Prescription Drug Abuse — FACTS and FIGURES

All information in the post below taken from the  drugabuse.gov website.

Prescription drug abuse is the use of a medication without a prescription, in a way other than as prescribed, or for the experience or feelings elicited. According to several national surveys, prescription medications, such as those used to treat pain, attention deficit disorders, and anxiety, are being abused at a rate second only to marijuana among illicit drug users. The consequences of this abuse have been steadily worsening, reflected in increased treatment admissions, emergency room visits, and overdose deaths.

Prescription drug abuse remains a significant problem in the United States.

In 2010, approximately 7.0 million persons were current users of psychotherapeutic drugs taken nonmedically (2.7 percent of the U.S. population), an estimate similar to that in 2009. This class of drugs is broadly described as those targeting the central nervous system, including drugs used to treat psychiatric disorders (NSDUH, 2010). The medications most commonly abused are:

• Pain relievers – 5.1 million
• Tranquilizers – 2.2 million
• Stimulants – 1.1 million
• Sedatives – 0.4 million

Adolescents and young adults

Abuse of prescription drugs is highest among young adults aged 18 to 25, with 5.9 percent reporting nonmedical use in the past month (NSDUH, 2010). Among youth aged 12 to 17, 3.0 percent reported past-month nonmedical use of prescription medications.

According to the 2010 MTF, prescription and OTC drugs are among the most commonly abused drugs by 12th graders, after alcohol, marijuana, and tobacco. While past-year nonmedical use of sedatives and tranquilizers decreased among 12th graders over the last 5 years, this is not the case for the nonmedical use of amphetamines or opioid pain relievers.

When asked how prescription opioids were obtained for nonmedical use, more than half of the 12th graders surveyed said they were given the drugs or bought them from a friend or relative. Interestingly, the number of students who purchased opioids over the Internet was negligible.

Youth who abuse prescription medications are also more likely to report use of other drugs. Multiple studies have revealed associations between prescription drug abuse and higher rates of cigarette smoking; heavy episodic drinking; and marijuana, cocaine, and other illicit drug use among adolescents, young adults, and college students in the United States.

Older adults

Persons aged 65 years and older comprise only 13 percent of the population, yet account for more than one-third of total outpatient spending on prescription medications in the United States. Older patients are more likely to be prescribed long-term and multiple prescriptions, and some experience cognitive decline, which could lead to improper use of medications. Alternatively, those on a fixed income may abuse another person’s remaining medication to save money.

The high rates of comorbid illnesses in older populations, age-related changes in drug metabolism, and the potential for drug interactions may make any of these practices more dangerous than in younger populations. Further, a large percentage of older adults also use OTC medicines and dietary supplements, which (in addition to alcohol) could compound any adverse health consequences resulting from prescription drug abuse.

Risks of commonly abused prescription drugs

Opioids (used to treat pain):

• Addiction. Prescription opioids act on the same receptors as heroin and can be highly addictive. People who abuse them sometimes alter the route of administration (e.g., snorting or injecting) to intensify the effect; some even report moving from prescription opioids to heroin. NSDUH estimates about 1.9 million people in the U.S. meet abuse or dependence criteria for prescription opioids.
• Overdose. Abuse of opioids, alone or with alcohol or other drugs, can depress respiration and lead to death. Unintentional overdose deaths involving prescription opioids have quadrupled since 1999 and now outnumber those from heroin and cocaine combined.
• Heightened HIV risk. Injecting opioids increases the risk of HIV and other infectious diseases through use of unsterile or shared equipment. Noninjection drug use can also increase these risks through drug-altered judgment and decision making.

How Do Prescription and OTC Drugs Affect the Brain?

Taken as intended, prescription and OTC drugs safely treat specific mental or physical symptoms. But when taken in different quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs.

For example, stimulants such as Ritalin increase alertness, attention, and energy the same way cocaine does—by boosting the amount of the neurotransmitter dopamine. Opioid pain relievers like OxyContin attach to the same cell receptors targeted by illegal opioids like heroin. Prescription depressants produce sedating or calming effects in the same manner as the club drugs GHB and rohypnol, by enhancing the actions of the neurotransmitter GABA (gamma-aminobutyric acid). When taken in very high doses, dextromethorphan acts on the same glutamate receptors as PCP or ketamine, producing similar out-of-body experiences.

When abused, all of these classes of drugs directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction.

• CNS Depressants (used to treat anxiety and sleep problems):
  • Addiction and dangerous withdrawal symptoms.These drugs are addictive and, in chronic users or abusers, discontinuing them absent a physician’s guidance can bring about severe withdrawal symptoms, including seizures that can be life-threatening.
  • Overdose. High doses can cause severe respiratory depression. This risk increases when CNS depressants are combined with other medications or alcohol.
• Stimulants (used to treat ADHD and narcolepsy):
  • Addiction and other health consequences. These include psychosis, seizures, and cardiovascular complications.