Although the opioid crisis has highlighted the growing problem of overmedication and illegal sales of prescription drugs, prescription drug abuse is not a new issue. Substances with the potential for drug abuse have existed for centuries, coexisting both as medicine and as recreational drugs. However, regulating substances to curb their availability is a relatively new concept – separating prescription drug abuse from addiction to other legally-available or completely illicit drugs, such as alcohol or heroin respectively.
The Controlled Substances Act in 1970 first began classifying drugs based on medical potential and potential for abuse, distributing substances among five categories referred to as schedules. Before then, some doctors recognized that drugs like morphine could stop a patient from feeling pain, but often also led to a dependence on the drug. Addiction, while poorly defined, has long been accepted as a problem in the medical community, especially with powerful drugs such as opioids, stimulants, barbiturates, and depressants.
Today, there are hundreds of drugs regulated under the Controlled Substances Act. Some of these drugs are completely illegal and are not distributed save for very select research purposes – these are schedule I drugs. Other drugs are available for select medical treatments, through a prescription. Those drugs are called prescription drugs.
What is a Prescription Drug?
Prescription drugs, unlike over-the-counter (OTC) drugs, are controlled substances with psychoactive effects that help treat severe medical conditions. Ideally, prescription drugs are sold only to patients who need them, through a doctor’s recommendation in the form of a written and signed prescription.
Prescription medication includes different kinds of drugs, from stimulants to depressants, anti-depressants, opiates, anti-anxiety medication, barbiturates, and more. All prescription medication has a medical use – stimulants like amphetamine and methamphetamine are used to treat ADHD, while cocaine is used as a topical anesthetic, predominantly for nasal surgeries.
Not all prescription drugs share the same potential for abuse. Schedule V drugs have a low chance of being abused but are still dangerous enough to warrant the necessity of a prescription, meaning that the risk of abuse is higher than the benefit of making the drug available to all in the public. Schedule II drugs are much more dangerous – although all prescription drugs can lead to an addiction and an overdose, schedule II drugs are generally more addictive, and pose more of a danger for prescription drug abuse.
From Medicine to Recreation
Addictiveness or potential for drug abuse is defined by how people generally react to a drug. Not all psychoactive drugs qualify as possessing a potential for abuse. For example, caffeine is the most consumed psychoactive drug on the planet, yet a caffeine addiction is not treated as seriously as an addiction to many other substances because an addiction to caffeine does not present with the same self-destructive behavior as other addictions. An addiction is defined by a physical and/or emotional dependence on a substance, leading to self-destructive behavior and an inability to stop using despite clear negative consequences.
All prescription drugs are addictive because they manipulate the release of dopamine in the brain, and affect the mind in a myriad of ways, creating what is known as a “high”. This effect also changes the way the brain handles dopamine and its natural release, soon causing cravings and leading to an addiction, wherein a person chooses the drug over their usual schedules and activities.
Physical dependence refers to the changes made in the brain due to excessive and repetitive drug use. These changes cause a compulsive need for more drugs to maintain the “high”, including greater and greater doses to achieve the same euphoric effect due to growing drug tolerance. Trying to stop often causes symptoms of withdrawal in cases of physical dependence – these symptoms range from shivers and nausea to delirium, based on the drug and the level of drug use.
Treatment Options for Prescription Drug Abuse
Treating an addiction is a complicated manner, and it depends entirely on the patient, their drug or drugs of choice, and several other factors that influence the addiction and how it should be treated, including other existing mental health issues, the origin of said issues, the family history with addiction and other illnesses, socioeconomic factors, trauma and stress events in the past, and many other considerations.
Addiction treatment today is a highly specialized field that requires a thorough and in-depth look into each patient’s life, to help determine the best approach. There is no one-size-fits-all treatment, although many treatment options are explored across several different kinds of addiction, from alcoholism to opioid dependence.
There are certain drug-specific considerations. Cocaine, for example, is a stimulant much like methamphetamine, but cocaine is metabolized much more quickly, while it takes longer for meth to get out of the system. Alcohol is less addictive than heroin, but withdrawal symptoms for alcohol and other depressants can be fatal, while a heroin withdrawal is rarely if ever fatal, usually involving flu-like symptoms and nausea.
Overdose treatments are very different depending on what drug was taken. Opioid antagonists like naloxone can save a life if the patient is overdosing on an opioid, but alcohol poisoning is combatted through hydration, assisted breathing, and sometimes hemodialysis or stomach pumping to remove as much of the alcohol from the system as possible.
If you struggle with prescription drug abuse, then seek help. Your treatment program will adapt to your type of addiction, and most facilities will do their best to cater to your needs. Several different types of facilities exist to help patients in different parts of their recovery – residential clinics to provide a controlled and drug-free environment, outpatient programs that help patients maintain sobriety while going about their daily lives through regular therapy sessions, and sober living homes where tenants live together in a drug-free environment, sharing responsibilities and continuing to work or study for a living.
Getting help is the first step you need to take toward a better future. What kind of help you need is best determined by you after a thorough consultation with a medical professional.