Commonly
Abused Prescription Drugs
Three classes of prescription drugs are most commonly abused:
1.
Opioids – primarily used for
treating pain.
2. CNS depressants – barbiturates and benzodiazepines prescribed for
anxiety and sleep disorders.
3. Stimulants – used to treat sleep disorder narcolepsy, attention-deficit
hyperactivity disorder (ADHD), and obesity.
1.
Prescription Opioids
The opioid class of drugs is prescribed because of its analgesic (pain-relieving)
properties. Opioids prescribed for pain include:
- Morphine
- Codeine
- OxyContin® (Oxycodone)
- Darvon® (Propoxyphene)
- Vicodin® (Hydrocodone)
- Dilaudid® (Hydromorphone)
- Demerol® (Meperidine)
- Lomotil® (Diphenoxylate)
Opioids
are also called narcotics. Morphine
is often used to alleviate severe pain
before or after surgery, while milder
pain may be treated by codeine. Among
the drugs listed above, Demerol may
be prescribed less often due to its
side effects, while a few drugs such
as codeine and diphenoxylate (Lomotil)
can be used to relieve coughs and diarrhea
in addition to pain.
How
Opioids Work
Opioids block the transmission of pain messages to the brain by attaching to
certain proteins called opioid receptors in the brain, spinal cord, and gastrointestinal
tract. Opioids can cause drowsiness, constipation, and depressed respiration,
depending upon the amount consumed. When opioid drugs are abused, they can
also cause feelings of euphoria by affecting the brain regions that control
pleasure.
Consequences
of Opioid Use and Abuse
Opioids are powerfully addictive. Tolerance, physical dependence, and addiction
can result from long-term use of opioids. As the body develops tolerance for
opioids like OxyContin, the user
needs higher and higher doses to feel the same. Abusers experience withdrawal
when they
reduce or stop using the opioid, making it impossible to quit by
themselves. Withdrawal symptoms include:
- Restlessness
- Muscle and bone
pain
- Insomnia
- Diarrhea
- Vomiting
- Cold flashes with
goose bumps
- Involuntary leg
movements
One
large dose of an opioid drug could
lead to death from severe respiratory
depression.
Despite
the potent addictive qualities and
dangers of abuse of opioids, when medical
use of opioids is properly managed,
they are safe, rarely leading to addiction
and providing effective pain management.
Opioids
should not be combined with other drugs
except when supervised by a physician.
Other substances that depress the central
nervous system, like alcohol, antihistamines,
barbiturates, benzodiazepines, and
general anesthetics, can increase the
risk of life-threatening respiratory
depression.
OxyContin®
OxyContin, the brand name for oxycodone hydrochloride, is a semisynthetic opioid
analgesic. OxyContin is prescribed for chronic or long-lasting pain such
as back pain, cancer, or arthritis.
The
active ingredient in OxyContin is oxycodone,
which is also found in drugs like Percodan® and
Tylox®. However, OxyContin contains
10-160 mg of oxycodone in a timed-release
tablet. Painkillers such as Tylox contain
5 mg of oxycodone and often require
repeated doses to provide pain relief
because they lack the timed-release
formulation.
Addiction
to OxyContin is as severe as heroin,
as they are both derived from opium.
In some geographical areas, abuse of
OxyContin is more prevalent than the
use of heroin.
OxyContin
abuse has increased dramatically in
recent years. On the street, OxyContin
is also referred to as oxy, O.C., OxyCotton,
Oxy 80 (for the 80 mg dose), and killer.
OxyContin
abusers may crush the tablet and ingest
or snort it - or they may dilute it
in water and inject it. Crushing or
diluting the tablet disarms the timed-release
action of the medication and causes
a quick, powerful high. This practice
can lead to overdose on the active
ingredient in OxyContin, oxycodone,
releasing too much of the medication
into the bloodstream too quickly.
OxyContin
is highly addictive. An OxyContin abuser
can easily become obsessed with this
pleasurable rush and develop a physical
craving. Addiction to OxyContin manifests
through chronic use and increasing
tolerance so a user needs more and
more of it to feel the same effects.
OxyContin
and other opioids like heroin block
pain messengers to the brain and central
nervous system. They increase dopamine
in the brain, which causes pleasure
and euphoria. As the body seeks a balance,
compensating for the increased dopamine
and pleasurable feelings, tolerance
develops. That’s why the body
soon needs more and more OxyContin
to get the same feelings.
OxyContin
addiction can creep up on someone until
acquiring the drug occupies the abuser’s
mind full time, affecting friends,
family, career, finances and the law.
Respiratory
depression is the most serious risk
associated with OxyContin. OxyContin
should not be combined with other substances
that slow down breathing, including
alcohol, antihistamines (cold or allergy
medication), barbiturates, or benzodiazepines.
Other
common side effects of OxyContin include:
- Constipation
- Nausea
- Sedation
- Dizziness
- Vomiting
- Headache
- Dry mouth
- Sweating
- Weakness
OxyContin
will be come physically addictive over
time, causing withdrawal symptoms when
the drug is not present. Addiction
to OxyContin can be as powerful as
that of heroin.
Symptoms
of OxyContin withdrawal include:
- Restlessness
- Muscle and bone
pain
- Insomnia
- Diarrhea
- Vomiting
- Cold flashes with
goose bumps
- Involuntary leg
movements
Two factors set OxyContin
abuse apart from other prescription
drug abuse:
a.
OxyContin is a powerful drug that contains
a much larger amount of the active
ingredient, oxycodone, than other prescription
pain relievers. By crushing the tablet
and either ingesting or snorting it,
or by injecting diluted OxyContin,
abusers feel the powerful effects of
the opioid in a short time, rather
than over a 12-hour span.
b.
Great profits can be made in the illegal
sale of OxyContin. A 40 mg pill costs
approximately $4 by prescription, yet
it may sell for $20-40 on the street,
depending on the area of the country.
Abuse,
crime and fatal overdoses have all
been linked to OxyContin addiction.
Many reports of OxyContin abuse occur
in rural, economically depressed areas
with labor-intensive industries, such
as logging or coal mining. Because
of the temptation to make extra income,
people may sell their OxyContin prescriptions
for profit. Those addicted to OxyContin
become so driven to get more of it
that they will go to great lengths
to get the drug, including robbing
pharmacies and writing false prescriptions.
Most
individuals who are prescribed OxyContin,
or any other opioid, will not become
addicted, although they may become
dependent on the drug and will need
to be withdrawn by a qualified physician.
Individuals who are taking the drug
as prescribed should continue to do
so, as long as they and their physician
agree that taking the drug is a medically
appropriate way for them to manage
pain.
Treatment
for Addiction to Prescription Opioids
To be effective, opioid detoxification is often necessary before treatment
of opioid addiction. This allows for treatment and supervision of withdrawal
syndrome, helping the patient’s mind and body to adjust to the lack of
opioids. Once opioid detoxification is complete, a treatment plan can be put
into place.
Treatment
for prescription opioid addiction draws
on treatments successfully used for
heroin addiction, since heroin shares
the same potential effects and withdrawal
syndrome. Medications such as methadone
and LAAM (levo-alpha-acetyl-methadol)
as well as behavioral counseling can
be effective in treating opioid addiction.
Incorporating
a medication like methadone can provide
relief from the severe craving that
accompanies opioid addiction. It also
eliminates withdrawal symptoms. Methadone
itself is an opioid, though synthetic,
and it has been used for over 30 years
to treat opioid addiction.
LAAM
can block the effects of opioids for
up to 72 hours, too. Alternatively,
naltrexone can help by blocking opioid
effects but is used mostly in treatment
programs that promote complete abstinence
from opioids. Naloxone is a drug used
to treat opioid overdoses, as it can
counter the effects of opioids. Another
drug with potential to provide relieve
in treatment of opioid addiction is
buprenorphine, which is awaiting Food
and Drug Administration (FDA) approval.
