Prescription Drug Use Disorder

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

Definition

Prescription drug use disorder is when a person takes prescription medicines in a way that they are not meant to be taken. It causes them to seek and overuse them even when they cause harm to the person's health, job, schooling, or relationships.

Common ones that are misused are:

Causes

The cause is not known. Things like genetics, the environment, and peer pressure may play a role.

Brain Pathways
Brain nerve pathways

Addiction alters pathways in the brain.

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Risk Factors

This problem often starts in the teen or young adult years. Things that may raise the risk of this problem are:

  • Prior substance abuse, such as to alcohol
  • Having other people in the family with drug use disorders
  • Having mental health problems, such as anxiety or depression
  • Social and peer pressure
  • Easy access to medicines
  • Lack of knowledge about the dangers of abusing medicines

Symptoms

Problems may be:

  • Taking the medicine in much higher amounts for a longer time
  • Moving from one doctor to the next for more prescriptions
  • Spending large amounts of time getting, using, or recovering from using the medicine
  • Craving the medicine
  • Problems trying to cut down or stop using it
  • Withdrawal problems when trying to cut down or stop, such as nausea, vomiting, and sweating
  • Work, school, home, or relationship problems
  • Using the medicine despite the problems that it causes

Diagnosis

The doctor will ask about your symptoms and health history. You will also be asked about your use of prescription medicines. Your refill history may be checked. An exam will be done.

Blood and urine tests may be done to check for drugs.

Treatment

Treatment depends on the medicine that is being misused. The goals are to:

  • Help a person stop using
  • Slowly lower the amount of medicines in the person's body to ease withdrawal
  • Prevent the person from abusing again

It can take a long time to get better. People may need to be treated many times. It may include one or more of the following:

Medications

Medicines may be given to ease withdrawal and lower the risk of using again. Common ones are:

  • Methadone
  • Buprenorphine
  • Naltrexone

Therapy

Therapy can help a person learn about the choices that lead to the use disorder. This can help a person learn coping and problem-solving skills. A person can also learn how to replace problem behaviors with healthier choices. A person's family should be involved to offer support.

Support Groups

There are many organizations and support groups that can help. People meet often to talk about their misuse problems and their recovery.

Prevention

To lower the risk of this problem:

  • Take medicine as advised. Do not change the amount or schedule.
  • Learn how a medicine interacts with other medicines and supplements.
  • Do not use someone else's medicine.
  • Learn about the risks of medicine abuse.
  • Teach children about the dangers of abusing medicines.
  • Use a safe method to dispose of unused medicines.
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: http://ncapda.org/education/addiction. Accessed September 4, 2020.

Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. J Addict Med. 2015 Sep-Oct;9(5):358-367.

Opioid abuse and dependence. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/opioid-abuse-and-dependence. Accessed September 4, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 9/4/2020