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Some medications have psychoactive (mind-altering) properties and, because of that, are sometimes abused—that is, taken for reasons or in ways or amounts not intended by a doctor or taken by someone other than the person for whom they are prescribed. Prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.
The classes of prescription drugs most commonly abused are: opioid pain relievers, such as Vicodin® or Oxycontin®; stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall®, Concerta®, or Ritalin®; and central nervous system (CNS) depressants for relieving anxiety, such as Valium® or Xanax®.1 The most commonly abused OTC drugs are cough and cold remedies containing dextromethorphan.
People often think that prescription and OTC drugs are safer than illicit drugs. But they can be as addictive and dangerous and put users at risk for other adverse health effects, including overdose—especially when taken with other drugs or alcohol. Before prescribing medications, a healthcare provider considers a patient’s health conditions, current and prior drug use, and other medicines to assess the risks and benefits for a patient.
Prescription and OTC drugs can be abused in one or more of the following ways:
Someone is taking a medication that has been prescribed for somebody else. Unaware of the dangers of sharing medications, people often unknowingly contribute to this form of abuse by sharing unused pain relievers with their family members. Most teenagers who abuse prescription drugs are given them for free by a friend or relative.
Someone is taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the pills and snort or inject the powder. These consumption methods hastens the entry of the drug into the bloodstream and the brain and amplifies its effects. Taking medication for another purpose than prescribed. All the drug types mentioned can produce pleasurable results in sufficient quantities, so taking them to get high is one of the main reasons people abuse them.
ADHD drugs like Adderall® are also often abused by students seeking to improve their academic performance. However, although they may boost alertness, there is little evidence that they improve cognitive functioning for those without a medical condition.
Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain similarly to illicit drugs.
For example, stimulants such as Ritalin® achieve their effects by acting on the same neurotransmitter systems as cocaine. Opioid pain relievers such as OxyContin® attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and Rohypnol®. And when taken in very high doses, dextromethorphan acts on the same cell receptors as PCP or ketamine, producing similar out-of-body experiences.
When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.
Opioids can produce drowsiness, cause constipation, and—depending upon the amount taken—depress breathing. The latter effect makes opioids particularly dangerous, especially when snorted, injected, or combined with other drugs or alcohol.
While the relationship between opioid overdose and depressed respiration (slowed breathing) has been confirmed, researchers are also studying the long-term effects on brain function. Depressed respiration can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term psychological and neurological effects, including coma and permanent brain damage.
Researchers are also investigating the long-term effects of opioid addiction on the brain. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, regulating behavior, and responding to stressful situations.
More people die from overdoses of prescription opioids than from all other drugs combined, including heroin and cocaine.
More than 2 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers. The terrible consequences of this trend include overdose deaths, which have more than quadrupled in the past decade and a half. The causes are complex, but they include overprescription of pain medications. In 2013, 207 million prescriptions were written by physicians for prescription opioid pain medications. Stimulants can have substantial effects on the cardiovascular system. Taking high doses of a stimulant can dangerously raise body temperature and cause irregular heartbeat or even heart failure or seizures. Also, taking some stimulants in high doses or repeatedly can lead to hostility or feelings of paranoia.
CNS depressants slow down brain activity and can cause sleepiness and loss of coordination. Continued use can lead to physical dependence and withdrawal symptoms if discontinuing use.
Prescription opioid pain medications such as Oxycontin® and Vicodin® can have effects similar to heroin when taken in doses or in ways other than prescribed, and research now suggests that abuse of these drugs may open the door to heroin abuse.
Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before using heroin. Some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.
Many of these young people also report that crushing prescription opioid pills to snort or inject the powder provided their initiation into these methods of drug administration.
Dextromethorphan can cause impaired motor function, numbness, nausea or vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred due to the combination of dextromethorphan with decongestants often found in the medication.
All of these drugs have the potential for addiction, and this risk amplifies when abused. Also, as with other drugs, abuse of prescription and OTC drugs can alter a person’s judgment and decision-making, leading to dangerous behaviors such as unsafe sex and drugged driving.
For more information on prescription and OTC drugs, please refer to the following sources on NIDA’s Web site:
Research Report: Prescription Drugs
Prescription Stimulants (Abuse) Health Effects
Prescription Sedatives, sleeping pills*, or anxiolytics (Abuse) Health Effects
Prescription Opioids (Abuse) Health Effects
VOTC, Inc. is NOT a detoxification facility. However, once an individual receives detoxification services and is on MAT (Medically-Assisted Treatment), they can be admitted into one of our Residential SUD Treatment Programs.
If you are struggling with an opiate use disorder, here are our recommendations:
Local Detoxification Service Providers:
1.) Empire Recovery
2.) Mercy Hospital Bridge Program
Residential Programs: Women’s DHCS License & Certification #450020AN, expires 9/30/2024; Men’s DHCS License & Certification #450020EN, expires 2/28/2025.
Outpatient Programs: DHCS Certification #450020BN, expires 10/31/2024.
Note: All VOTC, Inc. programs are drug-free. VOTC, Inc. does not permit the unlawful use of drugs or alcohol on any of its facilities.
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