Prescription medications are a critical component of modern health care and are used to treat or manage a huge variety of conditions ranging from infection to pain to mental health issues.
Some types of medications have a high potential to be abused because they can produce a pleasurable high similar to recreational drugs like heroin, cocaine, or alcohol. Individuals who abuse prescription drugs for recreational purposes are at significant risk of developing an addiction to these substances.
Most Commonly Abused Prescription Drugs
The 3 most commonly abused types of prescription drugs are:
- Opioids such as oxycodone (OxyContin), hydrocodone (Vicodin), and tramadol (Ultram).
- Stimulants including methylphenidate (Ritalin), amphetamine (Adderall), and lisdexamfetamine (Vyvanse).
- Sedatives like diazepam (Valium), alprazolam (Xanax), and zolpidem (Ambien).
In most cases, individuals use prescription medications as directed by their doctor; however, abuse of these prescription drugs is becoming increasingly prevalent in the US. The National Survey on Drug Use and Health (NSDUH) reported that in 2014, more than 54 million Americans (20% of all people aged 12 years or older) had taken prescription drugs at least once during their lives for nonmedical reasons 2 This group included over 6.5 million people who had abused prescription drugs at least once in the previous month.
The problem of prescription drug abuse has increased dramatically since the 1990s, and in 2011, the Office of National Drug Control Policy declared it to be the country’s fastest-growing drug problem 3. The reasons for this rise in abuse is not clear, but several factors seem to be contributing to the problem. These include an increase since the 1990s in the number of prescriptions written for potentially addictive medications, the incorrect notion that prescription drugs are less dangerous than illegal drugs, and the rise of online pharmacies, which make it easier to obtain these drugs.
If you’re one of the many people who are suffering from an addiction to prescription drugs, you can get help in the form of detox and drug treatment with professionals who know how to safely detox off prescription drugs.
Effects and Symptoms of Prescription Drug Withdrawal
Prolonged use of prescription painkillers, stimulants, and sedatives will lead to dependence. This is because repeated exposure to these medications causes the body to adapt (or get used to) the presence of these drugs so suddenly stopping use can result in a number of symptoms, some of which can be dangerous.
This is known as withdrawal, and the severity of the associated symptoms are affected by factors such as:
- The specific drug of abuse.
- The user’s physical and mental health.
- How much of the drug was being abused.
- How long the abuse lasted.
The physical symptoms of prescription drug withdrawal vary between different drugs:
- Generally, there are fewer physical symptoms than psychological symptoms during withdrawal from stimulants. Physical symptoms include insomnia, extreme fatigue, and increased hunger.
- Withdrawal from opioids, on the other hand, can cause intense physical discomfort and flu-like symptoms, such as nausea, vomiting, sweating, and gastrointestinal distress.
- Withdrawal from sedatives can lead to a wide array of physical symptoms that can include muscle twitching, convulsions, and seizures.
Unlike the physical symptoms, the mental and emotional effects of prescription drug withdrawal are relatively similar when contrasting the various drug types. For the most part, the psychological symptoms of withdrawal might last for several weeks to several months. Common emotional and mental symptoms of withdrawal include the following:
- Drug cravings.
- Anhedonia (inability to take pleasure in life).
Withdrawal from certain substances like amphetamines is, in some cases, associated with psychotic symptoms.
The precise subset of symptoms and the severity with which they are experienced will depend on factors like the specific substance of abuse and the user’s health (both physical and mental). In some cases, the psychological symptoms of withdrawal may be sufficiently overwhelming as to trigger suicidal thoughts and attempts.
Withdrawal Duration and Management
Detoxification (detox), the process of clearing the body of drugs, is the first step in breaking the cycle of addiction. Detox can be completed in several days to several weeks depending on the specific drug involved, although several factors may increase the length of this process.
Prescription drug addicts are commonly advised to seek treatment in a supervised, medically assisted detox program where their symptoms can be monitored and managed to prevent or address any dangers that arise as part of the withdrawal syndrome. This is particularly important for those addicted to prescription sedatives, as withdrawal from these drugs can induce life-threatening seizures.
Medically assisted detox programs can help to ease the process by:
- Tapering patients off the substance of abuse. Tapering is a process of gradually reducing the dose of the substance over time so that the brain is able to readapt to the absence of the drug. This strategy can reduce withdrawal symptoms, which both improves safety for withdrawing patients and increases the chances that they will complete the detox process. This is imperative for substances like benzodiazepines (e.g, Ativan, Xanax, etc.) because of the seizure risk associated with sudden discontinuation.
- Medication-assisted treatment. Individuals who are dependent on prescription opioids may benefit from receiving drug substitutes (e.g, methadone, buprenorphine, Suboxone, etc.) and/or or opioid antagonist medications (e.g., naltrexone, the naloxone component of Suboxone) that have historically seen the most use in cases of illicit opiate dependence (e.g., heroin addiction). The opioid substitutes are less potent but have longer duration of effects than many of the commonly abused opioids. They are able to effectively reduce symptoms of withdrawal and craving in patients during detox. Full or partial antagonist medications are able to block the high produced by opioid abuse. Both of these pharmaceutical approaches are effective for discouraging a return to the compulsive drug behavior associated with an active addiction.
- Medical management of withdrawal symptoms. Nurses and doctors in medically supervised detox programs can provide medications (e.g., clonidine, anxiolytics, neuroleptics, etc.) to relieve certain physical and psychological symptoms of withdrawal.
Although people often feel much healthier and clear-headed after completing the detox process, it is important to emphasize that this is only the beginning of the journey to successful recovery from drug dependence. Drug addiction experts recommend participating in a rehabilitation program that combines behavioral treatments with medications, if appropriate, to have the best chance of breaking the compulsive cycle of addiction 5.
Do I Need Help?
Often, it can be genuinely difficult for prescription drug abusers to determine whether or not they are addicted to these substances. When a valid prescription is present, and medications are legally dispensed by doctors and pharmacists, many taking these drugs mistakenly believe they are less likely to cause addiction than illegal drugs. Long-term abuse of prescriptions can lead to several problems including accidental overdose (especially if medications are mixed with alcohol and other drugs), emergence or worsening of mental health disorders, and an increased risk of switching to illicit drugs if prescription drugs become too expensive or unavailable.
Individuals are at risk of becoming addicted to prescription drugs whenever they abuse these substances — that is, take medications that are not prescribed to them — or use them in ways inconsistent with their doctors’ recommendations.
Anyone who suffers withdrawal symptoms when they stop taking the drug regularly, who experiences the symptoms of prescription drug abuse, and who is unable to quit completely despite negative consequences of drug use (such as losing a job or being arrested for impaired driving) should seek help for substance abuse immediately.
How Does Supervised Detox Help?
In many cases, substance abuse treatment professionals will make the recommendation that individuals with drug dependencies undergo detox in a professional facility. Withdrawal from sedative medications, in particular, can be dangerous or even life-threatening, especially if these drugs were combined with alcohol or illicit drugs. Even withdrawal from stimulants and opioids can be so physically and emotionally difficult that people find it difficult to go through this process alone.
Mental health disorders that are frequently associated with addiction may interfere with a person’s ability to successfully recover. However, staff at detox facilities can help identify separate mental disorders and connect patients with resources to treat them, increasing the odds they will be successful in beating their addiction.
Finding a Prescription Drug Treatment Program
Treatment for addiction to any of the commonly abused prescription medications generally involves similar core components like therapy and counseling; however, specifics may change according to the specific drug of abuse. For example:
- Treatment for opioid addiction often include medications to reduce cravings along with individual or group counseling to provide encouragement and support on the road to recovery 7.
- Rehabilitation from an addiction to sedatives will include counseling as well as cognitive-behavioral therapy to help patients identify stressors that trigger drug cravings and new strategies to cope with these situations, and will require vigilant guidance and supervision throughout a potentially dicey withdrawal period.
- Treatment for dependence to prescription stimulants includes mostly behavioral therapies such as cognitive-behavioral therapy and contingency management interventions that use a system of rewards to encourage healthy behaviors 4.
Drug rehabilitation programs can last between 4 weeks and a year, depending on the type of program selected. There are residential/inpatient as well as outpatient options available. Sober living facilities can provide long-term support and provide a drug-free living environment. After completing treatment programs, many people in recovery from addiction find participation in peer-support groups helpful for long-term abstinence, including 12-step groups and secular programs like SMART recovery.
Prescription drug addiction is a dangerous condition that can be nearly impossible to overcome alone. It is the cause of extensive morbidity and mortality for huge numbers of people, many of whom began filling these now-abused prescriptions for therapeutic use. Regardless of the particular medication or circumstances involved, there is help available if you or a loved one is struggling with addiction to prescription drugs.
- Zhong, W., Maradit-Kremers, H., St Sauver, J. L., Yawn, B. P., Ebbert, J. O., Roger, V. L., . . . Rocca, W. A. (2013). Age and sex patterns of drug prescribing in a defined American population. Mayo Clin Proc, 88(7), 697-707.
- Center for Behavioral Health Statistics and Quality. (2015). 2014 National Survey on Drug Use and Health: Detailed Tables.
- Office of National Drug Control Policy. (2011). Epidemic: Responding to America’s Prescription Drug Abuse Crisis.
- National Institute on Drug Abuse. (2014). Prescription Drug Abuse.
- WebMD. (2015). Prescription Drug Abuse.
- National Institute on Drug Abuse. (2010). Comorbidity: Addiction and Other Mental Illnesses.
- Substance Abuse and Mental Health Services Administration. (2011). Medication-Assisted Treatment for Opioid Addiction: Facts for families and friends.