions of individuals around the world. But these drugs do have a “dark side,” one that becomes evident when the medications are used for unauthorized, illicit, or recreational purposes.

The nonmedical, unapproved use of prescription drugs (including opioids, painkillers, and stimulants) is a rapidly expanding problem that is leading to increasing rates of abuse and addiction in America today. According to a July 9, 2008, press release by The National Center on Addiction and Substance Abuse (CASA) at Columbia University, 85 percent of websites that sell controlled, addictive drugs such as OxyContin, Ritalin, Xanax, and Vicodin do not require consumers to present prescriptions.

About the Drugs

It has been estimated that as many as 20 percent of all Americans have used prescription drugs for unapproved purposes (a category that includes both using someone else’s prescription pills to treat a legitimate medical ailment as well as taking the pills for recreational purposes or to feed one’s addiction).

Narcotics, painkillers, sedatives, tranquilizers, and stimulants are among the substances that are commonly misused and abused. This unhealthy – and illegal – activity is engaged in by male and female members of almost all age groups, from pre-teens to the elderly.

The ability to access these controlled substances over the Internet has vastly increased the prevalence of prescription medication abuse in recent years.

Extent of the Problem

A Feb. 20, 2007 press release by the U.S. Office of National Drug Control Policy (ONDCP) indicated the degree to which prescription drug abuse is spiraling out of control:

Abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. Past year abuse of prescription pain killers abuse now ranks second—only behind marijuana—as the Nation's most prevalent illegal drug problem. While overall youth drug use is down by 23 percent since 2001, approximately 6.4 million Americans report non-medical use of prescription drugs.

New abusers of prescription drugs have caught up with the number of new users of marijuana. Much of this abuse appears to be fueled by the relative ease of access to prescription drugs. Approximately 60 percent of people who abuse prescription pain killers indicate that they got their prescription drugs from a friend or relative for free.

John Walters, Director of National Drug Control Policy, said, "Millions of Americans benefit from the tremendous scientific achievements represented by modern pharmaceutical products. But, when abused, some prescription drugs can be as addictive and dangerous as illegal street drugs. The new prescription drug disposal guidelines will help us stop and prevent prescription drug abuse, and the harm it can cause.

Adding to the risks associated with unsupervised access to prescription medications is that drugs purchased online may be of dubious quality. In its July 1 article on the EAASM study, Britain’s Daily Telegraph newspaper reported that 62 percent of drugs that researchers purchased online – including medicines that were supposed to treat heart and lung diseases, mental health conditions, and other neurological disorders – were “fake or substandard.”

Health Effects

Opioids such as morphine, codeine, and oxycodone, which are often prescribed to relieve pain, are also often abused – a situation that can lead to dire consequences. The drugs produce drowsiness and depress breathing, and even one excessive dose can be result in severe respiratory depression even death.

Chronic use of opioids can result in tolerance to the drugs so that higher doses must be taken to obtain the same initial effects. Long-term use also can lead to physical dependence, a state in which the body adapts to the presence of the drug and experiences withdrawal symptoms in the absence of the substances.

Depressants of the central nervous system (such as Valium, Xanax, and Halcion) are often prescribed to treat anxiety or sleep disorders. As with opioids, misusing these substances – especially in combination with alcohol – can lead to unconsciousness, depressed respiration, and death. NIDA also reports that, in cases of people who have been misusing these drugs for a long period of time and have built up a tolerance, rapid cessation can result in a reaction in which “the brain's activity can rebound and race out of control, potentially leading to seizures and other harmful consequences.”

Stimulants (including Adderall, Dexedrine, Concerta, and Ritalin) are prescribed to treat narcolepsy, Attention Deficit Hyperactivity Disorder, and some types of depression that have not responded to other treatments. The drugs increase energy and heighten a person’s alertness and ability to focus – but inappropriate doses can lead to irregular heartbeat, hypothermia (dangerously high body temperature), heart failure, and seizure. The drugs have also been associated with rage, hostility, and paranoia among heavy users.

Treatment

NIDA recommends that treatment plans for individuals who are addicted to prescription medications address both the biological and emotional aspects of the behavior. Also, depending upon the type and severity of the addiction, NIDA notes that medications, therapies, or a combination thereof may be most effective:

The two main categories of drug addiction treatment are behavioral and pharmacological. Behavioral treatments encourage patients to stop drug use and teach them how to function without drugs, handle cravings, avoid drugs and situations that could lead to drug use, and handle a relapse should it occur.

When delivered effectively, behavioral treatments-such as individual counseling, group or family counseling, contingency management, and cognitive-behavioral therapies can also help patients improve their personal relationships and their ability to function at work and in the community.

Some addictions, such as opioid addiction, can be treated with medications. These pharmacological treatments counter the effects of the drug on the brain and behavior, and can be used to relieve withdrawal symptoms, treat an overdose, or help overcome drug cravings. Although a behavioral or pharmacological approach alone may be effective for treating drug addiction, research shows that, at least in the case of opioid addiction, a combination of both is most effective.