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What are the Risks of Prescription Drug Abuse?

What are the risks of prescription drug abuse? Although most patients use medications as directed, abuse and addiction to prescription drugs are public health problems for many Americans. However, addiction rarely occurs among those who use medications as prescribed; the risk for addiction exists when medications are used in ways other than as prescribed.

Prescription drug abuse and addiction is no different from alcoholism or an addiction to any other substance. However, no one is prescribed alcohol or cocaine for medical reasons. People who suffer from chronic pain are in a very difficult position. Painkillers do relieve pain. For people who suffer from constant and chronic pain, narcotics may be necessary to allow them to have any quality of life. The downside is becoming physically dependent and risking the possibility of addiction.

Two types of the most commonly abused prescription drugs are opioids and benzodiazepines. Opioids are generally used to control pain. Benzodiazepines, or tranquilizers, are used to manage anxiety. These drugs are prescribed for short-term use such as acute pain and anxiety that is in reaction to a specific event. They may also be prescribed for chronic pain or generalized anxiety.

What are the risks of prescription drug abuse? The health risks associated with prescription drug abuse vary depending on the drug. For example, abuse of opioids, narcotics and pain relievers can slow or stop breathing. The abuse of depressants, including benzodiazepines and other tranquilizers, barbiturates and other sedatives, can result in seizure, respiratory depression and decreased heart rate. Stimulant abuse can lead to high body temperature, irregular heart rate, cardiovascular system failure and seizure. Inappropriate use of prescription drugs, including use without a prescription or medical supervision, or using in a manner other than exactly as prescribed, can lead to addiction in some cases.

The Drug Abuse Warning Network (DAWN) receives reports of emergency department (ED) episodes involving the non-medical use of legal drugs. These can involve the deliberate abuse of prescribed or legally obtained over-the-counter (OTC) medications or of pharmaceuticals diverted for abuse. Accidental overdoses or adverse reactions to OTC or prescription drugs taken as directed are not reportable to DAWN unless they are present in combination with an illicit drug. During 2005, there were an estimated 598,542 ED visits that involved non-medical use of prescription or OTC pharmaceuticals or dietary supplements. CNS agents were involved in an estimated 305,973 ED visits and psychotherapeutic agents were involved in an estimated 275,430 visits.

What are the risks of prescription drug abuse? Here are the socio-economic risks of prescription drug abuse:

  • Increased risk of accidents - traffic, home, work.
  • Increased risk of fatality from overdose if combined with other drugs.
  • Increased risk of attempted suicide, especially in depression.
  • Increased risk of aggressive behavior and assault.
  • Increased risk of shoplifting and other antisocial acts.
  • Contributions to marital/domestic disharmony and breakdown due to emotional and cognitive impairment.
  • Contributions to job loss, unemployment, loss of work through illness.
  • Cost of hospital investigations/consultations/admissions.
  • Adverse effects in pregnancy and in the new-born.
  • Dependence and abuse potential (therapeutic and recreational).
  • Costs of drug prescriptions.
  • Costs of litigation.

 

What are the risks of prescription drug abuse? Here is a chart with a clear overview of the many risk of common prescription drugs.

Prescription Drug:
Category and Name

Examples of Commercial and Street Names

DEA Schedule*/
How Administered**

Intoxication Effects/Potential Health Risks

Depressants

reduced pain and anxiety; feeling of well-being; lowered inhibitions; slowed pulse and breathing; lowered blood pressure; poor concentration/confusion, fatigue; impaired coordination, memory, judgment; respiratory depression and arrest, addiction

Also, for barbiturates - sedation, drowsiness/depression, unusual excitement, fever, irritability, poor judgment, slurred speech, dizziness

for benzodiazepines - sedation, drowsiness/dizziness

for flunitrazepam - visual and gastrointestinal disturbances, urinary retention, memory loss for the time under the drug's effects

barbiturates

Amytal, Nembutal, Seconal, Phenobarbital; barbs, reds, red birds, phennies, tooies, yellows, yellow jackets

II, III, V/injected, swallowed

benzodiazepines (other than flunitrazepam)

Ativan, Halcion, Librium, Valium, Xanax; candy, downers, sleeping pills, tranks

IV/swallowed

flunitrazepam***+

Rohypnol; forget-me pill, Mexican Valium, R2, Roche, roofies, roofinol, rope, rophies

IV/swallowed, snorted

Dissociative Anesthetics

increased heart rate and blood pressure, impaired motor function/memory loss; numbness; nausea/vomiting

Also, for ketamine - at high doses, delirium, depression, respiratory depression and arrest

ketamine

Ketalar SV; cat Valium, K, Special K, vitamin K

III/injected, snorted, smoked

Opioids and Morphine Derivatives

pain relief, euphoria, drowsiness/respiratory depression and arrest, nausea, confusion, constipation, sedation, unconsciousness, coma, tolerance, addiction

Also, for codeine - less analgesia, sedation, and respiratory depression than morphine

codeine

Empirin with Codeine, Fiorinal with Codeine, Robitussin A-C, Tylenol with Codeine; Captain Cody, Cody, schoolboy; (with glutethimide) doors & fours, loads, pancakes and syrup

II, III, IV/injected, swallowed

fentanyl

Actiq, Duragesic, Sublimaze; Apache, China girl, China white, dance fever, friend, goodfella, jackpot, murder 8, TNT, Tango and Cash

II/injected, smoked, snorted

morphine

Roxanol, Duramorph; M, Miss Emma, monkey, white stuff

II, III/injected, swallowed, smoked

opium

laudanum, paregoric; big O, black stuff, block, gum, hop

II, III, V/swallowed, smoked

other opioid pain relievers (oxycodone, meperidine, hydromorphone, hydrocodone, propoxyphene)

Tylox, OxyContin, Percodan, Percocet; oxy 80s, oxycotton, oxycet, hillbilly heroin, percs
Demerol, meperidine hydrochloride; demmies, pain killer
Dilaudid; juice, dillies
Vicodin, Lortab, Lorcet; Darvon, Darvocet

II, III, IV/swallowed, injected, suppositories, chewed, crushed, snorted

Stimulants

increased heart rate, blood pressure, metabolism; feelings of exhilaration, energy, increased mental alertness/rapid or irregular heart beat; reduced appetite, weight loss, heart failure

Also, for amphetamines - rapid breathing; hallucinations/tremor, loss of coordination; irritability, anxiousness, restlessness, delirium, panic, paranoia, impulsive behavior, aggressiveness, tolerance, addiction

for methylphenidate - increase or decrease in blood pressure, psychotic episodes/digestive problems, loss of appetite, weight loss

amphetamines

Biphetamine, Dexedrine; bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers

II/injected, swallowed, smoked, snorted

methylphenidate

Ritalin; JIF, MPH, R-ball, Skippy, the smart drug, vitamin R

II/injected, swallowed, snorted

Other Compounds

no intoxication effects/hypertension, blood clotting and cholesterol changes, liver cysts and cancer, kidney cancer, hostility and aggression, acne; adolescents, premature stoppage of growth; in males, prostate cancer, reduced sperm production, shrunken testicles, breast enlargement; in females, menstrual irregularities, development of beard and other masculine characteristics

anabolic steroids

Anadrol, Oxandrin, Durabolin, Depo-Testosterone, Equipoise; roids, juice

III/injected, swallowed, applied to skin

 

* Schedule I and II drugs have a high potential for abuse. They require greater storage security and have a quota on manufacturing, among other restrictions. Schedule I drugs are available for research only and have no approved medical use; Schedule II drugs are available only by prescription (unrefillable) and require a form for ordering. Schedule III and IV drugs are available by prescription, may have five refills in 6 months, and may be ordered orally. Most Schedule V drugs are available over the counter.

** Taking drugs by injection can increase the risk of infection through needle contamination with staphylococci, HIV, hepatitis, and other organisms.

*** Associated with sexual assaults.

+ Not available by prescription in U.S.

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