Can’t sleep or shake off stress? Maybe popping one – or three – pills will help. That kind of thinking led to the deaths of Brittany Murphy, Michael Jackson and Anna Nicole Smith. But prescription drug abuse can happen to anyone. Find out how easy it is to get hooked and where to get help. Plus, can you tell if someone you love is on drugs? Take our quiz to find out...
Stress keeping you up at night? A tablet of Valium helps. Suffering from back pain? Those Percodans are a lifesaver.
Taking a couple pills every day may not seem like a big deal. You know you’re in control.
Or are you?
Prescription drug abuse in the U.S. is rising among women and older adults, according to the National Institute on Drug Abuse (NIDA). Nearly seven million Americans used medications for non-medical reasons in 2007 – three million of them women.
The most abused drugs: narcotic painkillers, tranquilizers, anti-anxiety medications and stimulants.
“It’s a slippery slope with some prescription drugs,” says Neil Capretto, D.O., medical director of Gateway Rehabilitation Center in Pittsburgh, PA. “Anyone taking a controlled substance over time will at the very least become physically dependent.”
Women are more likely than men to be prescribed addictive prescription drugs and get hooked on them, NIDA research suggests.
That’s because they’re more likely than men to seek medical treatment, especially for mental health problems, Capretto says. “Women also communicate more with doctors than men do and thus are more likely to be prescribed something.”
Getting Hooked
How easy is it to get addicted?
“It depends on the amount of the substance used, the dose or strength” and how long you’ve been taking it, says Robert Karp M.D., associate medical director for inpatient psychiatric services at Overlook Hospital, Summit, N.J.
Those with certain psychiatric illnesses like depression, anxiety or a genetic tendency for addiction are also likely to get hooked, says Steven D. Passik, Ph.D., a psychologist at Memorial Sloan Kettering Cancer Center in New York.
“People with a family history of substance abuse or a prior history of alcohol or drug abuse are most vulnerable,” he says. “They may also be living with high stress or psychiatric problems, such as mood disorders like bipolar disorder or anxiety.”
In some, the abuse itself can create psychiatric symptoms such as depression, anxiety and even psychosis.
How Prescription Drug Addiction Works
So how do prescription drugs take control so strongly in the first place?
“Drugs literally hijack the reward system in the brain,” Capretto says. “They take over the drive center in the midbrain and increase dopamine, a neurotransmitter that causes pleasure.”
As addiction sets in and your tolerance builds, “that sense of euphoria gets harder and harder to capture,” says Loren Olson, M.D., a psychiatrist in Des Moines, Iowa. You need more of the drug to feel more like yourself and function at work or with family and friends. So you begin popping more pills.
Compounding the problem: withdrawal symptoms – nausea, sweating, cramping and insomnia – so uncomfortable that the only way to avoid them is to go back on the drug, Olson says.
“Physically, you may look like you have the flu in the morning,” Capretto says.
Your looks aren’t the only thing prescription drug abuse affects. It could even cost you your life.
“Opioids can cause severe respiratory depression or even death following a single large dose,” says Adrienne Marcus, Ph.D., executive director for the Lexington Center for Recovery in Mt. Kisco, N.Y.
You may also experience seizures after reducing or stopping some depressants.
High doses of stimulants “can cause irregular heartbeats, dangerously high body temperatures, cardiovascular failure and lethal seizures or can result in intense hostility and feelings of paranoia,” Marcus says.
Taking large amounts of one drug is bad enough. Even worse: mixing meds or taking them with an alcoholic drink, especially in high doses.
Popping Ambien pills after a few glasses of wine, for example, can lead to blackouts, memory loss and erratic behavior.
“Two plus two isn’t four – it’s more like 10,” Capretto says. “You’re pushing your nervous system in different directions at the same time."
Not everyone feels the same effects from these drugs either.
“If you take it and feel like you’re in love – or you feel calm or all warm and fuzzy – that’s a sign you may have a tendency for addiction,” he says.
Recognizing Prescription Drug Abuse
It’s easy to deny that your drug use is out of control. After all, if your doctor prescribed the drug, it must be safe, right?
Wrong, Capretto says. Just because a doctor prescribed the medication doesn’t mean it isn’t addictive, he says.
“Whether a patient gets a drug off the street or is prescribed it by a doctor, the potency and addictive nature doesn't change," he says.
In fact, many people spend years in denial before seeking help. Here are 7 warning signs and symptoms of addiction:
You have strong cravings for the medication.
Your drug use has become compulsive and you’re taking more than the prescribed dose.
You’re on a constant quest to obtain the drug through various means, whether borrowing from friends, shopping around doctors or even theft or forgery.
You continue to use the drug even though it’s hurting your job performance, relationships and other aspects of your life.
Your behavior has changed. You may be more secretive, argumentative and defensive.
You’re mixing drugs to achieve the same effect.
You’ve tried to stop or reduce your usage, but can’t.
If you’re experiencing these signs, it’s time to get professional help. Quitting may require treatment with drugs like naltrexone, methadone and buprenorphine.
Naltrexone blocks the effects of opioid painkillers but doesn’t get rid of withdrawal symptoms. Methadone and buprenorphine, on the other hand, help ease the addiction and prevent the misery of withdrawal.
Many addicts will need behavioral counseling or a recovery program; others require an intervention by family members to force them into treatment.
Using These Drugs Safely
Most people are using prescription drugs properly under supervision of a doctor who’s familiar with their medical history, Passik says.
A good physician should prescribe drugs only for a limited time and in small doses. Some doctors may also require regular urine tests to monitor usage.
“These drugs are all tools, and if they’re used properly, they’re great,” Capretto says.
The Troublemakers
Here are the most commonly addictive prescribed drugs:
Painkillers
What are they? Opioids are used to treat acute or chronic pain, as well as post-surgical pain and to relieve cough and diarrhea. They may be prescribed to treat pain from arthritis, fibromyalgia or cancer.
Common opioids: oxycodone (OxyContin, Percocet, Perdocan), codeine and morphine (Kadian)
How they work: Opioids attach themselves to proteins on the cell surface known as opioid receptors, which are found in the brain, spinal cord and gastrointestinal tract. They block pain messages sent to the brain.
They can also make you sleepy or constipated and induce euphoric feelings by affecting regions of the brain that control pleasure.
“Pain drugs are by far the most common [abused prescription drug] we see,” Capretto says.
Anti-anxiety drugs and sleeping pills
What are they? Central nervous system (CNS) depressants (also known as sedatives and tranquilizers) slow normal brain function. They’re usually prescribed for anxiety, tension, panic attacks and sleep disorders.
Common CNS depressants: benzodiazepines such as diazepam (Valium), alprazolam (Xanax) and chlordiazepoxide HC1 (Librium)
More sedating benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom), are sometimes prescribed for sleep disorders.
Barbiturates such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal) are also CNS depressants, but aren’t prescribed as often.
How they work: Most CNS depressants enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which decreases normal brain activity. An increase in GABA causes drowsiness and tranquility — the way you feel after a martini or two.
“It calms [people] down so they may feel more confident in groups,” Capretto says.
Nonbenzodiazepine sleep medications
What are they? These drugs are prescribed for insomnia. Though less likely to cause addiction and abuse, they can lead to psychological dependency: Users often believe they can’t sleep without them.
Common sleep drugs: Lunesta (Eszopiclone), Ambien (Zolpidem) and Sonata (Zaleplon)
How they work: Drugs in this category are similar to benzodiazepines and enhance the effects of GABA in the brain, thereby making you sleepy.
Stimulants
What are they? Stimulants are often used to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy and forms of depression that are resistant to other treatments.
Common stimulants: methylphenidate (Ritalin, Concerta) and dextroamphetamine (Dexedrine, Adderall)
How they work: Stimulants boost levels of dopamine, a neurotransmitter that enhances pleasure and focus. These medications are especially popular among college students trying to do more with less sleep.
For more information, visit our Mental Health Center.
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