Symptoms and Signs of Prescription Drug Abuse
Signs of drug use vary, but it’s a misconception that prescription drug side effects are tied solely to abuse or addiction. Long before dependence develops, a wide range of potentially harmful symptoms can occur, especially when more than one medication is taken concurrently. While widespread news coverage has greatly raised the visibility of the dangers of opioid painkillers, many other prescription drugs are subject to intentional and unintentional abuse. Too often, teens abuse these drugs intentionally and older adults do so unintentionally, both of which can result in tragic consequences. It is equally important to recognize potential signs of over-the-counter (OTC) drug abuse.
The active ingredient affects chemicals in the brain that may be unbalanced in people with insomnia. Next-day psychomotor impairment is more likely to occur if the drug is taken with less than seven to eight hours of remaining sleep, at higher than recommended doses, with other CNS depressants (e.g. alcohol) or with drugs that have the potential of altering the blood levels of zolpidem.1 Lunesta® (eszopiclone) is another popular sleeping pill that causes similar side effects. Short-term symptoms include:
- Prolonged reaction time
- Blurred/double vision
- Reduced alertness
- Impaired driving (the morning after taking the drug)1
The amphetamine family of prescription medications includes the stimulants Adderall and Ritalin. Although these drugs generally do not pose as severe risks as opioid painkillers, they can still be addictive and lead to psychosis. People who misuse them can become aggressive, paranoid and anxious, and in worst case scenarios, abuse can lead to heart attacks and death.2 When Ritalin is snorted, its effects mimic those of cocaine, producing strong feelings of euphoria.3 Short-term symptoms of both drugs are similar and include:
- Increased blood pressure, heart rate and body temperature
- Decreased appetite and sleep
- Increased energy
- Involuntary bodily movements
- Rapid talking2,3
Long-term symptoms include:
- Damage to brain cells
- Schizophrenia-like behavior
- Reduced concentration and performance
- Increased aggression or hostility
- Serious cardiovascular complications including stroke2,3
The drug Seconal (secobarbital), referred to as “red dolls” back in the 1970s, was once as abused as OxyContin, Valium and Xanax are today. Barbiturates are sedatives that slow down the central nervous system by increasing levels of a brain neurotransmitter called γ-aminobutyric acid (GABA). This mechanism causes muscles to relax, calms nerves, slows down the body and produces drowsiness.4 Today, benzodiazepines are the preferred choice for sedation or anti-anxiety treatment in clinical practice. Other barbiturates include Nembutal (pentobarbital) and phenobarbital.5 When combined with alcohol, narcotics, other barbiturates, sleeping pills, painkillers, muscle relaxants or some cold medicines, barbiturate use can result in severe side effects and fatal overdoses.4. Short-term symptoms include:
- Increased sensitivity to sound
- Heightened sensitivity to pain
- Increased perspiration
- Hallucinations or psychosis (rare)
- Memory and attention impairments
- Emotional instability
- Suicidal thoughts
- Incoordination and impaired balance
- Slurred speech
Long-term symptoms include:
- Chronic breathing problems
- Increased risk of bronchitis and pneumonia
- Loss of motor coordination control
- Sexual dysfunction
- Irregular menses
- Slowed reflexes
- Shortened attention span
- Short- and long-term memory loss
- Cardiac problems
- Liver and kidney problems
- Physical dependence/addiction6
Doctors prescribe this type of tranquilizer to treat anxiety and panic disorders, insomnia, seizures and alcohol withdrawal. Xanax is the number one abused benzodiazepine, followed by Ativan (lorazepam) and Valium (diazepam), as the second and third most widely abused tranquilizers in the U.S., respectively. Stopping cold turkey can result in life threatening seizures, tremors and muscle cramps.7 Short term symptoms include:
- Impaired coordination
- Vision problems
- Feelings of depression
Long-term symptoms include:
- Diminished cognitive function
- Decreased attention span
- Significant memory loss7
The addiction to prescription painkillers has reached epidemic proportions in the U.S. These include codeine, fentanyl, hydocodone, methadone, morphine, oxycodone, hydromorphone, ultram and variants with acetaminophen. Some prescription opioids are more powerful, addictive and dangerous than illicit opiates. Fentanyl, for example, is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin. Physiologic tolerance may occur from chronic opioid use, requiring escalating dosage to alleviate pain.8,9 Short-term symptoms include:
- Pain relief
- Slowed breathing
Long-term effects of oxycodone may include acetaminophen toxicity (when combined with acetaminophen as it is in Percocet and other variations) and kidney or liver failure.10 Long-term effects of hydrocodone include acetaminophen toxicity, liver damage and sensorineural hearing loss.11
Prescription and OTC Cough Syrup
Cough syrup abuse primarily affects teens who are misled by its sweet taste when it is mixed with other ingredients. Sizzurp, Lean and Purple Drank are street names for prescription cough medicine containing codeine mixed with soft drinks or candy for flavor. Symptoms of codeine cough syrup abuse include nausea, dizziness, impaired vision, memory loss, hallucinations, seizures, coma and death. Dextromethorphan (DXM) is a cough suppressant and expectorant found in many OTC cold medicines. DXM can produce euphoria, dissociative effects and hallucinations when taken in quantities greater than the recommended therapeutic dose.12,13
- FDA Elevates Warning for Psychomotor Impairment With Ambien. Neurology Advisor website. http://www.neurologyadvisor.com/sleep-disorders/fda-elevates-warning-for-psychomotor-impairment-with-ambien/article/516316/ Published August 16, 2016. Accessed October 15, 2016.
- Adderall. Drugs.com website. https://www.drugs.com/adderall.html Updated November 19, 1015. Accessed October 15, 2016.
- Ritalin Abuse. Drug Abuse website. http://drugabuse.com/library/ritalin-abuse/ Accessed October 15, 2016.
- Drug Addiction Treatment website. http://www.drugaddictiontreatment.com/types-of-addiction/prescription-drug-addiction/seconal-addiction/ Published July 7, 2013. Accessed October 15, 2016.
- Prescription Drug Addiction: Top 18 Facts for You & Your Family. Drugs.com website. https://www.drugs.com/slideshow/prescription-drug-addiction-1075 Published August 28, 2016. Accessed October 15, 2016.
- Barbiturates’ Side Effects. Drug Abuse website. http://drugabuse.com/library/barbiturates-side-effects/ Accessed October 15, 2016.
- Benzodiazepines: Uses, Side Effects and Risks. Medical New Today website. http://www.medicalnewstoday.com/articles/262809.php Updated April 13, 2016. Accessed October 15, 2016.
- Commonly Abused Drugs Charts. National Institute on Drug Abuse website. https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts Updated April 2016. Accessed October 15, 2016.
- What Is Fentanyl? The Drug That Killed Prince Has Killed Thousands of Others. NBC News website. http://www.nbcnews.com/news/us-news/what-fentanyl-drug-killed-prince-has-killed-thousands-others-n584961 Published June 3, 2016. Accessed October 15, 2016.
- The Effects of Oxycodone Use. Drug Abuse website. http://drugabuse.com/library/the-effects-of-oxycodone-use/#long-term-effects-of-oxycodone Accessed October 15, 2016.
- The Effects of Hydrocodone Use. Drug Abuse website. http://drugabuse.com/library/the-effects-of-hydrocodone-use/ Accessed October 15, 2016.
- Sizzurp: It’s Not Cool. NIDA for Teens website. https://teens.drugabuse.gov/blog/post/sizzurp-is-not-cool Published June 13, 2013. Accessed October 15, 2016.
- Drug Facts—Cough and Cold Medicine Abuse. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/drugfacts/cough-cold-medicine-abuse Updated May 2014. Accessed October 15, 2016.