When the Risks Outweigh the Benefits
Prescription drugs have legitimate reasons for being used and this should not be overlooked simply because they can become addictive. Of course, caution is in order, particularly for an individual who has previously struggled with addictions. You will recall that addictions often run in families and there are likely genetic components to how the brain processes substances with potentially addictive properties.
Someone with the propensity to addictions as noted through family history, or someone who has previously been addicted to non-medical substances and/or compulsive behaviors, should be very cautious when using prescription medications that could become addictive when abused.
Does this mean these medications can't ever be used? No. Surgery for a broken arm, the pain from cancer, or severe panic attacks, for example, create medical necessity for the use of prescriptive drugs with addictive potential. Nevertheless, for an individual at risk, close medical monitoring by a physician knowledgeable about addictions will be necessary.
Prescription drug addiction is now second only to marijuana in terms of being the most abused substance in the United States. Approximately 7 million Americans abused prescription drugs in 2006. This was greater than the number of people abusing cocaine, heroin, and Ecstasy combined.
Other populations have also been identified as “at risk” for addiction to prescription medications. What does it mean to be “at risk” for addictions? In general, a person who is “at risk” for addiction is someone who has a special interest in or is drawn toward an addictive substance, such as someone with chronic pain or someone who suffers from a mental illness.
It could be someone with a genetic predisposition or someone whose environment is heavily influenced with addictive substances and behaviors. An “at risk” person is likely someone with easy access. It may be someone who has experimented with an addictive substance, experienced the initial rush of pleasure, and is then tempted to further use.
The elderly is one population that is “at risk” for prescription drug addiction. As our senior population grows, so do chronic illnesses and broken bones. The elderly are three times more likely to be taking prescription medications than other people, are less likely to understand and follow directions, and are more likely to be taking multiple medications for longer periods of time.
As a person ages, the body begins to metabolize drugs differently. Typically, there is a decrease in the percentage of water and lean tissue in the body along with an increase in fat. The kidneys and liver function less efficiently. These changes affect how long a drug stays in the body and how much is actually absorbed into the body's tissues.
If this isn't taken into account by medical professionals or if a person doesn't follow instructions carefully, serious harmful consequences can result. Benzodiazepines, used to treat anxiety disorders, can be particularly hazardous in the elderly if misused, possibly leading to cognitive impairment.
Prescription drugs are now the most commonly abused drug among 12- to 13-year-olds. The recreational use of pain medications such as Vicodin and Percodan as well as the stimulant Ritalin is alarmingly on the rise. Education and supervision is essential to curb this trend.
Women, especially young women in their teen years and early twenties, are at greater risk for addiction to prescription drugs than men. The non-medical use of prescription medications among women may be attributed to the social pressure to lose weight, a desire to increase self-confidence, a way of coping with problems, and a means of reducing tension.
For women, there may be less social stigma in using prescription medications than street drugs. Statistics show that men and boys are more likely to become dependent on street drugs and alcohol, initially for the purpose of thrill-seeking, than on prescription drugs.
Health care workers such as physicians, nurses, pharmacists, and others with easy access to prescription medications are in a position to prevent addiction but may also be “at risk.”
Identifying a Problem
As with other addictions, there are signs to watch for that may indicate problems with prescription medications. Initially, this type of addiction may be more difficult to identify because use of the medication may have started out with legitimate purposes in mind.
Following are some questions you might ask to determine if you have a problem with prescription drugs:
Do you begin to wonder if you should cut down on your use of prescription drugs?
Do you become annoyed if others comment on your use of prescription drugs?
Do you feel guilty about taking prescription drugs?
Do you use prescription drugs for purposes other than those prescribed?
Do you feel shame, embarrassment, or uneasiness in asking your physician for an early prescription renewal?
One reason for the increase in prescription drug addiction is the development of web-based pharmacies called e-pharmacies. They often illegally sell drugs without prescriptions or consultations with the patient, making it easy to obtain numerous prescription drugs. The Drug Enforcement Agency (DEA) and the Federal Drug Administration (FDA) have ongoing investigations into this practice.
Physicians and other health care professionals should be on the alert for unscheduled requests to refill prescriptions or requests for a rapid increase in dosage. Continuing to request prescriptions for potentially addictive medications when there is no longer any valid medical reason is another danger sign.
“Doctor shopping” is when someone visits multiple practitioners or multiple medical facilities in an attempt to obtain as many prescriptions as possible without being detected as an addict. This is another sign that a person may be addicted to prescription medications.