Prescription Drug Abuse. Addiction To Pain-killers, Anti-depressants and Stimulants.
Commonly abused classes of prescription medications include opioids (for pain), central nervous system depressants (for anxiety and sleep disorders), and stimulants (for ADHD and narcolepsy). Opioids include hydrocodone (Vicodin®), oxycodone (OxyContin®), propoxyphene (Darvon®), hydromorphone (Dilaudid®), meperidine (Demerol®), and diphenoxylate (Lomotil®). Central nervous system depressants include barbiturates such as pentobarbital sodium (Nembutal®), and benzodiazepines such as diazepam (Valium®) and alprazolam (Xanax®). Stimulants include dextroamphetamine (Dexedrine®), methylphenidate (Ritalin® and Concerta®), and amphetamines (Adderall®).
What are opioids and what are the potential consequences of their use and abuse?
Opioids, include morphine, codeine, and related drugs such as oxycodone (OxyContin), hydrocodone (Vicodin), and meperidine (Demerol) and are commonly prescribed to relieve pain. Opioids can produce drowsiness and, in higher doses, depress respiration. Opioid drugs also can cause euphoria.
Taken as prescribed, opioids can be used to manage pain effectively without untoward side effects. Chronic use of opioids can result in tolerance, which means that users must take higher doses to achieve the same effects.
Long-term use of opioids or central nervous system depressants can lead to physical dependence and addiction. Opioids can produce drowsiness, constipation and, depending on amount taken, can depress breathing. Central nervous system depressants slow down brain function; if combined with other medications that cause drowsiness or with alcohol, heart rate and respiration can slow down dangerously. Taken repeatedly or in high doses, stimulants can cause anxiety, paranoia, dangerously high body temperatures, irregular heartbeat, or seizures.
Withdrawal can occur when an individual discontinues use of the drugs. Withdrawal symptoms may include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements. Individuals who are addicted to opioids are more likely to overdose on the drugs, which could be fatal.
What are CNS depressants and what are the potential consequences of their use and abuse?
Among the most commonly prescribed CNS depressants are barbiturates, such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal), which are prescribed to treat anxiety, tension, and sleep disorders; and benzodiazepines, such as diazepam (Valium) and alprazolam (Xanax), which typically are prescribed to treat anxiety, acute stress reactions, and panic attacks. Other benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom), are prescribed for short-term treatment of sleep disorders.
Although the various classes of CNS depressants work differently, they all produce a beneficial drowsy or calming effect in individuals suffering from sleep disorders or anxiety. If one uses these drugs over a long period of time, the body will develop tolerance, and larger doses will be needed to achieve the initial effects. In addition, continued use can lead to physical dependence and, when use is reduced or stopped, withdrawal. Both barbiturates and benzodiazepines have the potential for abuse and should be used only as prescribed. As with opioids, overdose of these drugs can be fatal.
What are stimulants and what are the potential consequences of their use and abuse?
Stimulants enhance brain activity, increasing alertness, attention, and energy, raising blood pressure, and elevating heart rate and respiration. Stimulants such as methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) are prescribed for the treatment of narcolepsy, attention-deficit/hyperactivity disorder, and depression that has not responded to other treatments. They also may be used for short-term treatment of obesity.
Individuals may become addicted to the sense of well-being and enhanced energy that stimulants can generate. Taking high doses of stimulants repeatedly over a short time, however, can lead to feelings of hostility or paranoia. Additionally, taking high doses of stimulants may result in dangerously high body temperatures and an irregular heartbeat.
Prescription Drug Abuse Chart
Category and Name
| Examples of Commercial
and Street Names
|Intoxication Effects/Potential Health Consequences|
|Depressants||reduced pain and anxiety; feeling of well-being; lowered inhibitions; slowed pulse and breathing; lowered blood pressure; poor concentration/confusion, fatigue; impaired coordination, memory, judgment; respiratory depression and arrest, addiction
Also, for barbiturates—sedation, drowsiness/depression, unusual excitement, fever, irritability, poor judgment, slurred speech, dizziness
for benzodiazepines—sedation, drowsiness/dizziness
for flunitrazepam—visual and gastrointestinal disturbances, urinary retention, memory loss for the time under the drug’s effects
|barbiturates||Amytal, Nembutal, Seconal, Phenobarbital; barbs, reds, red birds, phennies, tooies, yellows, yellow jackets||II, III, V/injected, swallowed|
|benzodiazepines (other than flunitrazepam)||Ativan, Halcion, Librium, Valium, Xanax; candy, downers, sleeping pills, tranks||IV/swallowed|
|flunitrazepam***+||Rohypnol; forget-me pill, Mexican Valium, R2, Roche, roofies, roofinol, rope, rophies||IV/swallowed, snorted|
|Dissociative Anesthetics||increased heart rate and blood pressure, impaired motor function/memory loss; numbness; nausea/vomiting
Also, for ketamine—at high doses, delirium, depression, respiratory depression and arrest
|ketamine||Ketalar SV; cat Valium, K, Special K, vitamin K||III/injected, snorted, smoked|
|Opioids and Morphine Derivatives||pain relief, euphoria, drowsiness/respiratory depression and arrest, nausea, confusion, constipation, sedation, unconsciousness, coma, tolerance, addiction
Also, for codeine—less analgesia, sedation, and respiratory depression than morphine
|codeine||Empirin with Codeine, Fiorinal with Codeine, Robitussin A-C, Tylenol with Codeine; Captain Cody, Cody, schoolboy; (with glutethimide) doors & fours, loads, pancakes and syrup||II, III, IV/injected, swallowed|
|fentanyl||Actiq, Duragesic, Sublimaze; Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, Tango and Cash||II/injected, smoked, snorted|
|morphine||Roxanol, Duramorph; M, Miss Emma, monkey, white stuff||II, III/injected, swallowed, smoked|
|opium||laudanum, paregoric; big O, black stuff, block, gum, hop||II, III, V/swallowed, smoked|
|other opioid pain relievers (oxycodone, meperidine, hydromorphone, hydrocodone, propoxyphene)||Tylox, OxyContin, Percodan, Percocet; oxy 80s, oxycotton, oxycet, hillbilly heroin, percs
Demerol, meperidine hydrochloride; demmies, pain killer
Dilaudid; juice, dillies
Vicodin, Lortab, Lorcet; Darvon, Darvocet
|II, III, IV/swallowed, injected, suppositories, chewed, crushed, snorted|
|Stimulants||increased heart rate, blood pressure, metabolism; feelings of exhilaration, energy, increased mental alertness/rapid or irregular heart beat; reduced appetite, weight loss, heart failure
Also, for amphetamines—rapid breathing; hallucinations/tremor, loss of coordination; irritability, anxiousness, restlessness, delirium, panic, paranoia, impulsive behavior, aggressiveness, tolerance, addiction
for cocaine—increased temperature/chest pain, respiratory failure, nausea, abdominal pain, strokes, seizures, headaches, malnutrition
for methamphetamine—aggression, violence, psychotic behavior/memory loss, cardiac and neurological damage; impaired memory and learning, tolerance, addiction
for methylphenidate—increase or decrease in blood pressure, psychotic episodes/digestive problems, loss of appetite, weight loss
|amphetamines||Biphetamine, Dexedrine; bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers||II/injected, swallowed, smoked, snorted|
|cocaine||Cocaine hydrochloride; blow, bump, C, candy, Charlie, coke, crack, flake, rock, snow, toot||II/injected, smoked, snorted|
|methamphetamine||Desoxyn; chalk, crank, crystal, fire, glass, go fast, ice, meth, speed||II/injected, swallowed, smoked, snorted|
|methylphenidate||Ritalin; JIF, MPH, R-ball, Skippy, the smart drug, vitamin R||II/injected, swallowed, snorted|
|Other Compounds||no intoxication effects/hypertension, blood clotting and cholesterol changes, liver cysts and cancer, kidney cancer, hostility and aggression, acne; adolescents, premature stoppage of growth; in males, prostate cancer, reduced sperm production, shrunken testicles, breast enlargement; in females, menstrual irregularities, development of beard and other masculine characteristics|
|anabolic steroids||Anadrol, Oxandrin, Durabolin, Depo-Testosterone, Equipoise; roids, juice||III/injected, swallowed, applied to skin|
* Schedule I and II drugs have a high potential for abuse. They require greater storage security and have a quota on manufacturing, among other restrictions. Schedule I drugs are available for research only and have no approved medical use; Schedule II drugs are available only by prescription (unrefillable) and require a form for ordering. Schedule III and IV drugs are available by prescription, may have five refills in 6 months, and may be ordered orally. Most Schedule V drugs are available over the counter.
** Taking drugs by injection can increase the risk of infection through needle contamination with staphylococci, HIV, hepatitis, and other organisms.
*** Associated with sexual assaults.+ Not available by prescription in U.S.
Can prescription drug addiction be treated successfully?
YES. Addiction is a treatable disease. Discoveries in the science of addiction have led to advances in drug abuse treatment that help
people stop abusing drugs and resume their productive lives.
Can prescription drug addiction be cured?
Addiction need not be a life sentence. Like other chronic diseases, addiction can be managed successfully. Treatment enables people to
counteract addiction’s powerful disruptive effects on brain and behavior and regain control of their lives.
What are the principles of effective addiction treatment?
Research shows that combining treatment medications, where available, with behavioral therapy is the best way to ensure successfor most patients. Treatment approaches must be tailored to address each patient’s drug abuse patterns and drug-related medical, psychiatric, and social problems.
How can medications help treat drug addiction?
Different types of medications may be useful at different stages oftreatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse.
Treating Withdrawal. When patients first stop abusing drugs, they can experience a variety of physical and emotional symptoms, including depression, anxiety, and other mood disorders; restlessness; and sleeplessness. Certain treatment medications are designed to reduce these symptoms, which makes it easier to stop the abuse. There are also Natural Supplements that will help with withdrawal symptoms.
Staying in Treatment. Some treatment medications are used to help the brain adapt gradually to the absence of theabused drug. These medications act slowly to stave off drug cravings, and have a calming effect on body systems. They can help patients focus on counseling and other psychotherapies related to their drug treatment.
Preventing Relapse. Science has taught us that stress, cues linked to the drug experience (e.g., people, places,things, moods), and exposure to drugsare the most common triggers for relapse. Medications are being developed to interfere with these triggers to help patientssustain recovery.
Does relapse to drug abuse mean treatment has failed?
No. The chronic nature of the disease means that relapsing to drug abuse is not only possible, but likely. Relapse rates (i.e., how often symptoms recur) for drug addiction are similar to those for other well-characterized chronic medical illnesses such as diabetes, hypertension,and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply embedded behaviors, and relapse does not mean treatment failure. For the addicted patient, lapses back to drug abuse indicate thattreatment needs to be reinstated or adjusted, or that alternate treatmentis needed.