Prescription Drug Use & Abuse, Consequences, Complexities of Addiction

Prescription Drug Use & Abuse
While most Americans use prescription medications appropriately, a growing minority are crossing the line between using medication as prescribed and abusing it for its physical and psychological effects: getting high, having fun, calming down—or even staying awake for long periods, such as when studying for a test in school (Ritalin, a drug used to alleviate the symptoms of attention deficit/hyperactivity disorder, is commonly called the “study buddy” drug on many high school and college campuses).

Experts point out that the problem exists not because people or drugs are inherently “bad.” Many people who become addicted to prescription drugs started using them for legitimate reasons. For a significant percentage of those people, use leads to abuse, which leads to addiction.

Consequences of Prescription Drug Abuse
A woman with serious anxiety and depression is prescribed an anti-anxiety drug. The drug relieves her worries and fears, promotes restful sleep and calms her troubled mind. Soon, she wonders whether taking more of the drug—or taking it more often—would help her feel even better.

Concerned about abuse, the woman’s doctor stops prescribing the drug (perhaps suggesting psychological counseling). Fearing the consequences of her returning anxiety, the woman begins “doctor shopping.”

Visiting several doctors, she complains of worsening anxiety symptoms, acting the part well. Unaware of her previous misuse of the drug, these doctors write prescriptions, which are then filled at different pharmacies. The woman now has an ample supply, and steadily continues increasing the frequency or the amount she uses. Eventually, she can’t function without the medication, and her body revolts when the drug isn’t present. Her downward spiral continues.

Another man feels some moderate back pain. His doctor has suggested over-the-counter analgesics and physical therapy. The man decides aspirin isn’t working well enough and that he doesn’t have time for exercising. Instead, he finds a source on the Internet for Vicodin, Percocet or Percodan—all containing a strong opiate compound known as oxycodone.

For a while, one pill a day keeps him pain-free. Eventually, after a hard day’s work in the yard, he tries two. Two makes him feel better than one. At some point, three will make him feel better than two. Another person’s downward spiral continues.

Three factors contribute to this problem:

    • the power of addiction itself
    • misconceptions as to what constitutes “abuse”
    • difficulties doctors and patients both experience when discussing the topic.

 

Complexities of Prescription Drug Addiction
In addition to people like those mentioned above, there are millions of individuals with serious medical problems, for whom prescription drugs literally make life worth living again.

According to experts in the medical field, it’s not that potentially addictive medications shouldn’t be used. Dr. Richard Brown, associate professor of family medicine at the University of Wisconsin Medical School, emphasizes, “[Narcotic medications] have an important place in the treatment of debilitating conditions. Drug addiction—characterized by drug craving that is out of control—is actually uncommon among people who use these medications as prescribed.”

This concept of “craving” is the root of addiction, and it has both physical and psychological components. The physical aspect of craving results when an individual develops a tolerance to a particular drug (after long-term use), so more of the drug is needed to alleviate symptoms. Without the drug, the user experiences withdrawal: a feeling often described as “the worst flu you’ve ever had, times ten.” So, to avoid the physical discomfort of withdrawal, the user craves the drug.

Psychologically, craving can be defined as the preoccupation with obtaining and using drugs, despite negative consequences (ranging from feelings of depression to job losses, relationship difficulties, and even run-ins with the legal system). 

A further complication enters the picture from the physician’s perspective. Some doctors have little or no experience or training in identifying drug abuse. Also, concerned about potential problems with the FDA (a government agency charged with oversight of narcotic drug prescribing), some doctors may error toward being too careful, refusing to write prescriptions for opiate medications—even for patients who could truly benefit from them.

This teeter-totter situation of curtail abuse, while still helping those who need strong prescription drugs is—and will probably always be—a difficult balancing act.