What is prescription drug abuse?
Although most people
take prescription medications
responsibly,
there has been an increase in
the nonmedical use of or, as
NIDA refers to it in this report,
abuse1 of prescription drugs in
the United States.
What are some of the commonly
abused prescription drugs?
Although many prescription
drugs can be
abused, there are several
classifications of medications
that are commonly abused.
The three classes of
prescription drugs that are
most commonly abused are:
- Opioids, which are most often prescribed to treat pain;
- Central nervous system
(CNS) depressants, which
are used to treat anxiety
and sleep disorders; and
- Stimulants, which are
prescribed to treat the
sleep disorder narcolepsy
and attention-deficit
hyperactivity disorder
(ADHD).
Opioids
What are opioids?
Opioids are commonly
prescribed because of
their effective analgesic,
or pain-relieving, properties.
Medications that fall within
this class-referred to as
prescription narcotics-include
morphine (e.g., Kadian,
Avinza), codeine, oxycodone
(e.g., OxyContin, Percodan,
Percocet), and related drugs.
Morphine, for example, is
often used before and after
surgical procedures to alleviate
severe pain. Codeine, on the
other hand, is often prescribed
for mild pain. In addition to
their pain-relieving properties,
some of these drugs-codeine
and diphenoxylate (Lomotil)
for example-can be used to
relieve coughs and diarrhea.
How do opioids affect
the brain and body?
Opioids act on the brain
and body by attaching to
specific proteins called opioid
receptors, which are found
in the brain, spinal cord, and
gastrointestinal tract. When
these drugs attach to certain
opioid receptors, they can
block the perception of pain.
Opioids can produce drowsiness,
nausea, constipation,
and, depending upon the
amount of drug taken, depress
respiration. Opioid drugs
also can induce euphoria
by affecting the brain regions
that mediate what we perceive
as pleasure. This feeling is
often intensified for those
who abuse opioids when
administered by routes other
than those recommended. For
example, OxyContin often is
snorted or injected to enhance
its euphoric effects, while at
the same time increasing the
risk for serious medical
consequences, such as opioid
overdose.2
What are the possible consequences
of opioid use and abuse?
Taken as directed, opioids
can be used to manage pain
effectively. Many studies
have shown that the properly
managed, short-term medical
use of opioid analgesic drugs
is safe and rarely causes
addiction-efined as the
compulsive and uncontrollable
use of drugs despite adverse
consequences-or dependence,
which occurs when the
body adapts to the presence
of a drug, and often results
in withdrawal symptoms
when that drug is reduced
or stopped. Withdrawal symptoms
include restlessness,
muscle and bone pain, insomnia,
diarrhea, vomiting, cold
flashes with goose bumps
("cold turkey"), and involuntary
leg movements. Long-term use
of opioids can lead to physical
dependence and addiction.
Taking a large single dose of
an opioid could cause severe
respiratory depression that can
lead to death.
Is it safe to use opioid drugs
with other medications?
Only under a physician's
supervision can opioids be
used safely with other drugs.
Typically, they should not be
used with other substances
that depress the CNS, such as alcohol, antihistamines,
barbiturates, benzodiazepines,
or general anesthetics, because
these combinations increase
the risk of life-threatening
respiratory depression.
1 A common vocabulary has not been established in the field of prescription drug abuse.
Because much of the data collected in this area focuses on nonmedical use of prescription
drugs, the definition of abuse used in this report does not correspond to the definition of
abuse/dependence listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
2 This does not apply only to opioids. Changes in routes of administration also contribute to the abuse of other prescription medications, and
this practice can lead to serious medical consequences.
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