What are some of the commonly abused prescription drugs?
Although many prescription drugs can be abused or misused, there are three classes of prescription drugs that are most commonly abused:
Opioids, which are most often prescribed to treat pain;
CNS depressants, which are used to treat anxiety and sleep disorders;
Stimulants, which are prescribed to treat the sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity.
Opioids
What are opioids?
Opioids are commonly prescribed because of their effective analgesic, or pain-relieving, properties. Medications that fall within this class—sometimes referred to as narcotics—include morphine, codeine, and related drugs. Morphine, for example, is often used before or after surgery to alleviate severe pain. Codeine, because it is less efficacious than morphine, is used for milder pain. Other examples of opioids that can be prescribed to alleviate pain include oxycodone (OxyContin), propoxyphene (Darvon), hydrocodone (Vicodin), and hydromorphone (Dilaudid), as well as meperidine (Demerol), which is used less often because of its side effects. In addition to their pain-relieving properties, some of these drugs—for example, codeine and diphenoxylate (Lomotil)—can be used to relieve coughs and diarrhea.
What are the possible consequences of opioid use and abuse?
Chronic use of opioids can result in tolerance for the drugs, which means that users must take higher doses to achieve the same initial effects. Long-term use also can lead to physical dependence and addiction—the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced or stopped. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia,
diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and involuntary leg movements. Finally, taking a large single dose of an opioid could cause severe respiratory depression that can lead to death. Many studies have shown, however, that properly managed medical use of opioid analgesic drugs is safe and rarely causes clinical addiction, defined as compulsive, often uncontrollable use of drugs. Taken exactly as prescribed, opioids can be used to manage pain effectively.
CNS depressants
What are CNS depressants?
CNS depressants are substances that can slow normal brain function. Because of this property, some CNS depressants are useful in the treatment of anxiety and sleep disorders. Among the medications that are commonly prescribed for these purposes are the following:
• Barbiturates, such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal), which are used to treat anxiety, tension, and sleep disorders.
• Benzodiazepines, such as diazepam (Valium), chiorodiazepoxide HC1 (Librium), and aiprazolam (Xanax), which can be prescribed to treat anxiety, acute stress reactions, and panic attacks; the more sedating benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom) can be prescribed for short-term treatment of sleep disorders.
In higher doses, some CNS depressants can be used as general anesthetics.
What are the possible consequences of CNS depressant use and abuse?
Despite their many beneficial effects, barbiturates and benzodiazepines have the potential for abuse and should be used only as prescribed. During the first few days of taking a prescribed CNS depressant, a person usually feels sleepy and uncoordinated, but as the body becomes accustomed to the effects of the drug, these feelings begin to disappear. If one uses these drugs long term, the body will develop tolerance for the drugs, and larger doses will be needed to achieve the same initial effects. In addition, continued use can lead to physical dependence and—when use is reduced or stopped— withdrawal.
Stimulants
What are stimulants?
As the name suggests, stimulants are a class of drugs that enhance brain
activity they cause an increase in alertness, attention, and energy that is accompanied by elevated blood pressure and increased heart rate and respiration. Stimulants were used historically to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. But as their potential for abuse and addiction became apparent, the medical use of stimulants began to wane.
Now, stimulants are prescribed for the treatment of only a few health conditions, including narcolepsy, attentiondeficit hyperactivity disorder, and depression that has not responded to other treatments. Stimulants may be used as appetite suppressants for shortterm treatment of obesity, and they also may be used for patients with asthma.
What are the possible consequences of stimulant use and abuse?
The consequences of stimulant abuse can be dangerous. Although their use may not lead to physical dependence and risk of withdrawal, stimulants can be addictive in that individuals begin to use them compulsively. Taking high doses of some stimulants repeatedly over a short time can lead to feelings of hostility or paranoia. Additionally, taking high doses of a stimulant may result in dangerously high body temperatures and an irregular heartbeat. There is also the potential for cardiovascular failure or lethal seizures.
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