To better understand the growing prescription drug epidemic, it is important to be aware of how these drugs are misused and how they are classified.
Prescription drugs are medications that require an authorization from a qualified doctor. The purpose of prescription drugs is to treat a wide variety of illnesses, ranging from mental health conditions to bacterial infections.
Prescription rates in the United States have been increasing since the 1990s, and prescription drug misuse continues to rise. To better understand this growing epidemic, it is important to be aware of prescription drug use, how these drugs are misused and how they are classified.
What Are Prescription Drugs?
Prescription drugs are regulated medications, and people must receive a medical prescription from a doctor to obtain them. These pharmaceutical drugs must be picked up from a licensed pharmacy that has received permission from a medical professional to dispense the medication.
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Prescription Drug Classes
The Drug Enforcement Administration (DEA) has prescription drug laws that classify drugs into five groups. A drug’s classification depends on its medical use and its potential for misuse or dependence. Most prescription drugs fall between Schedule II and IV.
The prescription drug schedule includes:
Schedule II
These are defined as drugs with a high potential for misuse, with use potentially leading to severe psychological or physical dependence. Examples of Schedule II prescription drugs include Vicodin, methadone, oxycodone, fentanyl, Adderall and Ritalin.
Schedule III
These are defined as drugs with a moderate to low potential for physical and psychological dependence. An example of a Schedule III prescription drug is Tylenol with codeine.
Schedule IV
These are defined as drugs with a low potential for misuse and low risk of dependence. Examples of Schedule IV prescription drugs include Xanax, Valium, Ambien, and Tramadol.
Prescription Drugs Dosage and Administration
Drug dosage and administration is different for each prescription. However, pharmacies attach labels to the bottles or packaging that give instructions on how to properly take the drug. The label may also provide instructions on things to avoid, such as operating heavy equipment or drinking alcohol while taking the drug. It is important to follow these instructions to ensure safety and prevent dangerous side effects.
An example of prescription instructions may be: “Take 250 mg twice daily for two weeks. Do not drink alcohol.” The instructions will provide the proper dose, how much to take, how often to take it and how long to take it.
Prescription mistakes have sometimes occurred in clinics and hospitals. They rarely result in the death of a patient but can affect the safety and quality of care. Some mistakes include providing the wrong drug name, the wrong dose, the wrong frequency of dosing or the wrong route of administration. However, the invention of electronic charts has helped reduce errors that result from poor handwriting, and allow for errors to be found more quickly.
Administration Methods
Prescription drugs can come in a variety of forms, but the most common forms are pills, tablets or oral suspensions (liquids). Skin patches are also possible.
Prescription pills and tablets are taken orally and digested in the stomach. From there, they are absorbed into the bloodstream and act on their target organ or area of the body. If someone is misusing prescription pills, they may crush them into a powder and snort it. They may also dissolve crushed pills or tablets in alcohol or water and inject the solution.
Transdermal patches are also used as a way to dispense medication into the body. For example, fentanyl is commonly administered through a patch to prevent overdoses. Since fentanyl is 80 to 100 times more potent than morphine, the drug is released from the patch in small quantities and absorbed through the skin over a long period of time. Once absorbed, the drug can move into the bloodstream and act on its target in the body.
There are many benefits to these patches. Since the drug is absorbed at a steady rate into the body, doses are applied much less frequently, so there’s less to keep track of. Unlike some pills, a person can still take the drug with an upset stomach. However, prescription pain patches can become dangerous or cause an overdose if the patch has been broken, cut open or chewed. Wearing too many patches can also cause an overdose.
Prescription medications can also be given in a liquid form that is consumed orally or injected. Doses are typically given in milliliters (mL), teaspoons (tsp) or tablespoons (tbsp). Liquid medications are typically prescribed to children who cannot swallow pills.
Commonly Abused Prescription Drugs
There are three main groups of commonly abused prescription drugs: central nervous system (CNS) depressants, opioids and stimulants.
CNS depressants work by slowing brain activity, and they are used to treat a variety of seizure, panic and sleep disorders. Opioids are prescription pain medications typically used to treat moderate to severe pain after surgery or injury. These drugs have a high addiction potential and are some of the most commonly misused substances. Prescription stimulants are used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy, a condition that causes someone to fall into a deep sleep uncontrollably.
Though each of these prescription drugs may have beneficial uses, they are often misused and can be found illegally without a prescription.
Street Names For Prescription Drugs
Instead of being sold under brand names, prescription drugs sold on the street may have “street names” related to their effects.
Examples of depressants include:
- Barbiturates: Barbs, reds, red birds, phennies, tooies, yellows, yellow jackets
- Benzodiazepines: Candy, downers, sleeping pills, tranks
Examples of opioids/morphine include:
- Codeine: Captain Cody, Cody, schoolboy
- Codeine combined with glutethimide: Doors and fours, loads, pancakes and syrup
- Morphine: M, Miss Emma, monkey, white stuff
- Methadone: Fizzies, amidone, chocolate chip cookies (when combined with MDMA)
- Fentanyl: Apache, China girl, dance fever, friend, goodfella, jackpot, murder 8, TNT, Tango and Cash
- Oxycontin/Percocet: Oxy, O.C., oxycotton, hillbilly, heroin, percs
- Vicodin: Vike, Watson-387
Examples of stimulants include:
- Amphetamines: Bennies, black beauties, crosses, hearts, LA turnaround, speed, uppers
- Methylphenidate: JIF, MPH, R-ball, Skippy, the smart drug, vitamin R
Side Effects of Prescription Drugs
The side effects of prescription drugs are usually found in a pamphlet provided with the prescription. It is important to understand the side effects of any given medication and know what is normal to experience. Some negative side effects can occur when prescriptions are not taken properly or are mixed with other drugs or alcohol.
Dangers of Prescription Drug Use
Prescriptions given by doctors are safest when the correct dose is taken over the prescribed interval. However, prescription drugs can become dangerous if they are used outside of their intended purposes.
It is dangerous to mix prescription drugs with other substances, including drugs and alcohol. Many labels will say, “Do not take with alcohol,” because mixing alcohol and prescription drugs can produce dangerous effects.
It is also dangerous to order prescription drugs online without a doctor. It is illegal to buy any controlled substance (drugs in Schedules II to IV) without a prescription from a doctor. Getting a prescription requires seeing a real doctor, and most states will require a physical examination before prescribing a drug. Purchasing drugs online from “cyber doctors” is not allowed under federal law. These drugs are not regulated by the FDA and they may come from an unknown origin. In addition, they may be ineffective or be different from what was ordered. It is important to always get prescription drugs from a licensed doctor and pharmacy.
How Long Do Prescription Drugs Stay in Your System?
Prescription drugs will leave a person’s system once they completely stop taking the drug, but ending drug use can result in withdrawal symptoms. When a person’s body requires a drug to function normally, ending use may shock their body’s systems and result in withdrawal. These symptoms can be dangerous, so it is best to consult a doctor before discontinuing a prescription medication.
Many different factors affect how long prescription drugs stay in the system. Everyone processes drugs at different rates, even when taking the same drug and dose at the same time. Factors that influence drug metabolism include:
Age
The older you are, the slower your metabolism is and the longer it takes to clear the drug out of your body.
Body Height and Weight
Dosing for drugs is dependent on a person’s measurements, which can affect how fast they will eliminate the drug from their body.
Liver and Kidney Function
The liver and kidneys are important organs in drug metabolism and can greatly affect how long a drug will stay in the body. If the liver or kidneys are damaged, drug elimination will be much slower than normal.
Genetics
There are different variations in genes that can affect drug metabolism and can make someone more likely to develop drug addiction or dependence.
Metabolism
The rate of metabolism plays an important role in how long prescription drugs stay in the body. Someone who has a faster metabolism will process the drugs more quickly than someone who has a slower metabolism.
The length of time that prescription drugs stay in urine or blood varies on the drug, but there are estimations. Estimated time frames include:
Benzodiazepines
3 to 6 weeks in urine, 2 to 3 days in blood.
Amphetamines
1 to 3 days in urine, 12 hours in blood.
Opioids
3 to 4 days in urine, 12 hours in blood.
How Do You Get Addicted To Prescription Drugs?
It is possible to become addicted to prescription drugs. Addiction occurs when someone’s brain chemically and physically changes its reward pathways to seek out the drug. A person can have both a physical and psychological addiction to a prescription drug, and they may also become dependent on it. Dependence occurs when a person’s body begins requiring the drug to normally function. Addiction is the compulsive use of a drug despite negative consequences due to changes in the brain, while drug dependence develops as a result of the body adjusting to a drug.
Prescription drug addiction can develop as a result of misusing drugs. This can include behaviors like:
- Taking a larger dose than a doctor prescribes
- Taking someone else’s medicine
- Using the medicine outside of its prescribed purpose (getting high, for example)
- Taking the medicine in a different way than what is prescribed
