Prescription drug addiction symptoms and treatment

Prescription drug addiction is a compulsive need to take prescription medications despite the consequences they cause and even when they’re no longer necessary. The term prescription drug refers to pharmaceutical medications that are only available with a doctor’s prescription and cannot be obtained over-the-counter.

Almost always, this kind of addiction is accidental. In other words, it starts with a doctor’s appointment regarding a specific health problem. The doctor prescribes certain medications, which patients may abuse. Prescription drug abuse leads to tolerance, dependence, and addiction. 

Prescription opioids and tranquilizers are common examples of medications that cause addiction. Of all prescription drugs, the most often abused are hydrocodone (Vicodin), codeine, fentanyl, morphine, and oxycodone (Percocet). 

Addiction to prescription medication manifests itself through a wide range of symptoms, including:

• Hostility
• Drug-seeking behaviors
• Taking higher doses than prescribed
• Appearing intoxicated, overly energetic, or lethargic
• Changes in sleeping and eating patterns
• Increased usage of alcohol
• Mood swings relating to the availability of prescription medications
• Irritability when medication is not available  
• Withdrawal symptoms when a prescription drug is not available
• “Doctor shopping,” or visiting multiple doctors to obtain more prescriptions
• Borrowing medications from others
• Using prescriptions at a much faster rate than prescribed
• Crushing or breaking pills
• Lying about the amount of medication used
• Ordering prescriptions from internet  pharmacies
• Stealing or forging prescriptions  

Like other forms of addiction, this problem is treatable. The most common treatment approaches for addiction and abuse of prescription drugs include:

• Behavioral therapy
• Medications 

This post focuses on symptoms and treatment options for prescription drug addiction.

1. Hostility

Hostility refers to unfriendly, offensive, argumentative, or angry behavior. A person with prescription drug addiction is particularly hostile toward their significant other, family members, and friends. They become hostile when other people express concerns about their behavior and medication abuse. 

A 2014 study by Carla Smith Stover and Andrew Kiselica published in the Aggressive Behavior journal states that being under the influence of addictive substances makes a person more hostile and also more likely to engage in intimate partner violence. 

Drugs act on neurotransmitters in the brain. The imbalance of these chemical messengers may influence a person’s behavior. That could explain the biological causes of hostility and aggressiveness related to the abuse of the prescription drug.

Also, environmental causes could play a role. For example, an addict may feel threatened, judged, or criticized.

2. Drug-seeking behaviors

Drug-seeking behavior refers to manipulative and demanding behavior for the purpose of obtaining the drug. An addict uses tricks and other strategies to deceive a healthcare professional and get a prescription for their medication.

For example, a patient may schedule an appointment to see a doctor and describe their symptoms as a lot worse than they really are. They may exaggerate the severity of pain or other problems. 

Some patients may claim nothing else works for their condition, except that specific drug. Others go so far as to suggest they are allergic to over-the-counter or non-addictive medications.

3. Taking higher doses than prescribed

Taking higher doses than prescribed means an individual exceeds the recommended or prescribed dosage of a medication, consuming a quantity that surpasses the healthcare provider’s instructions. 

A doctor prescribes a specific dosage of certain medication for the management of some health condition. In ideal circumstances, patients adhere to this recommendation religiously, but addiction works differently than regular prescription drug use.

A person with prescription pill addictions takes a higher dosage than recommended. In fact, they keep increasing doses gradually. That happens because persistent intake of drugs reduces the expression of dopamine receptors. As a result, an addict needs a higher dosage to experience the same effects of satisfaction and pleasure as they used to. 

Many prescription medications are strong and people build tolerance easily. Once they become tolerant to the drug, the current dose isn’t enough for them so they instinctively increase it. This leads to a vicious cycle of increased dosages and building tolerance.

4. Appearing intoxicated, overly energetic, or lethargic

Appearing intoxicated refers to slow movements, poor coordination, and slurred speech when under influence of a specific substance. Besides these effects, an addict may appear overly energetic and upbeat, or quite hyperactive. 

Some people are lethargic or have very low energy levels and lack interest or motivation in doing anything after prescription drug usage. 

These symptoms depend on the type of prescription medication abuse. Some medications are stimulants and provide an energy boost, whereas others are sedatives or tranquilizers that induce the opposite effect.

5. Changes in sleeping and eating patterns

Changes in eating and sleeping patterns refer to alterations or deviations from a person’s usual or established routines related to their dietary habits and sleep habits. This could include variations in the timing, quantity, or type of food consumed, as well as shifts in the regular sleep-wake cycle.

Addiction and abuse of prescription drugs manifest themselves through changes in eating or appetite and quality or duration of sleep. Even acute exposure to drugs of abuse can affect sleep quality, duration, and latency. However, chronic use causes more severe sleep disruption that extends to cognitive dysfunction, according to a 2019 paper from Rita J. Valentino and Nora D. Volkow published in Neuropsychopharmacology. 

People who are addicted to prescription drugs tend to experience changes in their eating patterns including decreased nutrient intake and absorption. Drugs of abuse can also affect hormones that regulate hunger and satiety.

These symptoms of addiction are not that tricky to spot. An addict may appear sleep deprived or exhibit noticeable changes in their eating pattern and weight.

6. Increased usage of alcohol

Increased usage of alcohol refers to a rise in the consumption of alcoholic beverages compared to a person’s typical or previous drinking habits. This can involve an uptick in the frequency, quantity, or intensity of alcohol consumption.

Prescription drug addiction tends to manifest itself through higher alcohol intake. An addict drinks more alcohol together with pills in order to enhance their effects. Doing so is incredibly dangerous. 

An article by Longo et al., published in the April 2000 issue of the American Family Physician  confirms that an estimated 80% of benzodiazepine usage occurs in the context of polydrug abuse, with the strongest link happening with concomitant opiate and alcohol addiction. Alcohol contributes to many cases of overdose. Using alcohol and abusable prescription drugs at the same time can lead to major respiratory depression and eventually overdose. 

Additionally, the use of alcohol may interfere with and undermine the treatment for prescription drug addiction. These two problems may go hand in hand in many cases. For example, a 2018 review by Katie Witkiewitz and Kevin E. Vowles published in the journal Alcohol: Clinical and Experimental Research shows alcohol use disorder increases the risk of developing opioid addiction. A person addicted to opioids is more likely to drink excessively.

7. Mood swings relating to the availability of prescription medications

Mood swings associated with the availability of prescription medications are, actually, rapidly and intensely fluctuating emotions dictated by the drug of abuse. For example, when an addict has their medications and takes them wherever they want, their mood is positive. They may appear happy, cheerful, energetic, and even friendly.

On the other hand, a lack of drugs or the inability to use them at a specific moment can lead to negative emotions. At this point, a person appears angry, irritated, mad, sad, depressed and has no energy. Sometimes an addict may seem moody or grumpy, but as soon as they take the drug, their mood improves.

8. Irritability when medication is not available

Irritability refers to the expression of frustration or anger in situations when a prescription drug is not available. Addiction includes a strong or compulsive need to use a specific substance. When a person with addiction is unable to use that drug, they may react through anger and irritability.

In fact, irritability is a constant burden for men and women with prescription drug addiction. It increases stress and puts additional pressure on relationships.

A patient without addiction doesn’t respond with anger in situations when they are unable to use the drug or because the medication is not available. They have no problem waiting, if necessary. On the other hand, someone with an addiction may even get furious if they can’t use the drug when they intend or need to do so.

9. Withdrawal symptoms when a prescription drug is not available

Withdrawal symptoms are physical or psychological features or changes that occur when a person stops taking a prescription drug. In other words, withdrawal symptoms are the first effects of prescription drug abuse i.e. reactions of the body to the absence of an addictive substance.

Some of the most frequent withdrawal symptoms include nausea and vomiting, dilated pupils, fatigue, sweating, anxiety and irritability, shakiness, muscle, and joint aches, goosebumps, increased heart rate, and yawning.

The severity of withdrawal symptoms depends on the specific type of prescription medication abused, the severity of addiction, and the amount of the drug taken during the day. In some cases, withdrawal symptoms can be severe and include psychosis and heart, nerve, or stomach problems. 

The exact timeline depends on the specific drug. In most cases, the symptoms occur within 24 hours after the last use. They achieve their peak in a few days and usually go away in a few weeks. Medical supervision is necessary for detox.

Sometimes, a person with prescription pill addiction can experience withdrawal symptoms even when not taking part in treatment. One of the telltale signs of addiction is continuing to use the drug and experiencing withdrawal symptoms when a person is unable to use the medication. Sometimes, it may not seem like a person has a problem until they’re in a situation that doesn’t allow them to use the drug, which leads to withdrawal. 

10. “Doctor shopping,” or visiting multiple doctors to obtain more prescriptions

Doctor shopping refers to visiting multiple doctors, pharmacies, and emergency rooms to gain sympathy or feign symptoms in order to obtain prescriptions for a specific drug. In most cases, people who doctor shop “complain” about toothache, migraine headache, ADHD, psychiatric disorders, and cancer.

Some people go so far as to injure themselves just to get a prescription from the ER. Doctor shopping includes other approaches too. For instance, a person may claim they’re from out of town and forgot to pack their medications. Others claim they lost their pills.

While people engage in a multitude of fraudulent activities to obtain prescriptions, doctor shopping has the highest success rate.

The reason people resort to doctor shopping is simple – the more doctors they see, the bigger the chance of getting more prescriptions. This allows persons with prescription drug addiction to have a constant “flow” of drugs, even when their doctor refuses to prescribe something. 

Many doctors notice drug abuse and refuse to give more prescriptions to their patients. However, people have found a way to navigate around this problem, which is why they see multiple doctors.

It’s not that difficult to recognize this symptom; a person has multiple prescriptions from different doctors or they inform a family member or friend they have a scheduled appointment with different physicians.

11. “Borrowing” prescription medications from others

Borrowing prescription medications means taking pills prescribed to someone else in order to satisfy the compulsive need to use drugs. Many people with prescription drug addiction will resort to taking someone else’s medications when they run out of pills or don’t have access to them.

Many people don’t think borrowing or sharing medications is dangerous. This kind of behavior is also considered drug abuse. Also, it can lead to health complications and overdose. That happens because prescriptions contain dosages that work for a specific patient and their needs.

Borrowing itself is usually carried out without the person being aware of it. In other words, an addict may steal a pill or two when having cravings. Sometimes the other person is aware the addict is “borrowing” their pills but will choose to ignore it. However, ignoring, in this case, is enabling and supporting prescription drug misuse.

12. Using prescriptions at a much faster rate than prescribed

Using prescriptions at a faster rate than prescribed refers to running out of the drug sooner than intended. A doctor prescribes medications such as opioids only when necessary. Patients need to take the prescribed dosage a specific number of times or within a specific timeframe. For many people, these instructions are easy to follow.

However, a person with prescription drug addiction uses pills too much. They take pills even when it’s not necessary, but only with a purpose to achieve the same pleasurable effects. Increased frequency of use means a person runs out of pills faster than expected.

Recognizing this symptom isn’t that difficult. A patient empties the bottle of pills quite fast or they request refills too frequently. Since a doctor or pharmacist suspects drug abuse is the problem, they may refuse to hand out a new prescription. That’s why a patient may visit multiple doctors or engage in other fraudulent actions.

13. Crushing or breaking pills

Crushing or breaking pills refers to the act of breaking apart pills into smaller pieces or crushing them entirely to achieve a powder-like substance. A 2012 paper by Vosburg et al., from the journal Drug and Alcohol Dependence reports users may crush pills into particles that are small enough to snort. Also, they sometimes crush pills and dissolve them in order to inject the drug.

Administration of drugs by crushing or breaking is associated with increased health risks including transfer of communicable diseases, as well as overdose.

When people snort or inject the pills they crush, the drug is quickly absorbed and moved into the bloodstream. This allows for faster onset of action. In other words, crushing pills accelerates and intensifies the effects of prescription drugs.

These actions are easy to recognize. Family members or friends can see their loved one breaking pills into smaller pieces or crushing them into small particles. Sometimes the traces of white powder are present on the table or other pieces of furniture.

14. Lying about the amount of medication used

Lying about the amount of medication used means someone is providing false information or intentionally misrepresenting the quantity or frequency of medication they have taken. 

People with prescription drug addiction tend to lie about the amount of medication they used.  This is a regular occurrence in persons who are administered particular prescriptions and make promises to their loved ones about resolving their prescription medication-related problems. 

Generally speaking, lying is a common symptom of any kind of addiction including prescription drug abuse and addiction. People lie about the amount of drugs used for several reasons. For example, they may lie to avoid confrontation with family members, friends, or coworkers. 

Also, sometimes a person with this addiction is stubborn and lies in order to avoid forced change. Basically, they’re aware of the problem but are downplaying its severity when people urge them to get help.

Escaping negativity is yet another reason a person may lie about the amount of drugs used. They don’t want their family members or friends to remind them about negative aspects of their behavior. For that reason, they often feel the need to paint a false picture that shows their addiction as a not-so-serious problem.Physiological changes may also contribute to lying.

A 2013 study by Nakamura-Palacios et al., published in the journal Alcohol: Clinical and Experimental Research states that addiction can cause damage to certain areas of the brain, such as  the frontal lobe. This increases the likelihood of aberrant behavior and lying.

15. Ordering prescriptions from internet pharmacies

Ordering prescriptions from internet pharmacies is the practice of obtaining prescription medications through online platforms or pharmaceutical websites.

Internet pharmacy is a type of pharmacy that operates via the internet only. Many online pharmacies claim patients are required to submit a doctor’s prescription to obtain the drug, but a lot of them don’t adhere to these regulations. 

A person with prescription drug addiction tends to use internet pharmacies to obtain the drugs. After all, many drugs are readily available online. Easy access allows patients to get their hands on prescription medication without hassle. 

At the same time, patients remain anonymous and nobody knows they’re purchasing a prescription drug. 

According to a 2006 study by Formal et al., from the Current Psychiatry Reports, no-prescription websites (NPWs) are prevalent. In fact, NPWs account for about a half of online search results for commonly misused opioids. 

People with prescription drug addiction find it easier to hide their problems when they make a purchase online. Plus, nowadays generic forms of various medications are available. The generics are cheaper thus allowing patients with addiction to get higher quantities. 

This symptom of prescription medication abuse can be tricky to notice unless a person uses someone else’s card to pay for the medication. Family members concerned about their loved one may want to check bank statements or browsing history to determine whether they visited an online pharmacy website or made a purchase.

16. Stealing or forging prescriptions

Stealing or forging prescriptions” involves the unauthorized acquisition or fabrication of prescription documents for obtaining medication. In the case of stealing, an individual takes a legitimately issued prescription without the owner’s consent. Forging involves creating a false prescription, often with the intent to obtain controlled substances or other prescription medications illegally.

Doctors prescribe some prescription medications, such as opioids, for short-term use only. Patients are required to take controlled dosages of these drugs. However, one of the most pronounced symptoms of prescription drug addiction is the act of stealing or forging prescriptions.

In a nutshell, a patient uses a specific drug too much and finishes the refill too quickly. Since they can’t get a prescription from their doctor to get the drug again in such a short timeframe, they resort to stealing blank prescription forms or forging the doctor’s signature, and performing other fraudulent actions.

Fraud with prescription drugs can take various forms. Now that the costs of high-quality copying equipment have dropped, it has become easier for people to forge prescriptions. Some people paint glue on the top edge of the prescription slip to make it look like it was ripped from the doctor’s pad.

Moreover, many people with prescription drug addiction tend to alter a legitimate prescription. All they do is increase the number of refills, change the type of drug, and increase the quantity.According to a 2007 study by Olivia Boeuf and Maryse Lapeyre-Maestre published in Drug Safety, forged recipes most frequently involve benzodiazepines, benzodiazepine analogs, and opioids.

What are the factors that may increase your chances of developing prescription drug addiction?

Factors that increase one’s chances of developing prescription drug addiction involve various elements that could contribute to an individual’s vulnerability to developing an addiction to prescription medications. Factors that may increase your chances of developing prescription drug addiction are listed below.

• Being an adolescent or young adult (18-25 years old)
• Family history of substance use disorders
• Past or present addiction to alcohol, tobacco, and other substances
• Lack of knowledge about potential harms and addictiveness of prescription drugs
• Having easy access to prescription drugs
• Pre-existing psychiatric conditions such as anxiety, depression, PTSD
• Peer pressure or socializing with people who abuse prescription drugs
• Past trauma such as the history of abuse in childhood
• High impulsivity (rebelliousness and impairment of emotional regulation)
• Increased screen time i.e. exposure to the internet and social media

What are the treatments that your doctor may recommend if you are diagnosed with prescription drug addiction?

Treatments that a doctor may recommend when someone is diagnosed with prescription drug addiction typically involve a comprehensive approach to address the physical, psychological, and behavioral aspects of addiction. The treatments that a doctor may recommend to patients diagnosed with prescription drug addiction are listed below.

• Behavioral therapy: the cornerstone of addiction treatment, including prescription drug addiction. The main goal of psychotherapy is to help patients change unhealthy or negative thinking and behavior patterns in order to stop drug use. Cognitive-behavioral therapy and contingency management are the most common therapies for the treatment of prescription drug addiction. These therapies teach strategies to manage cravings and avoid triggers or situations that would cause relapse. Patients can have individual therapy sessions or participate in family or group counseling, according to a 2020 research report titled, “How can prescription drug addiction be treated?” from the National Institute on Drug Abuse.
• Medications: used primarily in combination with therapy, never on their own. The use of pharmacotherapy in the treatment of addiction is called medication-assisted treatment (MAT). The most commonly prescribed medications are methadone, buprenorphine, and naltrexone, which prevent prescription drugs from affecting the brain or they decrease cravings and withdrawal symptoms. That way, they contribute to relapse prevention. Lofexidine is also prescribed in many cases to relieve physical symptoms of withdrawal. The withdrawal symptoms occur in detox i.e. the first stage of treatment for prescription drug addiction. They appear within 24 hours and last up to a few weeks or longer, but the symptoms are at their strongest two to three days after cessation of drug use.

Which prescription drug addiction treatment is the most effective?

The most effective treatment for prescription drug addiction is behavioral therapy, more precisely cognitive-behavioral therapy (CBT). One of the main goals of therapy, especially CBT, is to enable patients to find connections between their thoughts, feelings, or behaviors and drug use. 

Through therapy, patients learn that many emotions are illogical and irrational since they are tied to past experiences or environmental factors. When a person with prescription drug addiction understands why they act or behave a certain way or why they use drugs, they are better equipped to overcome their problem.

With therapy, patients learn to dismiss insecurities and false beliefs that lead to prescription drug abuse. They also improve communication skills and develop other skills that can help them cope with negative stimuli in a healthier manner.

While many people with prescription drug addiction receive medications during the treatment process, patients can’t rely on drugs only. That’s why therapy is the most effective and important aspect of the treatment. A study by Barry et al., from the January 2019 issue of Drug and Alcohol Dependence found that CBT was an acceptable, effective, and feasible approach for the treatment of opioid addiction and management of chronic pain.

The Journal of Substance Abuse Treatment additionally published a study by Moore et al., in 2016 which showed that a combination of physician management (PM) and CBT facilitated greater abstinence from all substances of abuse in comparison to PM alone. 

A 2010 paper on cognitive-behavioral therapy for substance use disorders published in  the Psychiatric Clinics of North America explained that CBT works because it lessens the highly reinforcing effects of drugs by building abilities to enable decreased usage and maintenance of abstinence or by raising contingencies linked to non-use. This is particularly important because prescription drugs and other addictive substances act as motivators for certain behaviors. 

Behavioral therapy also builds structure in a patient’s life, which is of huge importance for the treatment process.