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Prescription Drug FAQs

Here are a few prescription drug facts to help you sort out facts from fiction.

What Factors Led to the Opioid Painkiller Epidemic in the U.S.?

More than 30% of Americans have some form of acute or chronic pain, and the prevalence of chronic pain is more than 40% among older adults. Opioid analgesics are the most commonly prescribed drug class in the U.S., with 245 million opioid prescriptions dispensed by U.S. pharmacies in 2014. A compounding factor is that many physicians say they are not confident on how to safely prescribe opioids, how to detect abuse/addiction or how to discuss these issues with patients. Moreover, pharmaceutical companies have engaged in aggressive marketing to physicians and consumers. Prescribing opioids long term for pain typically requires escalating dosage in order to maintain the initial level of pain relief. People suffering from chronic pain often become dependent or addicted to opioids and end up needing treatment for prescription drug abuse. The other group that has contributed to this epidemic are people who intentionally abuse opioids to experience feelings of euphoria.1

Does the Term Narcotic Only Apply to Illicit Drugs?

The term narcotic has a connotation of being illicit, however, both illegal and prescription drugs fall under this class of drugs. Narcotic is another term for opioid painkiller or prescription analgesic. Codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine and tramadol are all narcotics. Heroin and opium are the most notorious illegal narcotics. Whether prescription or illicit, narcotics work by binding to pain receptors in the central nervous system to block pain signals. As a result, prescription narcotics are often prescribed to temporarily treat severe pain that does not respond to other types of pain relievers. Morphine is prescribed legally for late-stage cancers and other terminal illnesses to control severe pain. All of these drugs are addictive and subject to abuse.2

What are the Repercussions of Drinking Alcohol with Medications?

Mixing alcohol with certain medications can cause an array of side effects such as nausea, vomiting, stomach bleeding/ulcers, headaches, drowsiness, fainting and loss of coordination. Even worse, some combinations are especially lethal, increasing the risk of internal bleeding, heart problems, liver failure, seizures, breathing difficulties and even death.3 Prescription drugs are not the only culprits. Acetaminophen, the active ingredient in Tylenol, is particularly dangerous in combination with alcohol, readily causing hepatitis and liver failure. A 2011 study on 663 people hospitalized for acute liver toxicity associated with acetaminophen found that about 30% of those who took a single dose and 50% of those who took staggered doses also used alcohol, increasing the harmful effects of the drug.4

What are the Long-Term Risks of Using Codeine Cough Syrups?

Codeine cough syrups have become one of the most popular drugs of abuse in young people around the world. Although codeine is a less addictive opiate than heroin, continued use can result in physical and psychological dependence. Short-term side effects such as coma and death are well documented. Recent research suggests that chronic abuse of codeine cough syrup may cause progressive brain white matter integrity impairment. Furthermore, these white matter deficits may be linked to higher impulsivity traits.5

  1. Volkow ND, McLellan AT.Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies. N Engl J Med. 2016 Mar 31;374(13):1253-63. doi: 10.1056/NEJMra1507771.
  2. What Are Narcotics and Why Are They Addictive? Health Status website. https://www.healthstatus.com/health_blog/substance-abuse/what-are-narcotics-and-why-are-they-addictive/ Accessed October 16, 2016.
  3. Mixing Alcohol With Medicines. National Institute on Drug Abuse website. http://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm Updated 2014. Accessed October 16, 2016.
  4. Tylenol. Drug Watch website. https://www.drugwatch.com/tylenol/ Updated March 7, 2016. Accessed October 16, 2016.
  5. Qiu YW, Su HH, Lv XF, Jiang GH. Abnormal white matter integrity in chronic users of codeine-containing cough syrups: a tract-based spatial statistics study. AJNR Am J Neuroradiol. 2015 Jan;36(1):50-6. doi: 10.3174/ajnr.A4070. Epub 2014 Aug 7.
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