NIDA for Teens: The Science Behind Drug Abuse
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Drug Facts

Prescription Drugs

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What Are the Common Misconceptions About Prescription Drug Abuse?

A pile of prescription drugs.There's a reason why prescription drugs are intended to be taken under a doctor's direction: If used improperly, they can be dangerous. Despite what many teens and adults think, abusing prescription drugs is not safer than abusing illicit drugs. As the facts will tell you, prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended.

What Is Prescription Drug Abuse?

Prescription drug abuse is when someone takes a medication in an inappropriate way, such as:

  • Without a prescription
  • In a way other than as prescribed
  • For the “high” elicited

It includes taking a friend's or relative's prescription to treat pain or because you think it will help with studying. 

What Are the Most Commonly Abused Prescription and Over-the-Counter Drugs?

Opioids (such as the pain relievers OxyContin and Vicodin), central nervous system depressants (e.g., Xanax, Valium), and stimulants (e.g., Concerta, Adderall) are the most commonly abused prescription drugs.

Medications available without a prescription—known as over-the-counter drugs—can also be abused. DXM (dextromethorphan), the active cough suppressant found in many over-the-counter cough and cold medications, is one example. It is sometimes abused to get high, which requires taking large and potentially dangerous doses (more than what is on the package instructions).

What Are the Common Street Names for Prescription Drugs?

Prescription drugs have chemical names, brand names you may have heard before, and street names.

Opioids
Chemical Name (Brand Name) Street Names
  • Oxycodone (OxyContin, Percodan, Percocet)
  • Propoxyphene (Darvon)
  • Hydrocodone (Vicodin, Lortab, Lorcet)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Diphenoxylate (Lomotil)
  • Morphine (Kadian, Avinza, MS Contin)
  • Codeine
  • Fentanyl (Duragesic)
  • Methadone
  • Hillbilly heroin, oxy, OC, oxycotton, percs, happy pills, vikes
Depressants
Chemical Name (Brand Name) Street Names
Barbiturates
  • Mephobarbital (Mebaral)
  • Sodium pentobarbital (Nembutal)
  • Barbs, reds, red birds, phennies, tooies, yellows, yellow jackets
Benzodiazepines
  • Diazepam (Valium)
  • Alprazolam (Xanax)
  • Triazolam (Halcion)
  • Estazolam (ProSom)
  • Clonazepam (Klonopin)
  • Lorazepam (Ativan)
  • Chlordiazepoxide hydrochloride (Librium)
  • Candy, downers, sleeping pills, tranks
Sleep Medications
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Eszopiclone (Lunesta)
  • A-minus, zombie pills
Stimulants
Chemical Name (Brand Name) Street Names
  • Dextroamphetamine (Dexedrine, Adderall)
  • Methylphenidate (Ritalin, Concerta)
  • Skippy, the smart drug, Vitamin R, bennies, black beauties, roses, hearts, speed, uppers

 

How Are Prescription Drugs Abused?

It depends—some people take other people's medications for their intended purposes (e.g., to relieve pain, to stay awake, or to fall asleep). Others take prescription medications to get high, often at larger doses than prescribed, or by a different route of administration, such as by breaking or crushing a pill or capsule and then snorting the ingredients.

What Is Wrong With Abusing Prescription Drugs?

Virtually every medication presents some risk of undesirable side effects, sometimes even serious ones. Doctors consider the potential benefits and risks to each patient before prescribing medications. They understand that drugs affect the body in many ways and take into account things like the patient’s age, weight, and medical history; the drug’s form, dose, and possible side effects; and the potential for addiction. People who abuse drugs might not understand how these factors interact and put them at risk, or that prescription drugs do more than cause a high, help them stay awake, help them relax, or relieve pain.

  • Personal data. Before prescribing a medication, 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 make themselves vulnerable to 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 bloodstream, and reach the brain. When abused, prescription drugs may be taken in inappropriate doses or by routes of administration that change the way the drugs act in the body and brain, presenting overdose risk. For example, when people who abuse OxyContin crush and inhale the pills, a 12-hour dose hits their central nervous system all at once—which increases the risk of addiction and overdose.
  • Side effects. Prescription drugs are designed to treat a particular illness or condition, but they often have other effects on the body, some of which can be dangerous. These are referred to as side effects. For example, OxyContin stops pain, but it also causes constipation and drowsiness. Stimulants such as Adderall increase attention but also raise blood pressure and heart rate. 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 benzodiazepines (e.g., Valium), both of which can slow breathing. This combination could stop breathing altogether.
  • Addiction. 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 dosages and forms that are considered safe for that person. The person is also monitored by a physician. The drug addresses a real problem, which makes the person feel better, not high. But medications that affect the brain can change the way it functions—especially when they are taken repeatedly or in large doses. They can alter 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.

How Many Teens Abuse Prescription Drugs?

Every day in the United States, an average of 2,000 teenagers use prescription drugs without a doctor's guidance for the first time. Among youth who are 12 to 17 years old, 14.8% of high school seniors reported past-year nonmedical use of prescription medications. According to the 2012 Monitoring the Future survey, prescription and over-the-counter drugs are among the most commonly abused drugs by 12th graders, after alcohol, marijuana, synthetic marijuana (e.g., "Spice"), and tobacco. Youth who abuse prescription medications are also more likely to report use of other drugs. 

Where Do Teens Get Prescription Drugs?

The majority of both teens and young adults obtain prescription drugs they abuse from friends and relatives, sometimes without their knowledge. And according to the 2012 Monitoring the Future survey, about 50 percent of high school seniors said that opioid drugs other than heroin (e.g., Vicodin) would be fairly or very easy to get.

Why Do Teens Abuse Prescription Drugs?

Teens abuse prescription drugs for a number of reasons, including to get high, to treat pain, or because they think it will help them with school work. Interestingly, 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. 

What Happens When You Abuse Prescription Drugs?

Abusing prescription drugs can have negative short- and long-term health consequences.

  • Stimulant abuse can cause paranoia, dangerously high body temperatures, and an irregular heartbeat, especially if stimulants are taken in large doses or in ways other than swallowing a pill.
  • Abuse of opioids can cause drowsiness, nausea, constipation, and, depending on the amount taken, slowed breathing.
  • Abusing depressants can cause slurred speech, shallow breathing, fatigue, disorientation, lack of coordination, and seizures (upon withdrawal from chronic abuse).

Abuse of any of these types of medications may result in addiction.

Abusing over-the-counter drugs that contain DXM—which usually involves taking doses much bigger than recommended for treating coughs and colds—can impair motor function (such as walking or sitting up); produce numbness, nausea, and vomiting; and increase heart rate and blood pressure.

Abusing any type of mind-altering drug can affect judgment and inhibition and may put a person at heightened risk for HIV and other sexually transmitted diseases (STDs). 

Aren’t Prescription Drugs Safer Than Illegal Drugs, Such as Cocaine or Heroin?

No. Many people think that abusing prescription drugs is safer than abusing illicit drugs like cocaine and heroin because the manufacturing of prescription drugs is regulated or because they are prescribed by doctors. These circumstances don't mean these drugs are safe for someone who was not prescribed them or when taken in ways other than as prescribed.

Like illicit drugs, prescription drugs can have powerful effects in the brain and body. Opioid painkillers act on the same sites in the brain as heroin; prescription stimulants have effects in common with cocaine. And people sometimes take the medications in ways that can be very dangerous in both the short and long term (e.g., crushing pills and snorting or injecting the contents). Also, abusing prescription drugs is illegal—and that includes sharing prescriptions with friends. 

Why Don’t People Who Take Prescription Drugs for Medical Conditions Become Addicted?

On rare occasions they do, which is why a person must be under a doctor’s care while taking prescription medications. A doctor prescribes a medication based on an individual’s need, symptoms, and other factors, assigning a particular dosage to treat the problem effectively and safely. Typically, prescription drugs are taken in a form (e.g., a pill) that gets to the brain slowly and at a dose that treats the problem but doesn’t overwhelm the system—both of which reduce the likelihood of addiction.

Long-term medical use of certain prescription drugs can, however, lead to "physical dependence," because the brain and the body naturally adapt to chronic drug exposure. A person may need larger doses of the drug to achieve the same initial effects (known as “tolerance”). When drug use is stopped, withdrawal symptoms can occur. Dependence is not the same as addiction. It is one of the many reasons why a person should only take and stop taking prescription drugs under a physician's care. 

Is It Dangerous To Abuse Prescription Drugs in Combination With Other Drugs?

Yes. Both prescription and over-the-counter drugs pose increased risk of health complications when combined with other prescription medications, over-the-counter medicines, illicit drugs, or alcohol. For example, combining opioids with alcohol can intensify breathing problems and lead to death.

Are Over-the-Counter Drugs, Like Cough Medicine, Safer Than Prescription Drugs?

Cough and cold medications are some of the most commonly abused over-the-counter (OTC) medications. Many contain an ingredient called dextromethorphan (DXM). However, to get the "high" craved by people who use drugs, large quantities are needed. At high doses, DXM causes effects similar to those of the drugs ketamine or PCP by affecting similar sites in the brain. Ketamine and PCP are considered "dissociative" drugs, which make people feel disconnected from their normal selves. Such drugs affect memory, feelings, and thoughts. DXM is similar, and its abuse can affect control over movement; cause numbness, nausea, and vomiting; and increase heart rate and blood pressure.

When taken as directed, OTCs are safe and effective, but high doses can cause problems. And, some OTC medications can produce dangerous health effects when taken with alcohol. It's important to understand these risks, read the bottle labels, and take OTC medications only as directed.

Is Anyone Who Uses Prescription Drugs at Risk for Addiction? How Can I Protect Myself?

Not all prescription drugs have the potential for abuse and addiction—many drugs don’t even act in the brain. For example, antibiotics, which are used to treat infections, are not addictive.

You (and your parents) should read the label on prescription drugs and any information that comes with the prescription. This will include the doctor's instructions for how much to take and how often, as well as warnings about possible side effects. Read the label and learn whether you should take the medication with or without food, whether it will make you drowsy, and whether you can take it with other prescription or over-the-counter medicines. You can protect yourself by taking prescription drugs only according to these instructions. That includes the dosage and duration prescribed. If you have a question about a drug that has been prescribed for you, have your parents call your doctor or pharmacist.

If the drug is creating problems for you (e.g., if you experience unpleasant side effects or think you may be becoming addicted), consult your doctor immediately to see if a change is needed, or if the medication should be stopped altogether. But do not make these decisions on your own—there can be risks to changing dosage or stopping a medication abruptly. 

What Can I Do To Help Someone I Suspect Is Abusing Prescription Drugs?

When a person you care about has a drug problem, it’s not always easy to know what to do. If you are concerned about someone’s drug use (illicit or prescription), encourage him or her to talk to a parent, school guidance counselor, or other trusted adult. There are also anonymous resources, such as the National Suicide Prevention Lifeline (1-800-273-TALK) and the Treatment Referral Helpline (1-800-662-HELP).

The National Suicide Prevention Lifeline (1-800-273-TALK) is a crisis hotline that can help with many problems, not just suicide. This includes problems due to drug use. Family and friends who are concerned about a loved one, or anyone interested in mental health treatment referrals, can call this Lifeline. Callers are connected with a nearby professional who will talk with them about what they’re feeling or about concerns for family and friends.

In addition, the Treatment Referral Helpline (1-800-662-HELP)—offered by the Substance Abuse and Mental Health Services Administration—refers callers to treatment facilities, support groups, and other local organizations that can provide help for their specific needs. You can also locate treatment centers in your state by going to www.samhsa.gov/treatment.