The word “drugs” has very negative connotations. However, people take drugs every day. The newsagent sells drugs. The chemist most definitely sells drugs. A drug is simply a substance which can “affect the structure or any function in the body”1. It is common for people to think of drugs in black and white terms; it is either medicinal and safe, i.e. paracetamol or ibuprofen, or it is illegal and dangerous, i.e. heroin or cocaine.
However, the truth is that most drugs, even the aforementioned heroin and cocaine, can be prescribed by a doctor for medical use. That is not to say that all drugs prescribed by a doctor are completely safe; no two humans are the same, and different chemicals can cause different effects in people. This article will seek to explain some of the risks involved with prescription drugs, both for people concerned about addiction and for those in recovery.
In the UK it is thought that one in four people are prescribed some form of addictive drug; this means that upon cessation of taking the user can experience withdrawal symptoms. These include:
- Anti-depressants such as Prozac or Citalopram
- “Z-drugs” such as Zolpidem and Zopiclone, used primarily for sleep.
- Opioids and opiate drugs such as Codeine and Oramorph, used for pain relief.
- Benzodiazepines such as Valium and Xanax, commonly used for anxiety relief.
- Gabapentinoids such as Pregabalin and Gabapentin, used for nerve pain and anxiety.
- Stimulants such as Ritalin and Adderall, used for ADHD2.
Of course, the majority of the people who are prescribed these use them responsibly and do not go on to develop any sort of problem from them; when it is time to stop taking them they can taper off them responsibly. However, for a small percentage of the population these drugs can be just as dangerous as their illegal counterparts.
Whilst the causes of addiction are debated amongst scientists, it is fairly agreed upon that the dopamine systems of addicts are dysregulated. This is linked to impulsive behaviour, emotional dysregulation, and compulsively seeking substances or behaviours3. For people with addictive tendencies prescription drugs can be just as addictive as illegal drugs.
Our brains do not discriminate according to legality when it comes to mind-altering substances; drugs activate brain receptors and cause an effect on the body. It is also true that many prescription drugs activate similar reward pathways to their illegal counterpart; codeine and heroin being an example.
Prescription drug abuse can affect all areas of society, but has a higher incidence in a group not typically associated with drug addiction by the general public. Typically, people who abuse prescription medicines are predominantly white, more likely to be married or previously married, have at least a college education, and to be in employment4. In this study the most common drug of abuse was codeine.
It is important to note that just because a drug can be prescribed by a doctor that it does not mean that it is always obtained in this manner. Often pharmaceutical supplies are diverted, and many prescription drug addicts purchase their drugs from this black market5. Often, people in this situation can wrongly assume that because a drug is “prescription” that it is somehow safer than taking street drugs6.
Increasingly, “prescription drugs” have also been found being made in black market laboratories. This is the most common for benzodiazepines such as Xanax and Valium, which is gaining popularity as a drug of abuse in teenagers and has been linked to a number of deaths7. This is especially dangerous, as the clandestine nature of production means that one can never be sure of the strength of the tablets.
So what can be done if one is addicted to prescription drugs? A medically supervised detox is advised for those who are using physically addictive drugs. Like all drugs of abuse, it is possible to recover from addiction given the right support. Often, doing this in a controlled environment with the guidance of trained professionals yields the best results. This can enable the addict to discover the root cause of their addiction, and also to teach them to avoid triggers which may induce addictive behaviours.
For those who are already in recovery, it does not mean that one has to remain un-medicated for the rest of their life. It would be inadvisable to deny someone medication which they truly need; however it is also pertinent that the person in recovery is mindful of how they are using it. This means using strictly as the doctor prescribes, and having an honest and accountable dialogue with their doctor and support network. This accountability may seem distasteful to addicts who were “high-functioning” and self-reliant, even through their drug abuse. However, these steps can be necessary to put in place in order to let the person in recovery live the best quality of life possible for them.
1 “Definition Of Drug | Dictionary.Com”. Www.Dictionary.Com, 2020, https://www.dictionary.com/browse/drug.
2 “1 In 4 People Take ‘Addictive’ Medicines, Finds Review”. Nhs.Uk, 2020, https://www.nhs.uk/news/medication/1-4-people-take-addictive-medicines-finds-review/.
3 Foll, Bernard Le et al. “Genetics Of Dopamine Receptors And Drug Addiction: A Comprehensive Review”. Behavioural Pharmacology, vol 20, no. 1, 2009, pp. 1-17. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/fbp.0b013e3283242f05. Accessed 19 Aug 2020.
4 Fingleton, Niamh A. et al. “Non-Prescription Medicine Misuse, Abuse And Dependence: A Cross-Sectional Survey Of The UK General Population”. Journal Of Public Health, 2016, p. fdv204. Oxford University Press (OUP), doi:10.1093/pubmed/fdv204. Accessed 19 Aug 2020.
5 Fountain, Jane et al. “Diversion Of Prescribed Drugs By Drug Users In Treatment: Analysis Of The UK Market And New Data From London”. Addiction, vol 95, no. 3, 2000, pp. 393-406. Wiley, doi:10.1046/j.1360-0443.2000.95339310.x. Accessed 19 Aug 2020.
6 Twombly, Eric C., and Kristen D. Holtz. “Teens And The Misuse Of Prescription Drugs: Evidence-Based Recommendations To Curb A Growing Societal Problem”. The Journal Of Primary Prevention, vol 29, no. 6, 2008, pp. 503-516. Springer Science And Business Media LLC, doi:10.1007/s10935-008-0157-5. Accessed 19 Aug 2020.
7 Phillips, Noel. “‘Xanax’ Linked To More Than 200 Deaths”. BBC News, 2020, https://www.bbc.co.uk/news/health-47055499.