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Medication Abuse

Introduction

Medication abuse occurs when you’re not taking medication according to doctors/pharmacists instruction. Some examples of medication abuse are as below:

  • Taking medication that was prescribed for other people
  • Taking a larger dose than instructed
  • Taking medication in a different way from instruction. For example tablets were crushed and taken by snorting or injecting them
  • Taking medication for other purposes that are not in accordance with the indication prescribed/required, for example to get high

Medication abuse can cause addiction. Examples of medication which can cause addiction are painkillers containing opioid, tranquilisers, sedatives and stimulants. There is also non prescription medication (over the counter (OTC)) which is always abused, for example medication that contains dextromethorphan presented in cough and cold medication.

There are views that taking prescription and OTC medication is much safer in comparison to taking illicit drugs (cocaine, heroine, cannabis and etc.). However, taking prescription and OTC medication is only safe when it is consumed as instructed by doctors/pharmacists. Abuse of prescription and OTC medication can lead to risks of side effects, including overdose – especially when consumed with other medication or alcohol.

Examples of Medication and Its Abuse Effect on the Body

When taking prescription and OTC medication which is not needed or not according to the instruction, the effect on brain is as similar as taking illicit drugs.

Medication abuse can cause a lot of side effects as stated below:

Type of Medication
Desired Addiction Effect
Health Consequences
Painkiller containing opiod
Example : Codeine, Oxycodone, Methadone, Morphine, Fentanyl
Feeling happy and excited. It acts on the same receptor targeted by heroine. Drowsiness, constipation and slowed breathing. Slowed breathing occur especially when opoid is snorted or injected or taken with other medication or alcohol.
Tranquiliser and sedative
Example : Barbiturates, Benzodiazepines, Zolpidem
Reduce restlessness and brain activity which can cause drowsiness and loss of coordination and memory Lower blood pressure, slowed breathing which can cause death when it is consumed with alcohol.
Stimulant
Example : Amphetamine, Methylphenidate
Feeling excited, increase in energy and confidence level Increase heart rate, blood pressure, reduce weight, heart attack, stroke
Dextromethorphan
Example : Present in cough and cold medication
High doses acts on receptors targeted by phencyclidine (PCP) and ketamine which caused exhilaration and excitement Impaired motor function, numbness, nausea and vomiting, increased heart rate and blood pressure. There are cases where brain damage occur when breathing slowed down causing lack of oxygen in the brain.

Treatment of Medication Addiction

Medication addiction can be treated by behavioral treatment and pharmacological treatment (medicine). Research shows that treatment of medication addiction is more effective when patient received both methods through behavioral and pharmacological.

For behavioral treatment, patients is taught not to use medication, control addiction, avoid themselves from situations that could lead to medication use and how to manage occurring of relapse
.

Whereas pharmacological treatment is based on:

  1. Painkiller containing opioid

    Naltrexone – prevents opioid from acting on receptors
    Methadone – synthetic opioid stimulant which acts on the same receptor as other opioids. It can only be obtained through rehabilitation programme.

  2. Tranquiliser and sedative

    Patients with addiction to tranquilisers and sedatives need to undergo detoxification treatment supervised by doctors as the doses need to be tapered gradually. Patients should not stop taking the medication abruptly as it can threaten their life.

  3. Stimulant

    As of now, there is no medication approved to treat stimulant addiction. Therefore, treatment by tapering down the doses gradually is useful beside behavioral treatment.

  4. Dextromethorphan

    There is no medication that can treat dependency to Dextromethorphan. In overdose cases, Naloxone is used as an antidote. Addiction problem must be treated via behavioral treatment with family and professionals support. However, this treatment needs time and commitment from both patients and their family.

Facts on Medication Abuse

  1. Increase in prescription medication abuse and OTC has been reported in few countries in recent years. In Australia and United States, prescription medication abuse is higher compared to illicit drugs except for cannabis. It happens because patients acquire prescriptions through corruption, fake prescriptions, illegal sales by clinics and pharmacies, misuse within families, illegal patient-to-patient sales and counterfeit medication that can be obtained via the Internet.
  2. In general, illicit drugs use among males are more than females. However, data from 2005 to 2010 in Europe and United States shows that more females use tranquilisers and sedatives.
  3. Based on Drug Abuse Warning Network 2004, 1% of medication-related cases referred to emergency ward in United States were due to overdose of Dextromethorphan and half of the cases involved patients between the ages of 12 to 20 years old.

References

  1. http://www.drugabuse.gov/publications/prescription-drug-abuse/where-can-i-get-further-information-about-prescription-drug-abuse
  2. WHO World Drug Report 2012
  3. The New DAWN Report – Drug Abuse Warning Network; Emergency Department Visits Involving Dextromethorphan; Issue 32, 2006R
  4. National Institutes of Health. Medline Plus. Retrieved 04.08.14, from http://www.nlm.nih.gov/medlineplus/prescriptiondrugabuse.html
  5. National Institute on Drug Abuse. Retrieved 04.08.14, from http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications
  6. National Institute on Drug Abuse. Retrieved 04.08.14, from http://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs/commonly-abused-prescription-drugs-chart
Last Reviewed : 25 November 2015
Writer/Translator : Nur Izyani bt. Hanafi
Accreditor : Nur Sufiza bt. Ahmad