The Dangers of Prescription Drug Abuse

Safe for some, but dangerous or even deadly for others

Posted Jun 20, 2013

Opiate painkillers, benzodiazepine tranquilizers, and stimulants can be safely and effectively used, but when taken other than prescribed they carry significant risks.  Indeed, prescription drug abuse is the nation’s fastest growing drug problem, so much so that the CDC has classified it as an epidemic.

In 2009, 16 million Americans used prescription drugs for nonmedical purposes at least once in the previous year, and kids are definitely getting in on the act.  In my book Almost Addicted, I cite data from the Monitoring the Future survey which found that 2.7 percent of eighth graders and 8 percent of twelfth graders abused Vicodin in the year prior to the survey and 2.1 percent of eighth graders and 5.1 percent of twelfth graders having done so with OxyContin. 

Among high school seniors, 17 percent had abused illicit drugs other than marijuana during the previous year, and most of this drug use entailed prescription medication misuse.  In fact, more 12th graders had abused tranquilizers or prescription narcotics in the past year than heroin and cocaine combined.

Where are they getting these drugs?  70% of those 12 years or older who abused prescription drugs obtained them from friends and/or family—often by simply raiding the family medicine cabinet.  This kind of use is exceedingly problematic given that roughly one third of folks who eventually develop a substance use disorder begin by using prescription medications in a non-medical manner.

Why the increase in prescription drug abuse?  My assumption is that this rise is multifactorial, including the fact that doctors are likely prescribing more of these drugs than is warranted.  We all know stories of folks getting surgery and then—whether they asked for it or not—being handed a prescription for painkillers that they barely took.  Also, the media is rife with stories of high schoolers and college age kids who feign ADHD symptoms in order to be prescribed stimulants.  Beyond over prescription, I’d wager that many folks see these drugs as safe given that they can be used for medical purposes.  As a result, they probably carry less stigma than “street” drugs like heroin.  (In my psychiatric practice I have had patients tell me this more than once.)

The dangers of prescription drug abuse are essentially identical to abusing drugs generally, but the fact that they are prescribed and legal in some settings makes them more insidious.  The particular danger can vary from one drug to another.  Opiates, whether in medication form or heroin, are exceedingly alluring for some and carry with them a very real potential of overdose and death.  In addition, individuals can be highly vulnerable to the euphoria that these drugs can cause, which means that this class of drugs can be highly appealing to vulnerable individuals.  Driving while intoxicated, perhaps especially while on opiates or benzodiazepines, is obviously quite dangerous.  These drugs also carry with them the risk of becoming physically dependent on them.

Although no demographic is spared, young adults are most at risk, given their relative lack of experience in life and the fact that drug use while young can affect brain development given that our brains do not fully develop until we reach our mid 20s.   (In previous posts I have expanded on this point.)

The fact is that even casual drug use can create significant problems for vulnerable individuals--and apart from a personal or family history of drug problems it is often not possible to tell who is potentially vulnerable and who is not. 

The upshot: Although these medications can be safely used, they carry with them significant, potentially lethal, risks.