Prescription Drug Abuse

Medically Reviewed by Carol DerSarkissian, MD on March 17, 2024
6 min read

Prescription drug abuse is when you take a medication for a reason other than why the doctor prescribed it. Experts estimate that more than 18 million people ages 12 and older have used prescription drugs for nonmedical reasons in the previous year. That’s more than 6% of the U.S. population.

Abusing drugs -- even prescription drugs -- can change how your brain works. Most people start by choosing to take these medications. But over time, the changes in your brain affect your self-control and your ability to make good decisions. At the same time, you have intense urges to take more drugs.

The National Institute on Drug Abuse says three classes of prescription drugs are often abused:

Opioids. Since the early 1990s, doctors have been prescribing many more opioid painkillers such as codeine, hydrocodone, morphine (Astramorph, Avinza, Kadian, MS Contin, Oramorph SR), and oxycodone (OxyContin, Percocet, Vicodin). This is partly because of the rising age of the U.S. population and because more people are living with long-term pain.

These medicines manage pain well and can help boost your quality of life when you follow your doctor’s directions on taking them. It’s possible but not common to become addicted to or dependent on opioids when you use them for a short time or under a doctor’s close watch. But when you take them for a long time, they can lead to drug abuse, dependence, and addiction.

Opioid overdose can also be life-threatening. If you take them with medications that work on your central nervous system -- including alcohol, barbiturates, or benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), or diazepam (Valium) -- you have a higher chance of breathing problems or death.

Opioids can cause a mild joyful feeling. Some people using them illegally snort or inject them to get that effect faster. Injecting drugs raises your chances of getting diseases like HIV and hepatitis C.

Central nervous system (CNS) depressants. Millions of people in the U.S. use benzodiazepines (Ativan, Valium, Xanax) to treat anxiety and sleep disorders, including insomnia. They affect a chemical in your brain called GABA (gamma-aminobutyric acid). GABA lowers brain activity, making you drowsy or calm.

Barbiturates -- including amobarbital (Amytal), pentobarbital (Nembutal), phenobarbital (Luminal), and secobarbital (Seconal) -- are also CNS depressants. Doctors use them for anesthesia and prescribe them to treat seizures.

Taking CNS depressants for a few days or weeks may help you feel calm and sleepy. But after a while, you may need larger doses to get the same feeling. Using them with alcohol can cause slow heartbeat, slow breathing, and death.

If you take CNS depressants for a long time and stop suddenly, you might have life-threatening problems such as withdrawal seizures.

Stimulants. These drugs give your body a jump-start, with a huge boost in alertness, energy, and attention. They raise your heart rate, blood sugar, and blood pressure. They also narrow your blood vessels and open your airways.

Doctors started using stimulants to treat asthma and obesity. Today, they prescribe them for conditions such as ADHD, ADD, depression, and narcolepsy. Examples of stimulants are dextroamphetamine (Dexedrine, Dextrostat, ProCentra), lisdexamfetamine (Vyvanse), methylphenidate (Concerta, Daytrana, Methylin, Ritalin), and a mix of amphetamine and dextroamphetamine (Adderall).

Stimulant abuse -- for instance, by taking them in higher doses or by crushing pills and snorting them -- can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat.

Research shows that some things about you might make you more likely to abuse prescription drugs. These risk factors include your:

  • Friends’ or colleagues’ influence
  • Age
  • Biology, or things in your genes
  • Mental health
  • Knowledge about prescription drugs and how they might hurt you

Signs of abuse can depend on the drug involved. Someone who abuses opioids might have:

  • Dizziness
  • Slow or shallow breathing
  • Upset stomach, vomiting, or constipation
  • Slurred speech
  • Poor coordination
  • Mood swings
  • Depression or anxiety

Abuse of CNS depressants can cause:

  • Mood changes
  • Trouble walking
  • Trouble concentrating
  • Poor judgment
  • Slow reflexes
  • Slurred speech
  • Memory problems
  • Slow breathing

Symptoms of stimulant abuse include:

  • Weight loss and lack of appetite
  • Dizziness
  • Headache
  • Insomnia
  • Nervousness
  • High blood pressure
  • Uneven heart rate
  • Paranoia

Get more information on the signs of prescription drug addiction.

Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction.

Buprenorphine treats opiate withdrawal and dependence. Doctors often use it along with the drug naloxone (a combination that can be called Bunavail, Suboxone, or Zubsolv) to prevent relapse.

If you’ve been taking buprenorphine in pill form and your body has gotten rid of all of the drug you were abusing, you might have another form of buprenorphine implanted under your skin. This is called Probuphine. It provides a constant dose of buprenorphine for 6 months. Buprenorphine also comes as a monthly shot called Sublocade.

Other drug treatments for opiate withdrawal include methadone and the blood pressure medicine clonidine. Naltrexone blocks the effects of opiates and can prevent a relapse. It can be taken orally (Revia) or as a monthly injection (Vivitrol). 

Doctors recommend that people who misuse opioids keep naloxone, a medication that can reverse an overdose. It comes in a shot (Evzio) and a nasal spray (Narcan).

Experts believe that “medication-assisted treatment” with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction.

Counseling is the most common treatment for addiction to CNS depressants or stimulants. You might also need to detoxify (“detox”) your body under a doctor’s care.

The FDA offers these guidelines for safe prescription medication use:

  • Always follow the directions carefully.
  • Don't raise or lower doses without talking with your doctor first.
  • Never stop taking a medication on your own.
  • Don't crush or break pills, especially if they’re time-released.
  • Make sure you know how a drug will affect your driving and other daily tasks.
  • Learn about what can happen if you take a medication with alcohol or other prescription and over-the-counter drugs.
  • Talk honestly with your doctor about any personal or family history of substance abuse.
  • Never allow other people to use your prescription medications, and don't take theirs.

According to the National Institute on Drug Abuse, you should never use opioids with CNS depressants, including:

  • Alcohol
  • Antihistamines
  • Barbiturates
  • Benzodiazepines
  • Sleep medications
  • General anesthetics

Don’t use CNS depressants with other things that dull your central nervous system, such as:

  • Alcohol
  • Prescription opioid pain medicines
  • Some over-the-counter cold and allergy medications

Be careful using stimulants along with other substances that spark your nervous system, including:

  • Antidepressants, as supervised by a doctor
  • Over-the-counter decongestant medications
  • Some asthma medications

Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above:

  • Opioids may cause vomiting, breathing problems, a coma, or death.
  • CNS depressants can slow your heartbeat or breathing. If you stop or slow your dose too quickly, you could have seizures.
  • Stimulant abuse might lead to high body temperature, uneven heartbeat, aggression, paranoia, heart failure, or seizures.

Abuse makes you more likely to become dependent on or addicted to a drug. You also have a higher chance of committing a crime, being the victim of a crime, or having an accident.

Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before. Also, it’s easy to find online pharmacies selling these drugs.

Teens may take medication from their parents' medicine cabinets for themselves or their friends to use. Most young people have no idea what medications they’re taking and which ones may cause serious problems -- even death -- if used with other drugs or alcohol.  They might also believe that the medicines are safe because they’re prescription.

If you think a family member or close friend is abusing prescription drugs, talk with your doctor. They can refer you to drug treatment programs that might help. You can also call the Substance Abuse and Mental Health Services Administration crisis line at 1-800-662-HELP (4357).

Talk to the person about your concerns so they know that you’re aware of the problem. Be prepared for a lot of resistance and denial. Many people with addiction must face serious effects before they recognize that they have a problem and want help. Then, stand beside the person as they work to move beyond the addiction.