Many have a false belief that prescription drugs do not pose an addiction risk because the drug was prescribed by a doctor. However, prescription drugs are one of the most commonly abused substances in the United States. An addiction to opioids, benzodiazepines, and stimulants can create symptoms as severe and dangerous as those associated with heroin and cocaine addiction.
But recovery is possible. Recognizing the signs and getting professional treatment as soon as possible greatly improves your chance of long-term recovery.
What Is Prescription Drug Addiction?
Prescription drug addiction is classified as a substance use disorder (SUD). A person is considered to be addicted to prescription drugs if they are taking prescribed medicine in a manner that was not intended by the prescribing physician or using it compulsively despite negative consequences.[1].
The U.S. Food and Drug Administration (FDA) and the National Institute on Drug Abuse (NIDA) both classify the misuse of prescription drugs as a serious public health issue facing our nation, with tens of millions of Americans reporting misuse of a prescription drug each year.[2]
Unlike some substances, the majority of prescription drug addictions don’t begin with recreational use. Many people become addicted after developing a dependency on a medication that was prescribed for a legitimate ailment. For example, someone may find themselves addicted to benzodiazepines that were originally prescribed for anxiety or Adderall prescribed for ADHD. They’ll take the drugs as prescribed for a period of time until they find it too difficult to stop without experiencing withdrawal or distress.
It is also important to understand the difference between physical dependency and addiction. Dependence on a substance can happen without addiction, but it is a significant risk factor, and the two frequently co-occur.[3]
Most Addictive Prescription Pills: Drugs Commonly Misused
Prescription Opioids
Prescription opioids are prescribed to treat pain and include medications like oxycodone (OxyContin, Roxicodone), hydrocodone (Vicodin, Norco), and morphine. Despite their effectiveness for pain management, they also carry a risk of addiction and physical dependency. This is due to the way they affect the brain. When taken, opioids bind to the opioid receptors in the brain, flooding it with dopamine and producing feelings of euphoria and pain relief.[4] Continued use can create tolerance quickly, resulting in suppression of the brain’s natural opioid system and making it difficult to function normally without the medication.
Some common signs of prescription opioid misuse include:
- Taking higher doses than prescribed or more frequently than directed
- Euphoria or unusual drowsiness after taking medication
- Constipation, nausea, and slowed breathing
- Confusion or impaired coordination
- Seeking early refills or obtaining opioids from multiple providers
- Using opioids prescribed to someone else
Benzodiazepines and Sedatives
Benzodiazepines, including medications like alprazolam (Xanax), diazepam (Valium), and clonazepam, and sedative-hypnotics like zolpidem (Ambien), are typically prescribed for anxiety and sleep disorders. They work by enhancing GABA activity in the brain, producing sedation and anxiety relief.[5] Physical dependence can develop after just a few weeks of regular use, and benzodiazepine withdrawal is one of the few withdrawal syndromes that can be life-threatening.
Some signs that someone may be misusing benzodiazepines or sedatives include:
- Drowsiness, confusion, and memory problems
- Poor coordination and slurred speech
- Taking more medication than prescribed
- Using alongside alcohol or other central nervous system depressants
- Withdrawal symptoms such as severe anxiety, tremors, or seizures when doses are missed
Prescription Stimulants
Prescription stimulants such as methylphenidate (Ritalin, Concerta) and amphetamines (Adderall and Dextroamphetamine) are prescribed to treat attention-deficit hyperactivity disorder (ADHD) and certain sleep disorders, but are often misused by young adults and college students seeking cognitive enhancement or weight loss. At higher doses than prescribed, stimulants can produce euphoria, increased energy, and heightened focus, but also significant cardiovascular and psychological risks.
Some signs that someone may be misusing prescription stimulants include:
- Anxiety, paranoia, and agitation
- Elevated heart rate and blood pressure
- Insomnia and loss of appetite
- Taking someone else’s prescription or taking more than prescribed
- Mood crashes and fatigue when the drug wears off
- Continuing to use despite cardiovascular symptoms or declining mental health
Why Do People Abuse Prescription Medications?
Understanding why people misuse prescription medications is important for both prevention and treatment. The most common reasons include:
- Relief from pain, anxiety, or untreated/undertreated mental illness
- Euphoria or pleasure associated with taking prescription opioids or stimulants in excess
- Increased alertness or improved academic or work performance by young adults using stimulants
- Physical dependency that started with the legitimate use of prescription medications
- Preventing withdrawal symptoms for those who have become physically dependent
- Peer influence, particularly among young people sharing prescription medications
- Easy access through friends, family members, or home medicine cabinets
Risk Factors for Prescription Drug Abuse
Although not everyone taking prescription medications develops a substance use disorder, certain risk factors are associated with its development. These risk factors can include:
- Personal or family history of alcohol use disorder or other substance use disorder
- Co-occurring mental health disorders such as anxiety, depression, or ADHD
- Age: adolescents and young adults are overrepresented in rates of prescription drug misuse
- Access to prescription medications not prescribed to them
- Trauma history or a high-stress living environment
- Lack of understanding of the addiction potential of various prescription drug classes
- Prior misuse of another substance
Consequences of Prescription Drug Abuse
The consequences of misusing prescription medications are wide-ranging and impact physical health, mental health, relationships, and safety. The risks vary by drug class:
- Opioids — Opioid overdose, respiratory failure, physical dependence, and, increasingly, a transition to more potent, illicit opioids such as heroin or fentanyl when prescriptions run out
- Benzodiazepines and Sedatives — Respiratory depression (especially dangerous when combined with alcohol), memory impairment, and seizures upon withdrawal
- Stimulants — Cardiovascular emergencies, including heart attack, psychosis at high doses, severe insomnia, and significant mood disturbances
Across all drug classes, prescription drug misuse is associated with poor decision-making, difficulty maintaining relationships, declining academic and work performance, legal problems, and the progressive narrowing of life that is so common with addiction
How to Stop Abusing Prescription Medications Safely
Stopping use of prescription medications on one’s own may lead to complications, particularly when stopping prescription opioids and benzodiazepines. Safe discontinuation varies based on the type of drug and the physical dependency attached to it, and should always occur under the care of a healthcare professional.
For those with physical dependence on opioids, the standard of care is medication-assisted treatment using buprenorphine or methadone to reduce withdrawal and the risk of relapse.[6] Naltrexone is an additional FDA-approved medication for people who have already completed detox and want a non-opioid medication.
For those with physical dependence on benzodiazepines, the standard of care is a tapering protocol. Clients follow a medically supervised tapering protocol where the amount of the drug consumed is gradually reduced over weeks or months. Stopping abruptly is very dangerous due to the risk of severe withdrawal symptoms, such as seizures.[7]
For those with stimulant dependence, there is no FDA-approved medication. Treatment for stimulant disorder is grounded in behavioral-based treatment and clinical support.[8]
Prescription Drug Addiction Treatment at All In Solutions
At All In Solutions, we take the issue of prescription drug addiction just as seriously as we do any other substance use disorder. Treatment is At All In Solutions, we take the issue of prescription drug addiction just as seriously as we do any other substance use disorder. Treatment is always individualized, evidence-based, and provided at every level of care.
