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Prescription Drug Use Disorder

(Prescription Drug Abuse; Prescription Drug Addiction; Prescription Drug Dependence

Definition

A drug use disorder is marked by an out-of-control need and craving for a specific drug that affects relationships and social obligations such as work and school. Prescription medications are drugs given to treat a certain condition. Prescription drug use disorder is the compulsive seeking and overuse of prescription medications despite harmful consequences. Some medications have a higher risk of addiction. Even with proper use they are associated with alterations in the pathways in the brain. These pathways influence the senses of reward and well-being which can influence addiction.

Medication use disorder is inappropriate use of a medication. It may include taking higher doses than recommended, snorting pills, mixing with other drugs and alcohol, or using medication for the wrong reasons (such as using pain medication for sleep). Medication (drug) use disorder may only develop because of addiction or the addiction may develop after misuse of a medication.

There are certain prescription drugs that are commonly misused because they are more likely to cause addiction. These drugs include:

  • Opioids—used to treat pain, medication examples include:
    • Morphine
    • Codeine
    • Oxycodone
  • Central nervous system depressants—used to treat anxiety and sleep disorders, medication examples include:
    • Barbiturates
    • Benzodiazepines
  • Stimulants—used to treat narcolepsy and attention deficit hyperactivity disorder, medication examples include:
    • Dextroamphetamine
    • Methylphenidate

Causes    TOP

The reasons people misuse prescription drugs are largely unknown. It is most likely due to a combination of factors. The following may play a role in prescription medication addiction:

  • Genetic factors
  • Altered pathways in brain caused by addicting medications

Brain Pathways

Brain nerve pathways
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Risk Factors    TOP

Prescription drug use disorder for sleeping pills and mild anxiety drugs is more common in males, except for teenagers where the rate of use is higher among females. Other factors that may increase the chances of prescription drug use disorder:

Physical dependence may contribute to the development and continuance of addiction. Physical dependence is when your body needs a drug to function normally. Withdrawal symptoms when the medication is stopped or reduced can be a sign of physical dependence. It can make cessation of drug use difficult. Physical dependence may occur with misuse or with long-term proper use of medications.

Symptoms    TOP

The symptoms below are associated with prescription drug use disorder. If you experience any one of them, see your doctor.

  • Rapid increase in the amount of medication needed
  • Moving from one doctor to another for additional prescriptions
  • Craving the medication
  • Inability to stop or limit medication use
  • Withdrawal symptoms (can be intense and include nausea, vomiting, and sweating)
  • Using significant effort to acquire the medication
  • Medication use that interferes with activities
  • Compulsive use of the medication, despite adverse effects

Let your doctor know if you are having symptoms of physical dependence.

Diagnosis    TOP

Prescription drug use disorder can be difficult to diagnose. Prescription drug use disorder can start with someone who needs frequent medications for a long-term condition like chronic pain. This can make it difficult to distinguish the difference between addiction and medical need.

Your doctor will ask about your symptoms and medical history. A physical exam may be done. Your doctor will ask specific questions about your prescription medication use and may review your refill history.

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Drug use disorders can be treated effectively through detoxification and counseling. Treatment will depend on the type of drug you misuse and your specific needs.

Treatment options include the following:

Detoxification

This involves managing the symptoms of withdrawal while the medication leaves your system. Some symptoms of withdrawal can be life-threatening. Your medical team will slowly taper you off the drug and monitor your body's reactions.

Other medications may be used to counteract the effects of addiction and withdrawal symptoms. This should be done under the supervision of a doctor in a hospital or other outpatient setting to ensure your safety and effective detoxification.

It is important to follow up with other therapies to avoid relapse.

Behavioral Therapies

Behavioral therapies can help. This therapy will help you learn to function without the medication, handle cravings, and avoid situations in which relapse is likely. Behavioral therapy may include individual, group, or family counseling.

Medication    TOP

Certain medications can be used to treat opioid dependence that may be present with addiction. They may be used during detoxification to reduce withdrawal symptoms. They may also be continued through maintenance to decrease craving and reduce the risk of relapse. They are given as a part of an overall treatment approach including counseling. Common medication options include:

  • Methadone
  • Buprenorphine
  • Naltrexone

The choice of medication will depend on the drugs involved in the addiction, your medical history, and your recovery commitment.

Other medications may be needed to treat underlying issues, such as depression or anxiety. These medications may help you on your way to a full and productive life as well as prevent relapse.

Prevention    TOP

To help reduce the chances of a prescription drug use disorder:

  • Carefully follow directions that come with medications.
  • Be aware of potential interactions with other drugs.
  • Talk with your doctor before changing the dose.
  • Never use another person's prescription.
  • Tell your doctor all the medications you are taking. This includes over-the-counter medications and dietary and herbal supplements.

RESOURCES:

Narcotics Anonymous
https://www.na.org
National Institute on Drug Abuse
https://www.drugabuse.gov

CANADIAN RESOURCES:

Canadian Centre on Substance Abuse
http://www.ccsa.ca
Centre for Addiction and Mental Health
http://www.camh.ca

References:

Addiction. National Coalition Against Prescription Drug Abuse website. Available at:
...(Click grey area to select URL)
Accessed April 18, 2018.
Opioid abuse and dependence. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated March 5, 2018. Accessed April 18, 2018.
Over-the-counter medicines. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/drugs-abuse/over-counter-medicines. Accessed April 18, 2018.
Schinke SP, Fang L, Cole KC. Computer-delivered, parent-involvement intervention to prevent substance use among adolescent girls. Prev Med. 2009;49(5);429-435.
Last reviewed March 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 4/18/2018