Most Abused Prescription Drugs

Understanding Prescription Drug Abuse

Prescription drug abuse is a growing concern, with far-reaching implications for individuals and communities alike. Despite being prescribed by medical professionals, these drugs, when misused, can lead to physical dependence, addiction, and other serious consequences.

Defining Prescription Drug Abuse

Prescription drug abuse refers to the misuse of medication in a way not intended by the prescribing doctor. This could involve taking a higher dose than prescribed, consuming the drug for a non-medical purpose, or taking medication that was prescribed for someone else. It is a serious issue affecting people of all ages, from teens and young adults to the elderly. Prescription drug abuse is highest among teens and young adults, but misuse in older adults is also a growing problem, especially when they combine drugs with alcohol [1].

Reasons for abuse vary, with some individuals using these medicines to self-medicate, others succumbing to addictive tendencies, and some driven by the fear of addiction to prescribed medications.

Commonly Abused Prescription Drugs

The list of the most abused prescription drugs is headlined by a range of medications that include opioid painkillers, anti-anxiety medicines, sedatives, and stimulants. These substances have a high potential for misuse due to their effects on the brain and body.

Each of these drugs can cause physical and psychological dependence, leading to withdrawal symptoms and potential addiction when misused or consumed in large quantities over a prolonged period [1].

Understanding prescription drug abuse and the most commonly abused drugs is the first step towards addressing this silent and pervasive crisis. The following sections will delve deeper into the impact of such misuse, particularly focusing on opioids, stimulants, and sedatives, as well as discussing strategies to prevent prescription drug abuse.

The Impact of Opioid Misuse

Examining the landscape of the most abused prescription drugs, opioids are a significant contributor due to their potential for misuse and serious health consequences associated with overuse.

Opioid Painkillers and Misuse

Opioids are powerful painkillers often used for managing severe or chronic pain. However, they can also induce a sense of euphoria, making them highly susceptible to misuse. As per the Mayo Clinic, the prescription drugs most often misused include opioid painkillers, anti-anxiety medicines, sedatives, and stimulants.

Opioid Use Disorder (OUD) is sometimes referred to as "opioid abuse or dependence" or "opioid addiction," and is defined as a problematic pattern of opioid use that causes significant impairment or distress.

The misuse of opioids can be characterized by a variety of behaviors, including taking higher doses than prescribed, using opioids to get high, or combing opioids with alcohol or other drugs. This misuse can lead to dependency and eventually addiction, creating a cycle that can be difficult to break.

Consequences of Opioid Misuse

The consequences of opioid misuse are severe and can impact various aspects of an individual's life - from physical and mental health to relationships and employment status. Physical health effects can encompass a wide range of symptoms, including respiratory issues, decreased immune response, and in severe cases, overdose and death.

The National Institute on Drug Abuse indicates that efforts have been made to control the misuse of opioids. For instance, the Drug Enforcement Administration moved hydrocodone products from schedule III to the more restrictive schedule II in 2014, resulting in a decrease in hydrocodone prescribing that did not lead to increases in the prescribing of other opioids.

However, despite these efforts, the misuse of opioids remains a significant public health issue, necessitating further strategies and measures to curb this escalating crisis. These strategies include the use of Prescription Drug Monitoring Programs (PDMPs), abuse-deterrent formulations (ADF) of opioids, and increased awareness among physicians and patients about the risks associated with opioid misuse.

Stimulants and Sedatives Abuse

Two of the most abused prescription drugs categories are stimulants and sedatives. While these substances are often prescribed for legitimate medical reasons, misuse can lead to serious health consequences.

Stimulant Misuse and Effects

Stimulants, such as amphetamines, are usually prescribed for conditions like ADHD. However, they are often abused for their ability to induce a high, boost energy, or maintain weight. High doses of these substances can result in a dangerous rise in body temperature, irregular heartbeat, and even cardiac arrest. Amphetamines are often referred to by their street names, such as "bennies," "black beauties," and "speed".

Another commonly abused stimulant is Dextromethorphan (DXM), found in over-the-counter cold and cough medicines. This substance is especially popular among teenagers. Large doses of DXM can lead to hallucinations, vomiting, rapid heart rate, and in rare cases, brain damage [3].

Sedative Misuse and Consequences

Sedatives, including benzodiazepines, are frequently misused for their calming and sedating effects. Misuse of sedatives can lead to drowsiness, confusion, slowed breathing, and even overdose.

The misuse of sedatives can develop into physical dependence and addiction. Furthermore, when use is abruptly stopped, withdrawal symptoms can occur [4].

It is essential for physicians to balance the legitimate medical needs of patients with the potential risk for misuse and related harms when prescribing prescription stimulants, sedatives, or other potentially addictive substances. These facts underscore the importance of education, prevention strategies, and regulatory measures in curbing prescription drug abuse.

Prescription Drug Abuse Prevention

Preventing the misuse of prescription drugs is a complex issue that requires a multifaceted approach. Key strategies include the use of Prescription Drug Monitoring Programs (PDMPs) and increasing physician awareness about the potential risks associated with prescription drugs.

Role of Prescription Drug Monitoring Programs

Prescription Drug Monitoring Programs (PDMPs) are crucial tools in the fight against prescription drug misuse. These programs track the prescribing and dispensing of medications to patients and are designed to monitor any unusual or suspicious patterns of prescriptions that may indicate misuse.

According to the National Institute on Drug Abuse, some states have associated the use of PDMPs with lower rates of opioid prescribing and overdose. These programs can serve as an early warning system, enabling healthcare professionals to intervene before misuse escalates into addiction.

In a notable move, the Drug Enforcement Administration reclassified hydrocodone products from schedule III to the more restrictive schedule II in 2014. This resulted in a decrease in hydrocodone prescribing that did not lead to increases in the prescribing of other opioids.

Importance of Physician Awareness

Physician awareness plays a critical role in preventing prescription drug abuse. Physicians have a responsibility to balance the legitimate medical needs of patients with the potential risk for misuse and related harms when prescribing prescription stimulants, sedatives, or opioid pain relievers.

This calls for a thorough understanding of the pharmacological properties and abuse potential of different medications, as well as the ability to identify risk factors for misuse in patients. Physicians should be up-to-date with the latest research and guidelines on safe prescribing practices to minimize the risk of misuse and addiction.

Efforts should also be made to educate physicians about the benefits of Abuse-Deterrent Formulations (ADFs). ADFs are a type of medication designed to prevent abuse, and they have shown promising results in decreasing the illicit value of drugs.

In conclusion, preventing prescription drug abuse requires a comprehensive approach that involves monitoring prescription patterns, educating physicians, and utilizing abuse-deterrent formulations. These strategies, combined with federal initiatives to address opioid misuse and addiction, can significantly contribute to reducing the prevalence of prescription drug abuse.

Demographics and Prescription Drug Abuse

Prescription drug misuse impacts various populations in different ways. Understanding these demographic trends aids in creating targeted interventions and strategies to combat this growing problem.

Prescription Drug Misuse Among Teens

Prescription drug abuse is highest among teenagers and young adults. A study found that Hispanic and White students were more likely to report drug use and abuse than Asian and African American students prior to coming to college and during college.

Furthermore, the use of marijuana and other illicit drugs has increased significantly among college students in the U.S. over the past decade.

Table 1: Age and Drug Misuse

This age group needs specific attention due to their high susceptibility to prescription drug misuse and the potential long-term impacts on their health and well-being.

Prescription Drug Misuse Among Adults

While teens and young adults have the highest rates of prescription drug misuse, it's important not to overlook the issue of prescription drug abuse among adults and the elderly. Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol.

Table 2: Drug Misuse Among Adults

The misuse of prescription drugs among adults is a significant concern due to the potential interactions with other medications and the higher risk of serious health complications.

Understanding the demographics of prescription drug abuse is key to addressing this silent crisis. By tailoring interventions to specific age groups and populations, it's possible to reduce the misuse of the most abused prescription drugs and mitigate the associated risks.

Strategies to Curb Prescription Drug Abuse

Addressing the issue of prescription drug misuse requires a multifaceted strategy. From federal initiatives to innovative formulations, different approaches play pivotal roles in curbing the abuse of prescription drugs.

Federal Initiatives Against Drug Abuse

Federal efforts have been instrumental in fighting prescription drug misuse. In 2014, the Drug Enforcement Administration reclassified hydrocodone products from Schedule III to the more restrictive Schedule II. This action resulted in a decrease in hydrocodone prescribing without leading to increases in the prescribing of other opioids.

Furthermore, in 2015, the federal government launched an initiative to reduce overdose and prevent people from developing opioid use disorders. This initiative emphasized the importance of coordinated efforts to address opioid misuse, addiction, and overdose, demonstrating a commitment to tackling one of the most abused prescription drugs [4].

Prescription drug monitoring programs (PDMPs) are another significant tool for preventing and identifying prescription drug misuse. Some states have associated the use of these programs with lower rates of opioid prescribing and overdose.

Role of Abuse-Deterrent Formulations

In addition to regulations and monitoring programs, innovation in pharmaceutical formulations can also serve as a powerful tool against prescription drug misuse.

Abuse-deterrent formulations (ADFs) are one such innovation. These specially designed medications have properties that make them less desirable or attractive to potential abusers. For example, they may be formulated to prevent crushing or dissolving, methods often used by abusers to release a drug more quickly.

Currently, ADF opioids are on the market and have shown a decrease in the illicit value of drugs. Recognizing the potential of this approach, the FDA has also called for the development of ADF stimulants.

Physicians also play a critical role in this strategy. They should balance the legitimate medical needs of patients with the potential risk for misuse and related harms when prescribing prescription stimulants, sedatives, or opioid pain relievers.

These strategies, coupled with ongoing research and public awareness efforts, can help in the fight against the misuse of prescription drugs and protect individuals from the potential dangers of drug misuse.

References

[1]: https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

‍[3]: https://www.webmd.com/mental-health/addiction/ss/slideshow-commonly-abused-drugs

‍[4]: https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented

‍[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377408/