Abused Prescription Drugs

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Falsely believed as safe, prescription drugs have potential to be hazardous and abused just like illicit drugs.  The reasons they are legal is that they are targeted to treat a particular symptom or disease, but more importantly the likelihood for them to be toxic requires great concentrations.  In other words, the separation between therapeutic effect and toxicity is relatively far.  Both measures are on different ends of the drug effect spectrum.  Toxicity is achieved much easier in illicit drugs.   In the eyes of pharmacologists and medical practitioners, all drugs are poisons if given at the “right” amount or abused long enough.

Interestingly, current trends indicate that prescription drugs are beginning to be more abused regularly, even more so than the average “hardcore” drug such as cocaine, heroin or even alcohol.  This is particularly alarming with regards to teens and children where this type of drug abuse is becoming prevalent.  This age demographic is showing up at hospital emergency rooms for overdose and/or drug interactions.  Death is common in this setting because doctors generally do not know what prescription drug is taken and usually several drugs are taken at once.  Frequently the only plausible treatment for this type of drug abuse is pumping the stomach (gastric lavage) in an effort to remove drugs remaining in the gastrointestinal tract before they can cause more harm by going into the bloodstream after absorption. 

The reason for an increase in prescription drug abuse probably stems from the fact that they are more easily procured than illicit drugs.  Often they are free to the abuser and they rarely have to worry about getting caught by authorities.  Children can easily grab a few pills from the medicine cabinet in their house and ingest them.  Typically the reason for this drug habit is because the user wants to “try something new” or feel “high.”  Though this drug seeking behavior is in line with child-like adventuresome behavior, adults too can also fall victim to this abuse as evidenced by the recent high profile celebrity cases that have occurred.  However more often than not, this problem is a teenage affliction.

The regularly abused prescription drugs are usually weaker counterparts to their illicit siblings (i.e. stimulants and depressants), but not always.  Most are painkillers or hypnotics (sleep-inducers).  Descriptions of some the most abused are described below.  Keep in mind that the user is typically abusing several of these drugs at once that can result in a symptom that synergizes or counteracts each other. 

Opoids for Pain

Opioids such as methylmorephine (codeine), hydrocodone (Vicodin) and oxycodone (Oxycontin) are used to for their analgesic or pain relief effects.  These may also induce sleep.  Codeine is the most prescribed, and is mainly used in indications such as diarrhea and cough suppression.  These drugs can be easily abused because they generate euphoria in the brain.  The danger conversely is these drugs may cause respiratory failure leading to death.  Though less potent than heroin and morphine, these drugs can create tolerance if chronically used and they will result in withdrawal symptoms (seating, anxiety, nausea, vomiting) if taken off quickly.  Hydrocodone and oxycodone are prime for prescription drug abuse.

Sleep and Muscle Relaxers

Sleep-inducing and muscle relaxant drugs are popular drugs of abuse as well.  These include the benzodiazepines, diazepam (Valium) and alprazolam (Xanax).  Specific muscle relaxants such as carisoprodol (Soma) and baclofen (Lioresal) have diverse structures, but generally relax the nerves that innervate the muscles either at the site of pain or centrally (in the brain).  These drugs are abused because they calm the person down, allow sleep, and relieve pain.  Use of these drugs overtime requires higher doses (tolerance) that may induce not only psychological dependence but physiological dependence, similar to opioids.   These heightened concentrations could lead to toxic effects such as cardiac arrest, seizures and respiratory failure, all of which could possibly lead to death. 

ADHD and Hyperactivity

Last but not least, stimulants such Adderall (mixed amphetamine salts), Dexedrine (dextroamphetamine) and to a lesser extent Ritalin (methylphenidate) can be abused.   These drugs are normally prescribed for attention deficit hyperactivity disorder (Adderall, Ritalin) and narcolepsy (Dexedrine).  They increase the focus and wakefulness of the user, but in drug abuse it is utilized for its ability to induce a rush or euphoria similar to methylampethamine and cocaine.  Overuse may lead to cardiac arrest and risk taking behaviors that may lead to death.  Other effects include hyperthermia (high temperature), seizures and insomnia.

These are but a sampling of the many possible prescription drugs that can be abused.  This are of drug abuse is hazy because not everyone chooses the same drug necessarily.  Their recreational use often happens in concert with each other; there are many drug combinations.  The potential for death is high due to contradicting effects.  It is best to prevent drug abuse because treatment is difficult, especially in an emergency setting when the doctor is not privy to the different drugs used.

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