Substance abuse is as commonplace as prescription drug abuse.
Prescription Drug Abuse and Addiction: Commonly Abused …
For some time now, the abuse of illicit substances such as marijuana, cocaine, methamphetamine and heroin has been a persistent national problem. In more recent years, however, our country has seen an alarming rise of prescription drug abuse – now sharing the dubious limelight with the old standby street drugs are otherwise controlled substances, such as those prescribed to relieve pain and anxiety.
Many of these drugs continue to be prescribed legitimately, yet continue to end up in the hands of those intent on abusing them. As would be expected, the resale value of some of these medications can be quite high. The price to society as a whole, however, is also taking its toll, as more and more people find themselves in the ER or hospitals for prescription drug overdoses or worse, deaths.
Credit: Partnership for Drug-Free Kids
The broad classes of drugs that are most prone to non-medical use or abuse are the ‘painkillers’ or opiate analgesics such as oxycodone (Oxycontin), the ‘sleeping pills’ or ssedative-hypnotics such as zolpidem (Ambien), ‘anti-anxiety medication’ or sedative-anxiolytics such as alprazolam (Xanax), and, lastly, stimulants such as dextroamphetamine (Adderall) and methylphenidate (Ritalin).
Numbers from SAMHSA’s 2013 National Survey on Drug Use and Health (NSDUH) included non-medical usage statistics for these prescription-type drug classes for American’s ages 12 and older. The survey defines ‘non-medical use’ as the use of the drugs for the effect or feeling that they produce, as opposed to for some medical indication. The survey reports an alarming 6.5 million nonmedical users of prescription-type drugs (2.5% of the entire population, ages 12 and up), with a majority of those (4.5 million – or 1.7% of Americans) having misused the aforementioned ‘painkillers’ (opiate analgesics).
Prescription drug abuse (and painkiller abuse, in particular) is a huge problem. Indeed, prescription opioid drugs are now the second-most used illicit substance (behind marijuana) if and when America’s youth make a first foray into drug experimentation.
Prescription Painkillers – Most prescribed pain medications have an opiate or opiate derived (from the opium poppy) component. Others might contain synthetic opioids that, to some degree, mimic the effects of the opiates. These medicines modify pain signaling, and are frequently prescribed for a variety of types of moderate to severe pain relief. Drugs in this class include:
Prescription Sleeping Pills – At one point in time, the barbiturate depressants were prescribed as sleep aids. Since then, barbiturates have been replaced by the benzodiazepines and, more recently, the non-benzodiazepine sleep aids have gained favor as the prescription of choice for insomnia. The benzodiazepines and non-benzodiazepine sleeping pills exert their effects by modulation of the GABA (gamma amino butyric acid) neurotransmitter system in the brain. Drugs prescribed for sleep include:
Prescription Anxiety Medication – As mentioned before, the GABA modifying effects of the benzodiazepine medications work well as prescription anti-anxiety medications. Because of their habit-forming propensity, many of these medications are now prescribed for temporary bouts of anxiety rather than as a nightly sleep aids. Some anti-anxiety medications include:
See the extent of this addiction in the following article.
What is the scope of prescription drug misuse? | National Institute on …
Misuse of prescription opioids, CNS depressants, and stimulants is a serious public health problem in the United States. Although most people take prescription medications responsibly, in 2017, an estimated 18 million people (more than 6 percent of those aged 12 and older) have misused such medications at least once in the past year.7 According to results from the 2017 National Survey on Drug Use and Health, an estimated 2 million Americans misused prescription pain relievers for the first time within the past year, which averages to approximately 5,480 initiates per day. Additionally, more than one million misused prescription stimulants, 1.5 million misused tranquilizers, and 271,000 misused sedatives for the first time.
The reasons for the high prevalence of prescription drug misuse vary by age, gender, and other factors, but likely include ease of access.9 The number of prescriptions for some of these medications has increased dramatically since the early 1990s.10 Moreover, misinformation about the addictive properties of prescription opioids and the perception that prescription drugs are less harmful than illicit drugs are other possible contributors to the problem.11,12 Although misuse of prescription drugs affects many Americans, certain populations such as youth and older adults may be at particular risk.13,14
Misuse of prescription drugs is highest among young adults ages 18 to 25, with 14.4 percent reporting nonmedical use in the past year. Among youth ages 12 to 17, 4.9 percent reported past-year nonmedical use of prescription medications.16
After alcohol, marijuana, and tobacco, prescription drugs (taken nonmedically) are among the most commonly used drugs by 12th graders. NIDA’s Monitoring the Future survey of substance use and attitudes in teens found that about 6 percent of high school seniors reported past-year nonmedical use of the prescription stimulant Adderall® in 2017, and 2 percent reported misusing the opioid pain reliever Vicodin®.17
Although past-year nonmedical use of CNS depressants has remained fairly stable among 12th graders since 2012, use of prescription opioids has declined sharply. For example, past-year nonmedical use of Vicodin among 12th graders was reported by 9.6 percent in 2002 and declined to 2.0 percent in 2017. Nonmedical use of Adderall® increased between 2009 and 2013, but has been decreasing through 2017.17 When asked how they obtained prescription stimulants for nonmedical use, around 60 percent of the adolescents and young adults surveyed said they either bought or received the drugs from a friend or relative.
Youth who misuse prescription medications are also more likely to report use of other drugs. Multiple studies have revealed associations between prescription drug misuse and higher rates of cigarette smoking; heavy episodic drinking; and marijuana, cocaine, and other illicit drug use among U.S. adolescents, young adults, and college students.18–21 In the case of prescription opioids, receiving a legitimate prescription for these drugs during adolescence is also associated with a greater risk of future opioid misuse, particularly in young adults who have little to no history of drug use.14
More than 80 percent of older patients (ages 57 to 85 years) use at least one prescription medication on a daily basis, with more than 50 percent taking more than five medications or supplements daily.13 This can potentially lead to health issues resulting from unintentionally using a prescription medication in a manner other than how it was prescribed, or from intentional nonmedical use. The high rates of multiple (comorbid) chronic illnesses in older populations, age-related changes in drug metabolism, and the potential for drug interactions make medication (and other substance) misuse more dangerous in older people than in younger populations.22 Further, a large percentage of older adults also use over-the-counter medicines and dietary and herbal supplements, which could compound any adverse health consequences resulting from nonmedical use of prescription drugs.13
Types and treatments of prescription drug abuse are found in the next article.
Prescription Drug Abuse: Addiction, Types, and Treatment
Is it possible that you or someone you love is addicted to prescription drugs? Most of us take prescription drugs only for the reason the doctor intended. But the National Institute on Drug Abuse says about 48 million people (ages 12 and older) have used prescription drugs for nonmedical reasons in their lifetime. That figure represents approximately 20% of the U.S. population.
In recent years, there has been a dramatic rise in prescription drug misuse or abuse. This increase has led to more ER visits because of accidental overdoses and more admissions to treatment programs for drug addictions.
Addiction is a chronic brain disease that often happens again. It causes compulsive drug seeking and use despite harmful effects on the addicted person and the people around that person. The abuse of drugs — even prescription drugs — leads to changes in how the brain looks and works.
For most people, the first decision to take prescription drugs is voluntary. But over time, changes in the brain caused by repeated drug abuse affect a person’s self-control and ability to make sound decisions. While this is going on, the person continues to have intense impulses to take more drugs.
The National Institute on Drug Abuse says the three classes of prescription drugs that are often abused are:
Since the early 1990s, doctors’ prescriptions for opioid medications — such as codeine and morphine (Astramorph, Avinza, Kadian, MS Contin, Oramorph SR) — have greatly risen. That increase can be attributed to an aging population and more widespread chronic pain. Other drugs in this class include:
When they’re taken as prescribed, opioids and other painkillers manage pain well. They can improve quality of life for people with chronic pain. In fact, using opioids for the short term or under a doctor’s cautious supervision rarely leads to addiction or dependence. But when they’re used long-term, opioids may lead to drug abuse with physical dependence and addiction. Opioids can also be life-threatening in an overdose. When they are taken with substances that depress the central nervous system — including alcohol, barbiturates, or benzodiazepines such as alprazolam (Xanax), (Klonopin), or diazepam (Valium) — there is a much higher chance of respiratory depression, or even death.
Opioids can cause a mild joyful feeling. But opioids such as OxyContin are sometimes wrongly snorted or injected to boost that feeling.
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