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Prescription drugs


This page will help you to recognise the signs, symptoms and behaviours associated with the use and abuse of prescription drug, understand its effects, and find help.

What are prescription drugs?


A prescription drug is a licensed medicine that is regulated by legislation to require a prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription. These medications are helpful in treating a variety of health conditions and are only available when prescribed by a doctor or other healthcare professional.

The government restricts these medications because they may be harmful if they are not taken properly, or if they are combined with other medications. Doctors and other healthcare professionals are highly trained and experienced at selecting the best medication to use for a certain condition. The type of medication and the dosage prescribed is carefully determined.

It’s very important that the doctor’s directions are followed exactly to help treat the condition for which it was prescribed and to make sure the medication isn’t abused to cause unwanted effects.

Different types of prescription drugs


There are many prescription drugs that can be abused; the most commonly tend to be:

  • Opiates - often prescribed to treat pain e.g. codeine
  • Central nervous system depressants - which are used to treat anxiety and sleep disorders e.g. benzodiazepines such as diazepam and temazepam
  • Antidepressants - e.g. citalopram and mirtazapine
  • Antihistamines - e.g. chlorphenamine
  • Stimulants used to treat ADHD, such as dexamphetamine

Certain prescription medications, such as analgesics, sleeping pills, amphetamines and tranquillizers are commonly known for causing drug dependence. Three classes of prescription drugs that are often misused include:

Opioids


Since the early 1990s, doctors’ prescriptions for opioid medications, such as codeine and morphine, have increased.

That increase can be attributed to an ageing population, greater prevalence and understanding of conditions with chronic pain; when taken as prescribed, opioids and other painkillers manage pain effectively, improving the quality of life for people with chronic pain.

Using opioids for a short-term period under medical supervision rarely leads to addiction or dependence. However, when used long-term, opioids may lead to pain medication misuse with a physical dependence.

When taken with substances that depress the central nervous system, including alcohol, barbiturates or benzodiazepines, opiods can be potentially fatal, increasing the risk of respiratory depression.

The euphoric feeling associated with opioids is usually mild. However this euphoric feeling can lead to psychological dependence, where there is a state of emotional craving. Physical dependence is a physiological adaptation to a drug characterised by extreme physical symptoms after stopping the medication, more commonly known as withdrawal symptoms. According to the British Medical Association “New Guide to Medicines & Drugs” opioid dependence is rare under professional medical supervision.

CNS


Benzodiazepines depress the CNS. They are taken by millions of people worldwide to treat anxiety and sleep disorders, including insomnia. They are generally prescribed to treat insomnia, tension, and anxiety.

CNS depressants affect the brain neurotransmitter GABA (gamma-amino butyric acid). GABA works by decreasing brain activity, which results in a drowsy or calming effect.

Taking CNS depressants under medical supervision from a doctor is acceptable as they can monitor appropriate dosage levels. Initially, only a small dose is required to administer the desired calming effects, however, the longer the course of treatment the more likely it is the dose will be increased in order to sustain the same effect.

Using CNS depressants with alcohol is potentially fatal as they have the potential to slow down the heart and respiratory system. Suddenly stopping a course of CNS depressants, without medical supervision, can have life-threatening consequences such as causing seizures. Always consult a GP when ceasing a course of CNS depressants.

Stimulants


Stimulants cause an increase in alertness, energy and attention. Stimulants increase the heart rate and blood pressure, constrict blood vessels, increase blood glucose (blood sugar) and open the pathways of the respiratory system.

Stimulants are prescribed to treat problems such as Attention Deficit Hyperactivity Disorder (ADHD), depression and narcolepsy, amongst others.

Taken appropriately and under a doctor’s supervision stimulants are safe. When they are misused, for instance, by taking the medicines in higher doses or misusing the drug for recreational purposes, they have the potential for dependency and ongoing abuse. Using stimulants with decongestants may cause irregular heart rhythms and high doses of stimulants can cause high body temperatures.

What are the signs of prescription drug abuse?


There can be signs that a person is abusing prescription drugs, if that person is displaying THREE or more of these, it may be they are addicted to prescription drug use, these include –

  • Needing to take more of the drug to get an appropriate effect
  • Asking for repeat prescriptions early
  • Difficulty in trying to cut down or stop drug use
  • Feeling guilty about the drug use
  • Problems with work, finances or legal issues
  • Being secretive about the drug use
  • Arguments or disagreements with significant others about the drug use
  • Taking other medications to alleviate side effects of prescription drugs
  • Experiencing withdrawal symptoms when stopping/reducing the drug or between doses
  • Continuing to take the drug despite actual or likely negative consequences

When does normal use turn into an addiction?


If a person becomes physically and psychologically dependent, although not all drugs are capable of inducing a physical dependency.

Dependency is characterised by a feeling of not being able to do without a drug and a desperate need to obtain and consume the drug to alleviate feelings that arise from not having it.

What are the dangers of prescription drugs?


These are many and varied and depend on the type and dose of the drug. There are the risks involved with the short-term effects and with prolonged use.

They include:

  • Sedation - usually associated with short term use
  • Lack of coordination - again usually short term use
  • Altered states of consciousness - more likely in short term use
  • Gastrointestinal complaints, such as nausea (short term) and diarrhoea (short term) and constipation (long term)
  • Depressed respiration - high dose, acute
  • Changes in blood pressure or heart rate - short and long term
  • Changes in appetite - more likely short term
  • Interactions with other drugs and alcohol - short and long term
  • Tolerance and dependence - long term
  • Symptoms associated with withdrawal - longer term (Again differing with each drug) including anxiety, depression, seizures, tremor and insomnia

Prescription medications commonly misused include opioids, CNS depressors and stimulants. The Internet has seen a rise in unregulated sales of prescription drugs. These websites make it easier to obtain these commonly misused drugs.

If misusing prescription drugs, a person may be taking larger doses than a doctor has prescribed. For instance, if a doctor prescribed a pain medication to be taken three times daily and a person is finding themselves taking the same medication more frequently or taking twice as much, that is considered to be misusing prescription drugs.

A doctor may notice an increasing in requests for more prescriptions, or asking for increasing amounts of medications. In addition, a pharmacist may notice prescription drug abuse by spotting false or altered prescription forms.

Guidelines for an individual’s use of prescription drugs safely include -

  • Always follow the directions on the label carefully and accurately
  • Don’t increase or decrease medication doses without talking with a doctor first
  • Never stop taking medication, always finish a course of treatment or consult with a doctor first
  • Don’t crush or break pills (especially important if the pills are time-released)
  • Be clear about the drug’s effects on driving and other daily tasks
  • Learn about possible interactions of the prescription medicine with alcohol, other prescription medicines and over-the-counter medicines
  • Talk honestly with a doctor about any history of substance abuse
  • Never allow other people to use prescription medications

What help and support is there for families affected by prescription drug use?

Drug use affects the whole family, not just the user. When there’s a drug user in the family, whether it is a child or parent, everyone suffers and it can be so crippling that family members suffer as much as the user.

For those living close to a dependent drug user, trying to find help can be frustrating. It often seems that support is geared towards the user, when families struggle through problems too.

Fortunately there are support groups for family members too.

There are a number of groups whose sole focus is the support of family members and friends who have been affected by substance abuse and help address these issues.

One organisation that can help specifically with families and friends of drug users is Families Anonymous, who provide support to anyone whose life is, or has been, affected by someone else’s drug use.

Finding help


The Inexcess Support Directory lists more than 1600 service providers throughout the UK and is divided by region to help support and advise people how to find help in their own area. Click here to visit the Support Directory.