Commonly Abused Prescription Drugs
Certainly any prescription drug can be misused or abused, but in terms of addictive qualities, three categories of prescription drugs stand out. Not only are these particular categories of prescription medications more potentially addictive than others, they are also more dangerous when mixed or used in combination with other types of medications.
Opiates
Opiates were briefly presented earlier. As previously mentioned, opiates are primarily used to treat pain and can also be used to treat persistent coughs and diarrhea. Opiates achieve these pain-relieving effects by attaching to specific opiate receptors found in the brain, the spinal cord, and the gastrointestinal tract. Once attached to these receptors, opiates block the perception of pain. These receptors are intended for the body's naturally produced endorphins, which also reduce pain.
Fact
Opiates are the oldest known pain relievers. In fact, these drugs were available in many nonprescription, over-the-counter medications in the early part of the twentieth century. They were used for adults and children alike. It was only after problems with addiction became more apparent that these drugs became regulated by the government and available only with a prescription.
Opiates can also produce a sensation of euphoria by acting on the pleasure centers of the brain. When opiates are injected or snorted rather than taken orally, the feelings of euphoria are heightened. These feelings of pleasure and euphoria produced by the drugs are often used to mask emotional pain as well as physical pain. Besides their pain-relieving qualities, opiates also produce drowsiness, nausea, constipation, and depressed respirations in larger doses.
Because the body can become dependent on opiates, there will likely be withdrawal symptoms when the drug is stopped. The withdrawal symptoms may begin within hours of stopping the drug and can be quite uncomfortable. Restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, involuntary leg movements, cravings, runny nose, excessive sweating, yawning, and cold flashes with “goose bumps” are typical withdrawal symptoms.
For opiates, medical supervision of withdrawal is recommended. Opiates should never be taken in combination with other medications that also depress the CNS. Alcohol, antihistamines, barbiturates, benzodiazepines, or general anesthetics are examples of such medications. This is because opiates can depress the respiratory system. Taking large doses of opiates or combining opiates with CNS depressant medications can be life-threatening.
Alert
OxyContin is particularly dangerous when abused. It contains a much greater percentage of its active ingredient, oxycodone, in each pill compared to other pain relievers. When crushed or diluted with water, the addict can snort or inject the drug, obtaining powerful effects in a much shorter period of time than other drugs.
The most common examples of opiate drugs are oxycodone (OxyContin, Percodan, Percocet), propoxyphene (Darvon), hydrocodone (Vicodin, Lortab, Lorcet), hydromorphone (Dilaudid), meperidine (Demerol), diphenoxylate (Lomotil), morphine (Kadian, Avinza, MS Contin), codeine, fentanyl (Duragesic), and methadone.
CNS Depressants
The CNS is that part of the nervous system controlled by the brain and spinal cord. It is the main processing center for the body's entire nervous system. One can clearly understand how any medications affecting the CNS can have very serious consequences if used in an abusive manner. Medications in the CNS depressant category do exactly what the name implies; they depress or slow down the brain's ability to function. They do this by affecting the neurotransmitter gamma-aminobutyric acid (GABA).
CNS depressants increase GABA activity in the brain, slowing it down and thereby producing a calming effect. For an individual suffering from anxiety or sleep disorders, this is very helpful. However, as with other potentially addictive drugs, CNS depressants can lead to the development of tolerance, and withdrawal symptoms can occur when the drug is stopped. Withdrawal symptoms begin when the brain “bounces back,” so to speak, from its drug-induced inactivity. When this happens, the brain seems to race out of control and life-threatening seizures can occur.
Essential
It is never safe to mix medications unless under medical supervision. Even OTC medications can have harmful effects when taken in conjunction with other prescription drugs. And remember, alcohol, a potent substance on its own, can have lethal effects when taken with prescription medications, especially CNS depressants.
Less drastic symptoms can include confusion and dizziness, impaired judgment, memory problems, decreased intellectual performance, and lack of motor coordination. CNS depressants should not be combined with any other medication that has similar effects. This includes OTC cold remedies and allergy medications. Certain herbal compounds, such as valerian and kava, may exacerbate the effects of certain CNS depressants to a dangerous level. The combination of alcohol and CNS depressants can be lethal.
The CNS depressant category includes barbiturates and benzo-diazepines. Medications known as barbiturates are mephobarbital (Mebaral) and pentobarbital sodium (Nembutal). Benzodiazepines include diazepam (Valium), chlordiazepoxide hydrochloride (Librax), chlordiazepoxide (Librium), alprazolam (Xanax), tri-azolam (Halcion), estazolam (ProSom), clonazepam (Klonopin), and lorazepam (Ativan).
Why are stimulants used to treat attention deficit hyperactivity disorder (ADHD)?
ADHD is a disorder in which the norepinephrine and dopamine transport systems are defective, leading to a deficit in the available amount of these neurotransmitters. Nor-epinephrine and dopamine work in the prefrontal cortex and the striatum of the brain to help promote informational processing, working memory, and self-control. Stimulants inhibit the reabsorption of these neurotransmitters, making them more available for use.
Stimulants
Just as CNS depressants depress brain activity, stimulants stimulate the brain. They enhance one's sense of alertness, attention, and energy. Stimulants also increase a person's blood pressure, heart rate, blood glucose, and respirations. Sleep deprivation and a suppressed appetite may also result from stimulant use. The effects of stimulants are due to their enhancement of norepinephrine and dopamine in the brain.
You will recall that dopamine is responsible for the pleasure circuit in the brain. Based on that fact, you won't be surprised to learn that stimulants can also produce feelings of euphoria and pleasure. Stimulants are primarily used to treat narcolepsy, ADHD, and treatment resistant depression. In times past, stimulants were considered effective treatments for asthma, obesity, neurological problems, and so forth. However, their medical use has diminished because of their addictive nature.
Stopping the use of stimulants also leads to withdrawal symptoms. Fatigue, depression, and disturbed sleep patterns are common. Hostility or paranoia can occur with repeated high doses of some stimulants over a short period of time and excessive doses can cause severely elevated body temperature and cardiac arrhythmias.
Heart failure or seizures can be deadly results of stimulant abuse. Stimulants, like other prescription medications, should not be mixed with other medications unless directed by a physician. Especially dangerous is combining stimulants with OTC medications containing decongestants. This can lead to dangerously high blood pressure and an irregular heart rate. Common stimulants include dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta).
