|Commonly Abused Prescription
While many prescription drugs can be abused or
misused, these three classes are most commonly abused:
Opioids - often
prescribed to treat pain.
CNS Depressants - used
to treat anxiety and sleep disorders.
prescribed to treat narcolepsy and attention deficit/hyperactivity
commonly prescribed because of their effective analgesic or pain
relieving properties. Many studies have shown that properly managed
medical use of opioid analgesic drugs is safe and rarely causes
clinical addiction, which is defined as compulsive, often
uncontrollable use. Taken exactly as prescribed, opioids can be used to
manage pain effectively. Among the drugs that fall within this class -
sometimes referred to as narcotics - are morphine, codeine, and related
Morphine is often used before or
after surgery to alleviate severe pain. Codeine is
used for milder pain. Other examples of opioids that can be prescribed
to alleviate pain include oxycodone (OxyContin-an oral,
controlled release form of the drug); propoxyphene (Darvon);
hydrocodone (Vicodin); hydromorphone (Dilaudid); and meperidine
(Demerol), which is used less often because of its side
effects. In addition to their effective pain relieving properties, some
of these drugs can be used to relieve severe diarrhea (Lomotil, for
example, which is diphenoxylate) or severe coughs (codeine).
Opioids act 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 in the brain and spinal cord they can effectively block the
transmission of pain messages to the brain. In addition to relieving
pain, opioid drugs can affect regions of the brain that mediate what we
perceive as pleasure, resulting in the initial euphoria that many
opioids produce. They can also produce drowsiness, cause constipation,
and, depending upon the amount of drug taken, depress breathing. Taking
a large single dose could cause severe respiratory depression or be
Opioids may interact with other drugs and are only
safe to use with other drugs under a physician's supervision.
Typically, they should not be used with substances such as alcohol,
antihistamines, barbiturates, or benzodiazepines. These drugs slow down
breathing, and their combined effects could risk life-threatening
respiratory depression. Chronic use of opioids can result in tolerance
to the drugs so that higher doses must be taken to obtain the same
initial effects. Long-term use also can lead to physical dependence -
the body adapts to the presence of the drug and withdrawal symptoms
occur if use is reduced abruptly.
Symptoms of withdrawal can
include restlessness, muscle and bone pain, insomnia, diarrhea,
vomiting, cold flashes with goose bumps ("cold turkey"), and
involuntary leg movements. Methadone, a synthetic
opioid that blocks the effects of heroin and other opioids, eliminates
withdrawal symptoms, and relieves drug craving. It has been used for
over 30 years to successfully treat people addicted to opioids. Other
medications include LAAM (levo-alpha-acetyl-methadol), an alternative
to methadone that blocks the effects of opioids for up to 72 hours.
Naltrexone is a long acting opioid blocker often used with highly
motivated individuals in treatment programs promoting complete
abstinence, and also to prevent relapse.
slow down normal brain function. In higher doses, some CNS depressants
can become general anesthetics. CNS depressants can be divided into two
groups, based on their chemistry and pharmacology:
Barbiturates, such as mephobarbital (Mebaral) and pentobarbital sodium
(Nembutal), which are used to treat anxiety, tension, and sleep
Benzodiazepines, such as diazepam (Valium),
chlordiazepoxide HCl (Librium), and alprazolam (Xanax), which can be
prescribed to treat anxiety, acute stress reactions, and panic attacks.
Benzodiazepines that have a more sedating effect, such as triazolam
(Halcion) and estazolam (ProSom) can be prescriped for short-term
treatment of sleep disorders.
There are many CNS depressants, and most act on the brain similarly -
they affect the neurotransmitter gamma-aminobutyric acid (GABA).
Neurotransmitters are brain chemicals that facilitate communication
between brain cells. GABA works by decreasing brain activity. Although
different classes of CNS depressants work in unique ways, ultimately it
is their ability to increase GABA activity that produces a drowsy or
Despite these beneficial effects for people
suffering from anxiety or sleeping disorders, barbiturates and
benzodiazepines can be addictive and should be used only as prescribed.
CNS depressants should not be combined with any medication or substance
that causes sleepiness, including prescription pain medicines, certain
over-the-counter cold and allergy medications, or alcohol.
The effects of the drugs can combine to slow
breathing, or slow both the heart and respiration, which can be fatal.
Discontinuing prolonged use of high doses of CNS depressants can lead
to withdrawal. Because they work by slowing the brain's activity, a
potential consequence of abuse is that when one stops taking a CNS
depressant the brain's activity can rebound to the point that seizures
can occur. Someone thinking about ending their use of a CNS depressant,
or who has stopped and is suffering withdrawal, should speak with a
physician and seek medical treatment.
a class of drugs that enhance brain activity - they cause an increase
in alertness, attention, and energy that is accompanied by increases in
blood pressure, heart rate, and respiration. Historically, stimulants
were used to treat asthma and other respiratory problems, obesity,
neurological disorders, and a variety of other ailments. As their
potential for abuse and addiction became apparent, the use of
stimulants began to wane. Now, stimulants are prescribed for treating
only a few health conditions, including narcolepsy, attention-deficit
hyperactivity disorder (ADHD), and depression that has not responded to
Stimulants may also be used for short-term
treatment of obesity, and for patients with asthma. Stimulants such as
dextroamphetamine (Dexedrine) and methylphenidate (Ritalin) have
chemical structures that are similar to key brain neurotransmitters
called monoamines, which include norepinephrine and dopamine.
Stimulants increase the levels of these chemicals in the brain and
body. This, in turn, increases blood pressure and heart rate,
constricts blood vessels, increases blood glucose, and opens up the
pathways of the respiratory system. In addition, the increase in
dopamine is associated with a sense of euphoria that can accompany the
use of these drugs.
Research indicates that people with ADHD do not
become addicted to stimulant medications, such as Ritalin, when taken
in the form prescribed and at treatment dosages. However, when misused,
stimulants can be addictive. The consequences of stimulant abuse can be
extremely dangerous. Taking high doses of a stimulant can result in an
irregular heartbeat, dangerously high body temperatures, and/or the
potential for cardiovascular failure or lethal seizures. Taking high
doses of some stimulants repeatedly over a short period of time can
lead to hostility or feelings of paranoia in some individuals.
Stimulants should not be mixed with
antidepressants or over-the-counter cold medicines containing
decongestants. Anti-depressants may enhance the effects of a stimulant,
and stimulants in combination with decongestants may cause blood
pressure to become dangerously high or lead to irregular heart rhythms.
Treatment of addiction to prescription stimulants, such as
methylphenidate and amphetamines, is based on behavioral therapies
proven effective for treating cocaine or methamphetamine addiction. At
this time, there are no proven medications for the treatment of
stimulant addiction. Antidepressants, however, may be used to manage
the symptoms of depression that can accompany early abstinence from
Steroids (Anabolic-Androgenic) The major side
effects from abusing anabolic steroids can include liver tumors and
cancer, jaundice (yellowish pigmentation of skin, tissues, and body
fluids), fluid retention, high blood pressure, increases in LDL (bad
cholesterol), and decreases in HDL (good cholesterol). Other side
effects include kidney tumors, severe acne, and trembling.
In addition, there are some gender-specific side effects:
* For men--shrinking of the testicles, reduced
sperm count, infertility, baldness, development of breasts, increased
risk for prostate cancer.
* For women--growth of facial hair, male-pattern baldness, changes in
or cessation of the menstrual cycle, enlargement of the clitoris,
* For adolescents--growth halted prematurely through premature skeletal
maturation and accelerated puberty changes. This means that adolescents
risk remaining short the remainder of their lives if they take anabolic
steroids before the typical adolescent growth spurt. In addition,
people who inject anabolic steroids run the added risk of contracting
or transmitting HIV/AIDS or hepatitis, which causes serious damage to