But America’s fastest-growing group of drug addicts isn’t found on the streets. Instead, it could be the little old man or lady – or a family member -- who gets a fix from the medicine cabinet or at the local pharmacy. That’s because the United States is experiencing what some are calling a prescription opioids epidemic in abuse and overdoses.
Opioids are synthetic or natural chemicals that attach to receptors in the brain or body and help relieve pain. Heroin is an opioid, but there are also such prescribed medications as oxycodone, fentanyl and hydrocodone.
Government statistics claim that almost 15,000 people die annually from prescription painkiller overdoses, a figure that represents 44 deaths per day. While prescription painkillers garner the bulk of attention, heroin deaths have also increased nearly 40 percent between 2012 and 2013, the last year statistics are available.
Prescription drug abuse happens when a medication is taken in a way that a doctor did not intend. The abuse can include forged prescriptions, over-prescriptions, taking a friend’s medication, stealing medications and taking black-market drugs.
Some opioids are taken for pain, others for the high, to relax, relieve chronic pain and to ease anxiety. Because the drugs are relatively inexpensive, they have become popular among young adults looking for cheap highs and seniors who may have originally taken the pills for legitimate reasons but became too accustomed to the way they made them feel.
Beyond opioid painkillers, addictions are on the rise for sedatives, anti-anxiety medications and stimulants, the latter taken by many professionals, students and athletes for their performance effects.
Below are some commonly abused prescription drugs.
- Opioids, particularly oxycodone and drugs containing hydrocodone (Vicodin)
- Anti-anxiety medications and sedatives, including alprazolam (Xanax) and diazepam (Valium),
- Hypnotics, including zolpidem (Ambien)
- Stimulants, including methylphenidate (Ritalin), dextroamphetamine and amphetamine (Adderall XR) and dextroamphetamine (Dexedrine)
The signs of opioid, anti-anxiety or stimulant abuse are the same as any drug abuse -- erratic behavior, excessive sleepiness or hyperactivity resulting in decreased sleep, an unusually revved-up appearance or glassy eyes, sedation, mood swings, and inability to focus.
In some cases, addiction comes on gradually, as a patient deals with chronic pain and receives prescriptions from one or more compliant doctors. In other cases, they may borrow medicine from a friend and enjoy the experience so much that they start looking for the drugs available on the street. While some people are prescribed the drugs after surgery, they become used to the relief and start to extend their use. Peer pressure and a social environment where drug abuse is prevalent may also play a role with some younger people.
Other risk factors for prescription drug abuse include prior problems with alcohol or tobacco abuse; a family history of substance abuse issues; certain pre-existing psychiatric conditions that may be triggered by drug experiences; and in some cases, easy access to medications whether through the home medicine cabinet or compliant doctors. Although it’s hard to believe, given the amount of drug education, some people believe pills are not a serious drug problem, save for acquiring the medications, and thus do not realize that there are some health issues that may occur from repeated abuse.
Addiction in Older Adults
Addiction in older adults may be harder to trace. The multiple health problems associated with growing older may lead to multiple drug prescriptions, and particularly when combined with alcohol and a lack of social activities, may lead to addiction.
Taking drugs usually builds a tolerance that leads to higher and higher doses. When combined with alcohol or other drugs, including over-the-counter medications and illegal drugs, complications can occur. Opioid abuse can lead to a lowered breathing rate, low blood pressure, and eventually coma. Sedative and anti-anxiety medication abuse may lead to memory issues, low blood pressure and slowed breathing, particularly when combined with alcohol. People who take the sedatives may experience hyperactivity and seizures if they withdraw abruptly from taking the medications.
Stimulants can skyrocket blood pressure, cause seizures, tremors, aggressiveness and hallucinations, and users can become extremely paranoid. Vision also can be affected.
Because the brain’s reward center is stimulated by ingesting certain prescription drugs, long-term users are compelled to use higher doses. This creates symptoms of physical addiction and a compulsive need for the drug, which can lead to desperation and criminal acts in the addicted, including risky behaviors in return for drugs, motor vehicle accidents, poor job or school performance, and increasingly seeking the company of others involved in drugs and abuse.
Diagnosing Prescription Drug Addiction
Doctors can gauge symptoms but usually need an honest discussion of habits to formally diagnose a prescription drug problem. Treatment options depend on the type of drug being abused, the patient’s resources like insurance or financial ability, and sometimes the proximity to drug treatment centers with available space in their programs.
Counseling and other forms of psychotherapy are usually a big part of the treatment program. For some, detoxing, switching to less powerful medications like methadone, clonidine and buprenorphine, plus family or group therapy, are part of the step-downs from addiction.
Talk therapy usually will try to determine how and why addiction happened and seeking answers for improving relationships or other situations that may have triggered the spiral into addiction. The patient usually will learn how to avoid drug cravings and ways to prevent recurrence.
The road away from addiction is usually long and requires a serious commitment by the patient toward changing behaviors that led to their addiction. But people can and do overcome problems and lead productive lives. All it takes is a little help from committed friends, family and professionals.