12 Minutes

October 19, 2021 by THE BALANCE
Fact checked

The advent of medicines has been of great benefit to humans since various ailments can now be treated and the suffering associated with the illness is alleviated. However, what people often tend to overlook is the potential for abuse and addiction associated with certain medications, and for this very reason, some medicines are classified as ‘prescription only drugs’ so that their sales can be regulated to mitigate the misuse associated with them.

The catastrophe of prescription drug addiction has affected many parts of the world and the UK is no exception as the trend of prescription drug abuse is rising at an alarming rate. According to the National Health Service (NHS), every 1 in 4 individuals in England is using an addictive prescription drug such as anti-depressants, sleeping pills, and opioid pain killers which makes a quarter of the population of the UK, approximating to 12 million people which is a colossal number. 

The statistics for prescription drug addiction in the UK has been worrisome for the authorities in England and hence the National Institute for Health and Care Excellence (NICE) has updated their guidelines about the use of prescription medications in managing chronic primary pain stating that paracetamol, opioids, and other medications should not be advised for chronic pain since they can be harmful to the individual and can lead to addiction due to their pain-relieving effect.

Prescription drugs are medications that cannot be fetched over-the-counter and a prescription from the physician is needed to take hold of the drug. Prescription drugs are medicines prescribed for legitimate medical use such as to treat chronic pain, insomnia, anxiety, and other medical conditions. 

As long as these ‘prescription only’ medicines are used under the doctor’s recommendation, they are safe and effective to treat a relative illness or condition. However, when someone starts using these drugs in increased doses or for a duration longer than prescribed then this may lead to dependence and addiction which is quite dangerous for the individual’s health for a multitude of reasons as many unpleasant consequences ensue. 

There are various prescription drugs available in the UK that are frequently abused and an increase in hospital admissions is witnessed due to the misuse of these drugs. These include:

Prescription Opioids/ Painkillers

Opioids are narcotic analgesics that are a class of drugs that relieves moderate to severe acute and chronic types of pain. Opioid medicines act on the opioid receptors present in the brain and elsewhere in the body including the gastrointestinal tract and urinary bladder and thus produce a morphine-like effect. Opioids work by inhibiting the transfer of pain signals thus relieving the person from the painful sensation and also creates a feeling of pleasure and a generalised sense of well-being by increasing the release of dopamine. 

The effect of opioids on the dopamine release promotes the use of these prescription medicines as recreational drugs which are often used to achieve a high due to the ecstatic effect that supervenes after using these medications. 

Prescription opioids available in the UK include OxyContin, Codeine, Percodan, Tramadol, morphine, etc.

Prescription Benzodiazepines UK

Benzodiazepines, also known as ‘benzos’, are a class of psychoactive drugs that act as a tranquilizer. They are used to treat anxiety and sleep disorders such as insomnia. Benzodiazepines interfere with the release of GABA- an inhibitory neurotransmitter in the brain. Benzos act by increasing the effectiveness of GABA thereby reducing anxiety, causing sedation, and relaxing the muscles.

Benzodiazepines should not be used for more than 4 weeks as dependence develops quite rapidly and the individual experiences withdrawal symptoms after discontinuing the drug.  In the UK benzodiazepines are available as Diazepam and Valium.

Prescription Stimulants Pills UK

Stimulants are a class of drugs that act by increasing the transmission of impulses through the brain and body thereby making an individual more awake, alert, energetic, and confident. Due to this effect stimulants are the most widely abused drugs in the UK.

Stimulants are prescribed for the treatment of anxiety, attention deficit disorder, obesity, and narcolepsy among other ailments. Different stimulants work by different mechanisms but the result is common to all- they alter the brain signaling and heighten the alertness and gives a boost of energy. Those with attention deficit disorder can concentrate after taking these drugs, whereas those who are morbidly obese also benefit from stimulants since it increases the rate of reaction in the body thereby easing the weight loss process for such individuals. 

Common stimulants available in the UK include Adderall, Ritalin, Concerta, and Dexedrine. Apart from the astounding benefits associated with stimulants, they are widely abused due to the euphoric effect that ensues after using them.  

Prescription Sleeping Pills

Sleeping pills are referred to as ‘hypnotics’ or ‘sedatives’. They are used to treat bouts of insomnia. Sleeping pills act as central nervous system depressants thereby slowing the conduction of impulses across the brain and producing a sedative effect and making an individual fall asleep. 

People often find the effect of sleeping pills magical since it induces sleep and prevents them from the misery of staying up all night. However, these drugs are not suitable for long-term use and are a temporary treatment for insomnia but people often use these drugs longer than the duration prescribed to them. This leads to the development of dependence on the drug after which addiction may follow in most cases.

Some of the most common sleeping pills prescribed in the UK are Stillnoct and Zimovane which are Z-drugs. 

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are used to relieve pain, reduce inflammation, and treat fever. NSAIDs are used to treat headaches, arthritis, flu, strains and sprains, and other chronic types of pain. 

NSAIDs act by blocking the enzyme involved in the production of prostaglandin. Prostaglandins are chemicals present in the body that are involved in the perception of pain. Since NSAIDs decrease prostaglandin production the pain sensations are reduced, bringing comfort to the person. NSAIDs are not addictive by nature but they are often misused due to their pain-relieving property.

NSAIDs include ibuprofen, naproxen, high-dose aspirin, and celecoxib among others.

Yes, prescription drugs are addictive. The myth associated with prescription drugs being safe and that their prolonged use even for recreational purposes is legal, is false. There is no ground reality to the misconception that prescription drugs are safe to be abused since they treat legitimate ailments and disorders. 

People often assume that since these medications are legally prescribed by a general physician for treating pain after surgery, or anxiety, or to treat insomnia, so they can use it to attain the pleasurable effect associated with these medications. However, people remain oblivious to the fact that these prescription drugs can cause them as much harm as any illicit drug since overdose of these medications is simply fatal.

Psychoactive prescription medicines, meaning that they interfere with the working of the brain, are bound to cause dependence and addiction since they alter the signaling and functioning of the brain through various pathways. For instance, most prescription drugs interfere in the brain’s reward system, resulting in an increased release of the neurotransmitter dopamine. Dopamine is linked with the brain’s pleasure center and its release is associated with the heightened pleasurable and euphoric sensation which is highly addictive. 

In normal circumstances, dopamine release is kept in check by various inhibitory neurotransmitters so that the body can function normally in a balanced state. However, after abusing on drugs such as opiates that promote the release of dopamine, unhindered release of this neurotransmitter results, which makes the body enter into a temporary state of bliss and ecstasy that urges the individual to continuously use the drug since the body becomes dependent on it both physically and psychologically and in no time addiction follows after which a person tries all possible means whether legal or illegal to obtain the drug. 

Certain factors play a role in the development of addiction since not everyone who misuses the drug becomes addicted. Firstly, genetics play a very pivotal role in the development of addiction. Individuals who have a family history of drug abuse are more prone to get addicted to a drug that has the potential to cause dependence. Moreover, an individual who has a prior history of drug abuse, or has gone through a traumatic childhood, or has a history of sexual abuse, violence, or has faced the trauma of losing a parent or loved one is at an increased risk of developing an addiction to prescription drugs. Environmental factors are another major reason since people who live in a household where abusing drugs is not offensive and is unrestrained then such individuals are more likely to become addicted to prescription medicines given to them for legitimate reasons. Lastly, social media has also influenced the use of prescription medications as recreational drugs. 

Prescription Drug abuse cases have surged in recent years in the UK. The National Institute in Drug Abuse states that many individuals who are above 12 years of age have taken a prescription drug for non-medicinal purposes in their lifetime. 

It is ironic that as compared to illicit drugs such as marijuana, cocaine, heroin, prescriptions drugs are much more frequently abused in the UK. Statistics reveal that in 2013 there were 807 cases of fatal overdoses that involved prescription drugs which is a 16% rise compared to the previous five years. On the contrary, 718 deaths were reported as a result of taking heroin and cocaine and the number of deaths associated with illicit drugs has continued to fall since 2005. This explains the hazardous potential of prescription drug addiction that has taken its root and is now rampant in the UK. 

Opioids and benzodiazepines are among the most addictive prescription drugs that are widely abused.  As per a recent BBC News investigation, nearly 24 million opioid-based painkillers were prescribed by the general practitioners (GPs) in England in 2017 which is equivalent to 2,700 items prescribed every hour.

According to the analysis of the Public Health England (PHE) report, more than 11 million people in England have received one of the prescription drugs that were reviewed. These included benzodiazepines, opioid pain medicines, antidepressants, gabapentinoids, and Z-drugs. 

It is difficult to pick prescription drug abuse because it is easy to disguise prescription drug addiction under legitimate reasons for taking the drug. 

It is easy to continue using prescription medicine for recreational reasons or out of dependence on the drug and nobody suspects that their loved ones who were taking the medicine for a certain ailment are now in the deadly trap of addiction. For this reason, you must keep yourself well informed about the symptoms that may result when someone is abusing prescription drugs. 

The symptoms associated with prescription drug abuse are as follows:

  • Constantly preoccupied about the thoughts of using the medicine. If they have taken the medicine they are worried about having enough supplies for their next dose.
  • Going to different doctors to attain prescription drugs.
  • Changing their primary doctor if they have refused to prescribe the drug again.
  • Using the drug long after the condition for which the medicine was given has improved.
  • Not able to maintain proper self-hygiene and grooming.
  • Acquiring medicine through illicit means such as the dark web.
  • Hiding their pills and bottles of tablets out of fear of being caught.
  • Being defensive when asked about the reasons for the unnecessary use of medications.
  • Isolating themselves from friends and family.
  • Lagging at workplace and academics. 
  • Losing interest in activities that earlier used to excite them.
  • Frequent and unexplained mood swings.
  • Being cranky if they run out of their drug supplies. 

These are all red flags that you should not ignore as they indicate that the person is addicted to prescription medicines. 

Every medicine has certain side effects along with the benefits associated with it but when misused by taking the drug in excess and for a duration longer than prescribed such that it leads to addiction then the side effects can be deleterious. 

Following are the side effects of prescription drug addiction:

  • Nausea
  • Vomiting
  • Mood swings
  • Anxiety 
  • Agitation
  • Depression
  • Poor decision making
  • Poor judgment
  • Unsteady gait due to loss of coordination
  • Increased heart rate
  • High blood pressure
  • Constipation
  • Loss of concentration and focus
  • Disturbed sleep pattern

Moreover, there are certain dangers associated with prescription drug addiction since the vicious cycle of drug addiction can lead to loss of financial stability, broken relationships, and deteriorating health. Since most of the prescription drugs are psychoactive substances they interfere with the signaling of the brain resulting in a long-term adverse effect on the brain by altering the brain chemistry and this can lead to depression, anxiety, paranoia, and an entire range of psychosis including schizophrenia. 

As some substances are known to be central nervous system depressants so they depress the respiratory centers in the brain leading to decreased and shallow breathing that impairs the oxygen supply to vital organs like the brain and the heart and may result in coma and even death. 

The greatest risk associated with prescription drug addiction is the danger of overdose since it can be rapidly fatal. Overdose can result if an individual is taking the drug either legally or illegally. If someone has taken an increased amount of prescription medicine or has combined it with other substance that aggravates its effect than overdose is likely to result. For instance, opioids should not be used with other anti-anxiety medicines due to the risk of detrimental consequences.

Overdose usually takes place in the setting when two or more substances are concomitantly used to achieve a high such as mixing benzos with alcohol. 

Overdose can also happen in individuals who are going through medication-assisted treatment (MAT) for opioid abuse and addiction treatment.

Certain individuals are at a greater risk of overdose. These include individuals who are above the age of 65, those who are already battling with a chronic liver or kidney disease, those who are abusing prescription drugs, and those individuals who have the habit of taking medicines in doses greater than prescribed. 

Side effects of an overdose are signs that a person has taken the drug at a dangerous level and these include a pale face, shallow breathing, seizures, limp body, and bluish discolouration of fingernails. As soon as you notice these signs, it is imperative that you take the person to emergency to save his life.

No, you cannot mix prescription drugs with alcohol. Since different prescription drugs have a different range of side effects, these negative effects are sometimes exacerbated after using the drug with alcohol and at other times alcohol completely negates the therapeutic effect that the drug is supposed to have on the body. Either way, it is harmful to mix prescription drugs with alcohol as the results can be life-threatening.

Mixing alcohol and sedatives is contraindicated since alcohol increases the sedation associated with these prescription drugs and can result in deep sleep after which a person may find it difficult to wake up. Likewise, the use of opioids and alcohol can be deadly since mixing the two can cause heightened euphoria which induces risk-taking behaviour. 

Side Effects of mixing Prescription Drugs and Alcohol

Side effects of mixing prescription drugs and alcohol include:

  • Drowsiness
  • Headache
  • Dizziness
  • Loss of consciousness
  • Nausea and vomiting
  • Shallow breathing
  • Internal bleeding
  • Depression
  • Seizures
  • Liver damage
  • Trouble sleeping
  • Heart problems- Stroke or heart attack

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