It is difficult to recognize prescription drug dependence, both for the person who has it and those around him. Nowadays, knowledge in this field, as well as the resources and support offered, contribute more than ever to breaking the cycle of dependence and to the recovery of individuals with dependence.
Any drug can become dangerous under certain conditions. However, among the prescription drugs regularly misused are:
- Opioid pain medication (fentanyl, Percodan, Demerol, OxyNEO, etc.);
- stimulants (Ritalin, Concerta, Adderall, Dexedrine, etc.);
- sedatives and tranquillizers (benzodiazepines, Valium, Ativan, Xanax, etc.);
- antimigraine drugs (alone or combined with caffeine or analgesics);
- sedating antihistamines (if taken frequently).
Some people are particularly vulnerable to developing a dependence on prescription drugs: lonely older adults (whose prescription drug dependence is often underestimated), people with responsibility overload, people exposed to stress or a trying event, as well as young people, who increasingly turn to this type of substance use.
Even if we do not have the exact global statistics on the non-medicinal use of prescription drugs such as synthetic opioids, benzodiazepines or synthetic stimulants, it seems that the non-medicinal use of these products constitutes “a growing health problem in a number of developed and developing countries”. Canada is no exception to this (ONUDC, 2012).
A survey revealed that 22.9% of Canadians aged 15 and over indicated that they used a psychoactive pharmaceutical in the year preceding the survey. Opioid pain relievers were the most commonly used substances, followed by sedatives or tranquillizers and stimulants, with usage rates being 16.7%, 9.1% and 0.9% respectively. Of all these users, 3.2% (equivalent to 0.7% of the total population) stated that they had used off-the-shelf cold and cough medications for non-medicinal reasons, i.e., solely for the experience or feeling that these products provide, or to get high. The prevalence of the non-medicinal use of dextromethorphan, the active ingredient in these products, was also reported by 0.9% of men and 0.6% of women (CADUMS, 2011).
The most commonly prescribed psychotropic drugs – namely, anti-anxiety drugs, hypnotics, antidepressants and antipsychotics – are used against a wide array of indications, including nervousness, sleep disorders, anxiety, depression and psychosis. Since they are prescribed and have therapeutic purposes, one might reason that they are not dependence-forming, but this is not really the case. Even though these drugs are needed at a certain point in time to alleviate or end physical or mental suffering, they can create dependence.
Problem prescription drug use consists either of intentionally using drugs that are not prescribed for you to experience a sensation of euphoria (a high), or to bring about a change in mood, or of misusing a prescribed drug.
A study carried out in 2014-2015 involving students in grades 7 to 12 revealed that psychotropic drugs were in third place (4%) among the drugs most frequently used. Usage frequency for psychotropic drugs is the same as for synthetic cannabinoids, directly after cannabis (17%) and alcohol (40%).
According to Health Canada (2017) problem prescription drug use can have serious health effects, in particular, substance use disorders (addiction), overdose and even death. These risks increase if drugs are used:
- at higher doses than the doses prescribed;
- in a different way or for other reasons than those indicated on the prescription;
- with alcohol, or with other prescription, off-the-shelf or illegal drugs.
Anyone can develop prescription drug dependence, and it is very difficult to recognize and admit. Here are a few signs that could indicate that it might be time to seek help.
- Continuing use of drugs despite an improvement in health. The person continues to take the drug against their doctor’s recommendations, justifying this by the presence of vague feelings of discomfort.
- An increase in the use of drugs because of the development of tolerance to their effects. As a result, to achieve the same effect, the person gradually has to increase the dose and the frequency with which they take the drug.
- Doctor shopping or having several prescribing doctors and visiting several pharmacies to have a prescription filled.
- Frequent or marked mood swings, big energy slumps or problems with concentration (these symptoms are often related to withdrawal). Other withdrawal symptoms are anxiety, nausea, vomiting, goosebumps, etc.
- Asking for or taking drugs prescribed for another person.
- Social withdrawal. The person neglects their professional, social and family activities and may even neglect their personal hygiene.
- Denial and a defensive attitude. A person who tries to camouflage or deny prescription drug dependence often takes a defensive attitude when questioned about their drugs or health.