NIDA for Teens: The Science Behind Drug Abuse
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Drug Facts

Prescription Drugs

What Is Prescription Drug Abuse?

A pile of prescription drugs.

Also known as:

Opioids: Hillbilly heroin, oxy, OC, oxycotton, percs, happy pills, vikes

Depressants: barbs, reds, red birds, phennies, tooies, yellows, yellow jackets; candy, downers, sleeping pills, tranks; A-minus, zombie pills

Stimulants: Skippy, the smart drug, Vitamin R, bennies, black beauties, roses, hearts, speed, uppers

Prescription drug abuse is when someone takes a medication that was prescribed for someone else or takes their own prescription in a way not intended by a doctor or for a different reason—like to get high.

It has become a big health issue because of the dangers, particularly the danger of abusing prescription pain medications. For teens, it is a growing problem:

  • After marijuana and alcohol, prescription drugs are the most commonly abused substances by Americans age 14 and older.
  • Teens abuse prescription drugs for a number of reasons, such as to get high, to stop pain, or because they think it will help them with school work.
  • Most teens get prescription drugs they abuse from friends and relatives, sometimes without the person knowing.
  • Boys and girls tend to abuse some types of prescription drugs for different reasons. For example, boys are more likely to abuse prescription stimulants to get high, while girls tend to abuse them to stay alert or to lose weight. 

When prescription drugs are taken as directed, they are usually safe. It requires a trained health care clinician, such as a doctor or nurse, to determine if the benefits of taking the medication outweigh any risks for side effects. But when abused and taken in different amounts or for different purposes than as prescribed, they affect the brain in ways very similar to illicit drugs.

When prescription drugs are abused, they can be addictive and put the person at risk for other harmful health effects, such as overdose (especially when taken along with other drugs or alcohol). And, abusing prescription drugs is illegal—and that includes sharing prescriptions with family members or friends. 

Commonly Abused Prescription Drugs

There are three kinds of prescription drugs that are commonly abused. Visit our separate Drug Facts pages to learn more about each of these classes of drugs:

  • Opioids—painkillers like Vicodin, OxyContin, or codeine
  • Depressants—like those used to relieve anxiety or help a person sleep, such as Valium or Xanax
  • Stimulants—like those used for treating attention deficit hyperactivity disorder (ADHD), such as Adderall and Ritalin

To find out what people are doing to prevent teen prescription drug abuse, visit our PEERx initiative.

Find information on abuse of cough and cold medications.

But Aren’t Prescription Drugs Safe?

Prescription drugs are often strong medications, which is why they require a prescription in the first place. Once they are abused, they are no less dangerous than drugs that are made illegally. Even when they are not abused, every medication has some risk for harmful effects, sometimes serious ones. Doctors consider the potential benefits and risks to each patient before prescribing medications and take into account a lot of different factors, described below. People who abuse drugs might not understand how these factors interact and put them at risk.

  • Personal information. Doctors take into account a person's weight, how long they've been prescribed the medication, and what other medications they are taking. Someone abusing prescription drugs may overload their system or put themselves at risk for dangerous drug interactions that can cause seizures, coma, or even death.
  • Form and dose. Doctors know how long it takes for a pill or capsule to dissolve in the stomach, release drugs to the blood, and reach the brain. When abused, prescription drugs may be taken in larger amounts or in ways that change the way the drug works in the body and brain, putting the person at greater risk for an overdose. For example, when people who abuse OxyContin crush and inhale the pills, a dose that normally works over the course of 12 hours hits the central nervous system all at once. This effect increases the risk for addiction and overdose.
  • Side effects. Prescription drugs are designed to treat a specific illness or condition, but they often affect the body in other ways, some of which can be dangerous. These are called side effects. For example, OxyContin stops pain, but it also causes constipation and sleepiness. Stimulants, such as Adderall, increase a person’s ability to pay attention, but they also raise blood pressure and heart rate, making the heart work harder. These side effects can be worse when prescription drugs are not taken as prescribed or are abused in combination with other substances—including alcohol, other prescription drugs, and even over-the-counter drugs, such as cold medicines. For instance, some people mix alcohol and depressants, like Valium, both of which can slow breathing. This combination could stop breathing altogether.

How Are Prescription Drugs Abused?

People abuse prescription drugs by taking medication in a way that is not intended, such as:

 1 Taking someone else's prescription to self-medicate. 2 Taking a prescription medication in a way other than prescribed. 3 Taking a medication to get high.
  • Taking someone else’s prescription medication. Even when someone takes another person’s medication for its intended purposes (such as to relieve pain, to stay awake, or to fall asleep) it is considered abuse.
  • Taking a prescription medication in a way other than prescribed. Taking your own prescription in a way that it is not meant to be taken is also abuse. This includes taking more of the medication than prescribed or changing its form—for example, breaking or crushing a pill or capsule and then snorting the powder.
  • Taking a prescription medication to get high. Some types of prescription drugs also can produce pleasurable effects or “highs.” Taking the medication only for the purpose of getting high is considered prescription drug abuse.

How Does Prescription Drug Abuse Affect Your Brain?

In the brain, neurotransmitters such as dopamine send messages by attaching to receptors on nearby cells. The actions of these neurotransmitters and receptors cause the effects from prescription drugs. Each class of prescription drugs works a bit differently in the brain:

  • Prescription opioid pain medications bind to molecules on cells known as opioid receptors—the same receptors that respond to heroin.These receptors are found on nerve cells in many areas of the brain and body, especially areas involved in the perception of pain and pleasure.
  • Prescription stimulants, such as Ritalin, achieve their effects the same way as cocaine, by causing a buildup of dopamine.
  • Prescription depressants make a person feel calm and relaxed in the same manner as the club drugs GHB and rohypnol.

Learn more about how the brain works and what happens when a person abuses drugs.

What Are the Other Effects of Prescription Drugs?

Prescription drugs can cause dangerous short- and long-term health problems when they are not used as directed or when they are taken by someone other than the person they were prescribed for.

  • Abusing opioids like oxycodone and codeine can cause you to feel sleepy, sick to your stomach, and constipated. Depending on the amount taken, opioids also can make it hard to breathe properly.
  • Abusing stimulants like Adderall or Ritalin can make you feel paranoid (feeling like someone is going to harm you even though they aren’t). It also can cause your body temperature to get dangerously high and make your heart beat too fast. This is especially likely if stimulants are taken in large doses or in ways other than swallowing a pill.

Abusing depressants like barbiturates can cause slurred speech, shallow breathing, sleepiness, disorientation, and lack of coordination. People who abuse depressants regularly and then stop suddenly may experience seizures.

In addition, abusing over-the-counter drugs that contain DXM can also produce very dangerous effects.

Abuse of any of these types of medications can lead to addiction. And, abusing any type of drug that causes changes in your mood, perceptions, and behavior can affect judgment and willingness to take risks—putting you at greater risk for HIV and other sexually transmitted diseases (STDs). 

Prescription drugs can increase risk for health problems when combined with other prescription medications, over-the-counter medicines, illicit drugs, or alcohol. For example, combining opioids (painkillers) with alcohol can make breathing problems worse and can lead to death.

Can You Get Addicted to Prescription Drugs?

Yes, prescription drugs that act in the brain, including opioid painkillers, stimulants, and depressants, may cause physical dependence that can turn into addiction.

Dependence happens because the brain and body adapt to having drugs in the system for a while. A person may need larger doses of the drug to get the same initial effects. This is known as “tolerance.” When drug use is stopped, withdrawal symptoms can occur. Dependence is not the same as addiction, but it can contribute to a person developing an addiction. It is one of the many reasons why a person should only take (and stop taking) prescription drugs under a doctor's care. 

Studies show that when people take a medication as it is prescribed for a medical condition—such as pain or attention deficit hyperactivity disorder (ADHD)—they usually do not become addicted, because the medication is prescribed in amounts and forms that are considered safe for that person. But medications that affect the brain can change the way it works—especially when they are taken over and over or in large doses. They can change the reward system, making it harder for a person to feel good without the drug and possibly leading to intense cravings, which make it hard to stop using. This is no different from what can happen when someone takes illicit drugs—addiction is a real possibility. When a person is addicted to a drug, finding and using that drug becomes the most important thing—more important than family, friends, school, sports, or money.

Other kinds of medications that do not act in the brain, such as antibiotics used to treat infections, are not addictive.

Can You Die If You Abuse Prescription Drugs?

Yes. Prescription drug abuse causes more than half of the deaths in the United States from drug overdosing. In the last decade, the number of deaths from abuse of prescription drugs has increased dramatically.

In 2001, 9,197 people died from a prescription drug overdose; that number jumped to 22,810 in 2011. The trend holds true for young people—765 young people died as a result of a prescription drug overdose in 2001. In contrast, more than 2.5 times that—1,950 young people—died from an overdose in 2011. Close to 17,000 (74%) of all deaths from abuse of prescription drugs involved opioid painkillers and more than 6,800 (30%) involved a class of depressants known as benzodiazepines (some deaths include more than one type of drug).1

1. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2011 on CDC WONDER Online Database, released 2014. Available at http://wonder.cdc.gov.

How Many Teens Abuse Prescription Drugs?

Prescription and over-the-counter drugs are the most commonly abused substances by Americans age 14 and older, after marijuana and alcohol.

Past year illicit use among 12th graders, Marijuana 36.4%, Amphetamines 8.7%, Synthetic Marijuana 7.9%, Adderall 7.4%, Vicodin 5.3%, Cough med 5.0%, Tranquilizers 4.6%, Hallucinogens 4.5%, Sedatives 4.8%, Salvia 3.4%, Oxycontin 3.6%, MDMA 4.0%, Inhalants 2.5%, Cocaine 2.6%, Ritalin 2.3%
Monitoring the Future Study: Trends in Prevalence of Any Prescription Drug for 12th-Graders; 2010 - 2013 (in percent)*
Drug Time Period 12th-Graders
2010 2011 2012 2013
Any Prescription Drug Lifetime 21.60 21.70 21.20 21.50
  Past Year 15.00 15.20 14.80 15.00
  Past Month 6.90 7.20 7.00 7.00

For the most recent statistics on teen drug abuse, see results from NIDA’s Monitoring the Future study.

 

What Should I Do If Someone I Know Needs Help?

If you or a friend are in crisis and need to speak with someone now, please call:

  • National Suicide Prevention Lifeline at 1-800-273-TALK (they don't just talk about suicide—they cover a lot of issues and will help put you in touch with someone close by).

If you need information on treatment and where you can find it, you can call:

For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.

To find out what people are doing to prevent teen prescription drug abuse, visit our PEERx initiative.