Prescription Drug Abuse, Dependence & Addiction

Prescription drug misuse is a prominent issue in the United States. In 2020, 16.1 million people (12 years and older) reported misuse of prescription medications within the past year. Experts believe the actual numbers are even higher.

What exactly is drug “misuse,” and how does it differ from abuse, dependence, and addiction? After all, it wasn’t that long ago that these terms were used interchangeably. 

This article aims to clarify these terms and their relationship with prescription drug use. With a more accurate understanding of substance use terminology, we can better assist those suffering from addiction. 

Is Prescription Drug Misuse Different from Addiction?

Prescription drug misuse occurs when a person uses medication for a reason other than what a doctor has prescribed. In most scenarios, misuse is unintentional. For example, a person may miss their regular dose at lunch and double their dosage at dinner. 

Drug abuse has a recognizable distinction from misuse. A person abuses prescription medications when they have a continued tendency to seek out the drug or continue to use it to the point of distress and/or impairment. 

Since the body’s natural response to a substance is to adapt to it, users may experience uncomfortable withdrawals when  they stop taking it. To avoid withdrawal symptoms, the person may self-medicate to quell cravings. This is called dependence. 

At one time, dependence and addiction were thought to be synonymous. However, it’s possible to depend on a drug without being addicted.

The National Institute on Drug Abuse (NIDA) defines addiction, or substance abuse disorder (SUD), as a chronic disease. It involves compulsive drug-seeking behaviors with no regard to ramifications or potential harm. 

Dependence, on the other hand, is most recognized by the symptoms of tolerance and withdrawal. 

Misusing drugs, even prescription drugs, can permanently change how a person’s brain operates long-term because it directly influences the body’s production of neurotransmitters.

It is possible for a person to develop a tolerance to a substance (meaning they need more of it to get the same effect), and even experience withdrawal symptoms, without exhibiting the compulsive drug-seeking behaviors that characterize addiction. A common example of this might be a habitual coffee drinker. 

However, once a person begins to experience tolerance and/or withdrawal, addiction is usually not far behind.  

Why Are Prescription Drugs Addictive?

Prescription drugs mimic naturally occurring neurotransmitters within the nervous system. Neurotransmitters are chemical messengers for the body, regulating everything from breathing to healing. Without them, your body would cease to function.

Misusing drugs, even prescription drugs, can permanently change how a person’s brain operates long-term because it directly influences the body’s production of neurotransmitters. 

While many people begin taking medications with direction from their physician, long-term use can trick the brain into believing it needs the drug to keep neurotransmitter chemicals at the necessary levels. 

This causes the brain to  over- or under-produce neurotransmitters to compensate, which affects a person’s self-control and decision-making processes. 

Which Prescription Drugs Are Commonly Abused?

 According to the National Institute on Drug Abuse, the  three most often-abused prescription drugs are benzodiazepines, opioids, and stimulants. 


Benzodiazepines (benzos) are central nervous system (CNS) depressants. They work by influencing a neurotransmitter called gamma-aminobutyric acid (GABA). 

GABA lowers brain activity, which causes a person to feel calm or drowsy. However, GABA also regulates seizures, anxiety, depression, and irritability. 

Physicians use benzos to treat seizures, anxiety, and sleep disorders. They are also applied as standard anesthesia. 

Common benzodiazepine prescriptions include:

One of the most common ways people misuse benzos is by combining them with alcohol. The results of this combination range from slowed breathing and heart functions to death. 

Using benzos as prescribed can help a person feel calm and sleepy. However, long-term use can lead to the body building up a tolerance to the substance, meaning that person will require  higher dosages to get the same efficacy. 

Anyone who has been taking benzos long-term should consult a medical professional for help about tapering off the drug to avoid unpleasant and life-threatening problems such as withdrawal-related seizures.  


Prescription opioids are particularly effective in helping manage pain when used as instructed. While it is possible to become addicted or dependent while taking short-term opioid prescriptions, it is uncommon. 

Opioid use without the supervision of a trained physician and/or over a longer period of time almost always leads to abuse, dependence, and addiction.

Common opioid prescriptions include:

In addition to managing pain, opioids often cause people to experience euphoric feelings. People who misuse prescription opioids may snort or inject them to increase the speed of their effects. Unfortunately, drug injection increases the risk of infectious diseases, such as human immunodeficiency virus (HIV) and Hepatitis C. 

Whether taken by injection or another method, opioid  overdose is life-threatening. Moreover, combining opioids with  other medications that affect the central nervous system (CNS) (such as alcohol and benzodiazepines) drastically increases the risk of cardiovascular and respiratory failure.

Opioid use without the supervision of a trained physician and/or over a longer period of time almost always leads to abuse, dependence, and addiction.


Stimulants boost body alertness, attention, and energy. By narrowing blood vessels and opening airways, they help to raise heart rate, blood sugar, and blood pressure. 

Physicians first began using stimulants as a treatment for asthma and obesity. Today, physicians prescribe stimulants for conditions such as ADHA, ADD, depression, and narcolepsy.

Examples of stimulants include:

Some people abuse stimulants for the “rush” of energy they provide. This anticipated rush may influence people to snort crushed pills or take stimulates in higher doses than prescribed. These behaviors can lead to addiction. 

High doses of stimulants tend to raise body temperature and increase aggression and paranoia. Misusing stimulants or using them alongside other medications has dangerous side effects, such as uneven heartbeat, heart failure, and seizures.

Is There Treatment for Prescription Drug Addiction?

Yes! Detox and counseling are the most common treatments for depressant and stimulant addiction. 

When it comes to treating opioid addiction, however, experts believe that medication-assisted treatment (MAT) is the most effective method. MAT combines cognitive behavioral therapy (CBT) with medications to help patients regain control without the likelihood of further dependence. 

If you are struggling with opiate dependence or addiction, your doctor may prescribe buprenorphine. Buprenorphine alleviates withdrawal symptoms and appears in either a pill form, shot (Sublocade), or skin implant (Probuphine). It is often used alongside naloxone (Bunavail, Suboxone, Zubsolv) to prevent relapse.

Experts recommend that people who misuse opioids keep naloxone on hand, as the medication can reverse an overdose. Naloxone comes in a shot (Evzio) and nasal spray (Narcan).

Can I Prevent Prescription Drug Abuse?

Most people believe that medications are safe simply because they are prescription. They are unaware of their medications’ affiliated side effects or complications. 

Thankfully, the FDA offers these guidelines for safe prescription medication use:

  • Always take medications as carefully directed by your doctor.
  • Don’t raise, lower, or stop doses without consulting your doctor first.
  • Don’t crush or break pills, especially if they are time-released.
  • Confirm that you know how a drug will affect your driving and other daily tasks.
  • Confirm you understand the side effects of medication use when combined with alcohol or drugs
  • Talk honestly with your doctor about any personal or family history of substance abuse, dependence, or addiction.
  • Never allow other people to use your prescription medications.
  • Never take the prescription medications of another person.

Help for Prescription Drug Abuse, Dependence, and Addiction

If you need immediate, 24/7 help for yourself or someone abusing prescription drugs, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) crisis line at 1-800-662-HELP (4357).

If you or someone you know is  struggling with prescription drug abuse, Sequoia can help! We provide counseling that helps identify triggers and teaches skills for independent problem-solving for success after treatment.

Our specialized team will stand beside you, helping you move beyond addiction to gain control of your life in safe and healthy ways. Contact us today for a consultation!