Key takeaways:

  • There are multiple ways someone can be considered to be abusing prescription medication; including using it without a prescription, using more than intended, taking for longer than intended, or using in dangerous ways (e.g. crushing pills and snorting them).
  • Consuming alcohol while using prescription medication, even over-the-counter drugs, often has harmful side effects. Some alcohol and medication interactions can render the medication ineffective while other interactions may produce harmful toxins.
  • According to the National Institute on Drug Abuse, 50% of people between the ages of 57 to 85 take more than 5 medications or supplements daily, meaning they are more likely to make a mistake with one set of medication and may end up abusing it.

Each year, more than 131 million Americans (or 66% of the population), are prescribed some form of medication. While many of these medications are needed to improve a person’s physical or mental health, even prescribed medications carry some risks, including the risk for misuse, abuse, and addiction. Certain types of prescription drugs are more addictive than others, including many which are classified by the DEA as controlled substances.

Prescription drug abuse

Prescription medications are the third most abused category of drugs in the US behind tobacco and alcohol and ahead of illicit substances like meth or heroin. In 2017, an estimated 18 million people had misused such prescription medications in the past year. [3]

There are multiple ways someone can be considered to be abusing prescription medication; including using it without a prescription, using more than intended, taking for longer than intended, or using in dangerous ways (e.g. crushing pills and snorting them). Abusing any form of prescription medication can be harmful to health and has the potential to form an addiction. [3] 

The most commonly abused types of prescription medications are: [1][3]

  • Opioid painkillers such as hydrocodone, oxycodone, codeine, and fentanyl. According to the 2017 National Survey on Drug Use and Health, an estimated 2 million Americans misused prescription pain relievers for the first time within the past year, which averages to approximately 5,480 initiates per day. 
  • Tranquilizers and sedatives such as benzodiazepines like Halcion and Xanax or sleeping aids like Ambien. The same report as above found that 1.5 million misused tranquilizers, and 271,000 misused sedatives for the first time in 2017.  
  • Stimulants such as Adderall, Dexedrine, and Concerta, commonly prescribed to those with ADD, ADHD, or sleep disorders like narcolepsy
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Why do people abuse prescription drugs?

There are many reasons why some people abuse prescription medications. Some people do have valid medical or mental health reasons and begin abusing their prescription in order to overcome tolerance, achieve better or faster effects, or manage their symptoms. Others will abuse prescriptions in order to achieve a high, get relaxed, or get rid of unwanted or upsetting thoughts or feelings. 

Here are some of the common reasons people abuse prescription drugs:

  • To feel good or get high
  • To relax or relieve stress, anxiety, or tension (i.e. painkillers and sedatives)
  • To reduce appetite or the need to sleep (i.e. stimulants)
  • To boost mood or energy levels (i.e. stimulants or painkillers)
  • To gain acceptance from peers (i.e. teens and young adults)
  •  To overcome tolerance or get the desired effects
  • To better manage symptoms of a mental health issue (i.e. anxiety or depression)
  • To reduce chronic pain or symptoms of another health or medical problem
  • To improve functioning, focus, or study or work productivity (i.e. stimulants)
  • To experiment with the effects or combined effects of a drug

What are prescription pain relievers?

Prescription pain relievers or painkillers are predominantly formed of the opioid drug class. These drugs are used to treat a wide range of pain conditions including cancer-related pain, chronic pain, physical trauma, post and pre-surgery, muscular pain, and skeletal pain. 

Opioids are a class of central nervous system (CNS) depressants that work by binding to opioid pain receptors in the brain, effectively blocking pain signals to the brain. [4] Common opioid painkillers include; oxycodone (i.e.OxyContin), hydrocodone (Vicodin), codeine, morphine, Dilaudid, and fentanyl. While these medications are highly effective at managing pain, they also are controlled drugs that carry a high risk for abuse and addiction. [2] 

Some of the dangers associated with opioid use and prescription opioid abuse include: [2][4]

  • The high risk for becoming addicted or dependent on the drugs
  • The risk for developing tolerance (needing to increase the dose to get desired effects)
  • The high risk of accidental overdose (especially when combined with alcohol or other drugs OR when purchasing opioids illegally)
  • The risk for respiratory depression, which is the primary cause of accidental opioid overdose
  • Impaired thinking, judgment, and coordination; increasing the risk for injuries, accidents, and impairments
  • The experience of painful withdrawal symptoms when trying to cut back or stop on your own (once a physical dependence has formed)

What are tranquilizers and sedatives?

Tranquilizers and sedatives most often fall under the benzodiazepine drug class, as well as the sleeping aid or “Z drug” drug class. As with opioids, they are a form of CNS depressants that can help with a variety of conditions including anxiety, panic attacks, muscle spasms, insomnia, and other sleeping disorders. They work by slowing brain function to a point where the user feels drowsy and or calm. [6] Common tranquilizers and sedatives include Xanax, Valium, Ativan, Halcion, Klonopin, and Ambien

Prescribed sedatives can be helpful to those struggling with insomnia, anxiety, or even neurological disorders like epilepsy, but they are also controlled substances that carry a high risk for abuse and dependence. [2] In large doses or when combined with other sedatives, including alcohol, sedative drugs can even lead to fatal overdoses. [5] 

Some of the dangers associated with sedative use and prescription sedative abuse include: [2][5]

  • Increased risk for drowsiness and daytime sleeping
  • Lowered cognitive functioning and impaired decision making
  • Increased risk for respiratory depression (especially when combined with alcohol or other drugs)
  • High risk for abuse and addiction
  • Difficult, uncomfortable, and sometimes fatal withdrawals, including seizures (once a physical dependence has formed)
  • Impaired coordination and motor functioning, increasing the risk for accidents, injuries, and impairments

What are stimulants?

Stimulants form their own drug class and are used to treat conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, depression, as well as being a primary component in steroids and weight loss medication. Stimulants release dopamine into the brain affecting the pleasure and reward center. This can affect mood, concentration, and alertness. Taken in high doses they also cause sensations of euphoria. [6] Common stimulants include Adderall, Ritalin, Dexedrine, Concerta, and diet pills.

While these drugs can help people struggling with conditions like ADD, ADHD, or Narcolepsy, they are also controlled substances that carry a high risk for abuse and addiction. [2] In addition, these medications can cause heart problems, high blood pressure, and other unwanted effects.  

Some of the risks associated with prescription stimulant abuse and misuse include: [6]

  • Increased blood pressure
  • Heart problems and stroke
  • Lowered appetite and unintended weight loss
  • Nausea and G.I. pain
  • Insomnia
  • Paranoid thoughts or psychosis
  • Overdose
  • Addiction or dependence
  • Fatigue, irritability, or depression when crashing or withdrawing

Recognizing prescription drug abuse

If you feel you or someone you know may be abusing prescription medication then there are some warning signs that can help confirm or deny your suspicions, including:

  • Secretive behavior
  • Running out of prescriptions early
  • “Doctor shopping” to find new prescribers
  • Lying or exaggerating conditions 
  • Unexplained changes in mood or behavior
  • Stealing or asking to borrow money
  • Changes in sleep, appetite, hygiene, or weight
  • Asking to take another person’s prescription

Visit our warning signs of addiction guide for full details.

Mixing alcohol and prescription drugs

Consuming alcohol while using prescription medication, even over-the-counter drugs, often has harmful side effects. Some alcohol and medication interactions can render the medication ineffective while other interactions may produce harmful toxins. [7] 

Alcohol, even in small amounts, can also increase certain medications' side effects, such as drowsiness, light-headedness, and sleepiness, which impair coordination and can make operating machinery, driving, and some work environments very dangerous. As alcohol interacts with all medications differently, it is always recommended that you read the warning label on the bottle or speak to your pharmacist/doctor before drinking in combination with medication. [7]

Because alcohol can adversely interact with hundreds of commonly used medications, it's important to observe warning labels and ask your doctor or pharmacist if it's safe to use alcohol with any medications and herbal remedies that you take. 

Some common alcohol and prescription medication combination side effects include: [7]

  •     Nausea and vomiting
  •     Headaches
  •     Drowsiness
  •     Dizziness
  •     Fainting
  •     Changes in blood pressure
  •     Abnormal behavior
  •     Loss of coordination
  •     Accidents

And more severe or life-threatening complications such as: [7]

  • Liver damage
  • Heart problems
  • Internal bleeding
  • Impaired breathing
  •  Depression
  • Seizures
  • Overdose or death

Prescription drug abuse by demographic

Addiction, abuse, and dependence affect communities and demographics in a myriad of different ways and the same is true with prescription medication abuse.

Prescription drug abuse in seniors

Older people are particularly susceptible to prescription drug abuse, with most starting abuse by accident. According to the National Institute on Drug Abuse, 50% of people between the ages of 57 to 85 take more than 5 medications or supplements daily, meaning they are more likely to make a mistake with one set of medication and may end up abusing it. [3] As the body gets older its ability to absorb and metabolize medication weakens As the drug stays in their system longer, seniors may become unknowingly addicted to a prescribed drug even if taking it in regular amounts.

Learn more about addiction and seniors here.

Prescription drug abuse in teens and young adults

Misuse of prescription drugs is higher amongst young adults than any other age demographic; with 14.4% aged between 18 and 25 reporting abuse in the past year. In teens aged between 12 and 17, 4.9% reported misuse or nonmedical use. [3]

Prescription drug abuse is the fourth highest type of substance abuse after tobacco, alcohol, and marijuana in 12th graders. A 2017 survey by NIDA indicated that 6% of high school seniors abused prescription stimulants such as Adderall and around 2%  had abused prescription opioid painkillers like Vicodin. [3]

You can learn about the warning signs of addiction in teens here, as well as the best ways to talk about drugs and alcohol with your children. 

Prescription drug abuse in pregnant women

As babies in the womb absorb parts of what their mothers ingest, misusing prescription drugs can lead to the fetus developing a dependence. This can result in the child experiencing withdrawal symptoms after birth, a condition known as neonatal abstinence syndrome (NAS). 

This often results in the child having to stay for a prolonged period of time in a neonatal intensive care ward and may require medication treatment if experiencing NAS from opioid painkillers. Pregnant mothers are advised to speak to a doctor or pharmacist before continuing a course of prescription medication.[3] There are other medical risks associated with substance abuse and pregnancy, most notably Fetal Alcohol Syndrome (FAS)

Treatment and recovery from prescription drug addiction

Like all forms of addiction, prescription medication addiction can be treated with specialist help. No one form of treatment is right for everyone, nor is there one form of treatment for all substance addictions. Speaking with a treatment provider, addiction specialist, or doctor can help to assess which type of treatment is right and help you or a loved one begin their journey to recovery.