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Causes and risk factors for prescription drug abuse

Prescription drug abuse can be defined as the use of any prescribed medication outside of the way intended by the person who prescribed it.

Things that may be classified as misusing prescription drugs include:

  • Taking more of the medication than prescribed 
  • Taking medication that was not prescribed to you
  • Taking medication in a way that was not prescribed (such as injecting ground-up tablets)
  • Using medication for a purpose not intended, such as getting high or to sleep 
  • Recreational use of prescription drugs

There is increasing awareness of the potential for people to become addicted to or dependent upon prescription drugs.

Medications which can lead to dependence are regularly and widely prescribed within the NHS.

Those most likely to lead to dependence include opioids, sedatives, tranquillisers, and stimulants. Broadly, sedatives, painkillers and antidepressants.

That is not to say those medications cannot be appropriately prescribed. There are cases where they are positively transformative, but an awareness of the causes and risks of addiction is one of the most effective ways of guarding against it or, where it does occur, ensuring early and positive intervention.

What are potentially addictive medications commonly prescribed for?

One in four adults were prescribed benzodiazepines, z-drugs, gabapentinoids, opioids for chronic non-cancer pain, or antidepressants in 2017-2018, according to a recent Public Health England report.

All fall into the category of prescribed drugs that are associated either with a risk of dependence or withdrawal.

These drugs are mostly prescribed for:

  • Benzodiazepines – anxiety.
  • Z-drugs – sleeping tablets 
  • Gabapentinoids is a joint term for gabapentin and pregabalin – used to treat epilepsy, neuropathic pain 
  • Pregabalin – anxiety.
  • Opioids, such as morphine and codeine, may be prescribed for chronic pain or, in the case of methadone, as a heroin substitute. 

Painkiller abuse facts

Abusing prescription drugs and painkillers can be extremely dangerous – even fatal.

Using medications that have not been prescribed to you may lead to severe harm and may interact with other substances or medications to cause unexpected outcomes.

Opioids can reduce blood pressure, breathing rate to a point of inducing coma or breathing to stop.

It is very possible to become addicted to opioid-based painkillers and it is usually advised that they are not used as a long term method of pain control.

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Signs of prescription drug dependency

The most commonly reported symptoms of dependency to prescribed medication are pain and insomnia, according to the Public Health Research Consortium

Mental health disorders and symptoms of those are the next most prevalent.

Other signs of dependency on prescription drugs mirror those of alcohol and illicit substance addictions.

They may include:

  • Craving the drug
  • Obsessive thought about the drug
  • Difficulty to control use or an inability to refrain from use 
  • Continuing to use even if directed to stop
  • Prioritising taking the drug over other things where that is not appropriate behaviour
  • In some circumstances – physical withdrawal symptoms
  • Using more or using for longer than intended

Other signs may include:

  • Mood swings
  • Stealing or lying
  • Changes in sleep patterns
  • Poor decision making
  • Appearing to be unusually energetic or unusually sedated
  • Seeking prescriptions from more than one doctor

Causes of prescription drug abuse

People may abuse prescription drugs to:

  • Induce pleasurably feelings / get high
  • Seek to reduce appetite 
  • Try to manage symptoms, such as pain or insomnia
  • Due to physical dependency that has built up to the medication 
  • Try to improve concentration or performance
  • Attempt to be accepted by certain social groups 

Risk factors for prescription drug abuse

There are certain circumstances in which people are felt to be more at risk of moving into prescription drug abuse or dependence. 

Taking clear advice from a doctor about what medications to take and sticking to instructions over how to take them reduces the risk of harm or abuse.

Whilst an American study indicated those most at risk of dependence to prescribed medication may be:

  1. Older people
  2. Women
  3. People in poor health
  4. Daily drinkers  

It said people under the age of 25 and those in full-time employment were at lesser risk of developing a dependency.

Though the research is worthy of note, it is important to remember that there will be people who fall outside of these parameters that develop a problem. Addictions can form at any age and in people from any background.

Other factors that may increase the likelihood of abuse may include:

  • Past or current addictions to other substances or alcohol
  • Family history of substance or alcohol abuse
  • Some psychiatric conditions
  • Peer pressure
  • Lack of understanding and knowledge of the risks

If you are concerned about you or a loved one’s use of prescribed medication it is the best sign that there may be a problem.

The UK Government’s prescribed medicines review noted that being prescribed opioid pain medicines for longer than 90 days was associated with overdose and dependence.

What to do if you are worried about prescription drug abuse

The ‘prescribed medicines review’ noted that patients within the NHS experienced difficulty in finding and accessing treatment for prescription drug misuse issues and doctors may be reluctant to accept or recognise withdrawal symptoms.

It recommended that patients need to be able to seek treatment and support without being stigmatised. Non-medical treatments, such as talking therapies, should be better promoted and used where appropriate. However, that message has not necessarily sunk in with all doctors.

You should always be empowered and encouraged to fully understand the medication you are taking and there should be a regular review of your medication. 

If you have not got the support you need from NHS providers and continue to be worried about your use of medications, private services are available to help. It is possible to overcome addiction even if you have tried and failed before.

It is important not to stop taking the prescribed medication without consulting a medical professional.

If you are worried about someone else’s use of prescription medications then a well thought out intervention can prove transformative. Even if you are not yet sure they are addicted, see our ‘how to help a drug addict’ tips for some advice.

About the author: Martin Preston

Martin is our Founder and Chief Executive. Martin is himself in long term recovery and started Port of Call to help families navigate treatment options. In 2020 Martin will open Delamere Health Ltd, the UK’s first purpose built addiction treatment clinic.

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