Drugs don’t have to be illegal to be problematic. Prescription drug misuse and prescription drug addiction is widespread and growing.
More than 76 million antidepressants were dispensed in the UK in 2019-20 according to NHS Business Services Authority (NHSBSA) data and aaccording to the British Medical Journal (BMJ) the number of prescriptions for antidepressants in England has almost doubled in the past decade. Almost 8 million people received at least one prescription item for antidepressant drugs in 2019-20 in England. COVID-19 is also showing an impact with on average 10% more antidepressants being prescribed each month since the pandemic hit in March 2020.
The same types of issues are being seen in the prescription of stimulants as the number of patients who were prescribed at least one item for CNS stimulants such as Adderall and Ritalin has risen by 44% in five years.
And opioids are not different. It’s estimated by NHS England in 2019 that 7.1 million adults in England take prescribed opioids or gabapentinoid medication such as Gabapentin and Pregabalin. In addition to this medication such as codeine, morphine, zopiclone and tramadol are often prescribed as repeat prescriptions.
So What Are The Consequences Of Misusing Prescription Drugs?
Well in a recent interview recording artist Lilly Allen discussed the negative impact of her addiction to the prescription drug Adderall and more recently Harry Brant, a model and cosmetics entrepreneur, died of a prescription drug overdose at the age of 24 and he is not the only one.
As with any drug problem there are always consequences:
Opioids can cause low blood pressure, a slowed breathing rate and potential for breathing to stop, or to go into a coma. The risk of overdose can be high with a significant risk of death.
Anti-anxiety medications and sedatives can cause memory problems, low blood pressure and slowed breathing. Abruptly stopping the medication may cause withdrawal symptoms that can include nervous system hyperactivity and seizures and like opioids the risk of overdose can be high with a significant risk of death.
Stimulants can cause dangerously high body temperature, heart problems, high blood pressure, fits or tremors, hallucinations, aggressiveness, and paranoia.
Since the start of the pandemic Help Me Stop’s enquiry line has been awash with calls concerning prescription drug misuse with people struggling to know who to turn too.
So What Kind Of Prescription Drugs Can Be A Problem?
There are too many prescription drugs to list that can be problematic if misused but the 6 big ones are:
- Opiates such as Fentanyl, Morphine, Hydrocodone, Oxycodone and Codeine
- Antidepressants such as Citalopram and Prozac
- Weight loss pills such as Orlistat, Alli and Xenical
- Insomnia and sleeping pills such as Zopiclone.
- ADHD medicine including Ritalin and Adderall.
- Anti-anxiety medicine such as Pregabalin and Benzodiazepines such as Xanax and Valium
What How Does Prescription Drug Problems Start?
Problems with prescription drugs usually begins after a person has a legitimate need for them. Life-changing events such as serious illness or a painful accident can, for instance, give a person really need for strong painkillers such as morphine to get through their recovery and healing. While these are carefully prescribed by medical professionals, the simple fact is that substances like morphine are highly addictive. The same is true for other drugs prescribed for anxiety, depression, sleep problems etc.
When Do You Know You Have A Problem With Prescription Drugs?
The following actions are examples of behavioural symptoms of problematic use that are specific to prescription drug abuse.
- Not sticking the prescription: A key indicator of a problem is when the individual is consuming their prescribed drugs faster than is recommended by their prescription, GP or psychiatrist. Often, they are then representing at their surgery or going online if their surgery has an online portal and requesting a repeat prescription more frequently than they should. You would hope that this would be picked up by their prescriber but more often than not it isn’t and some people have gone on for years like this. It was only in November 2020 that a senior coroner demanded action by NHS England, to ensure that GPs monitor repeat prescriptions properly, after an 84 year old man with dementia died from an overdose of tramadol.
- Losing prescriptions: It is possible to have your prescription replaced by your GP if you claim to have lost it. Unsurprisingly, this is commonly attempted by individuals who are abusing their prescribed substance in a bid to obtain more than their prescription states.
- Ordering prescription drugs online: It is so easy to get prescribed drugs online now that many people will set up multiple accounts to do this.
- Buying on the street: 76 million antidepressants were dispensed in the UK and 7.1 million adults in England are taking prescribed opioids or gabapentinoid medication such as gabapentin and pregabalin so it is not a surprise that many of these, and other prescribed drugs, are diverted to the street. Also, street prescribed drugs come in from other sources via the black market. Some of these prescribed medications are legitimate others are not so a street bought Xanax can in fact contain all sorts of things.
- Mixing a prescribed medication with alcohol or other drugs in order to enhance the feelings of euphoria
- Self-administering the drug in a way other than prescribed, i.e., crushing and snorting or injecting the drug for a more powerful high
- Taking your prescription after the health issue has passed.
What Are My Options If I Have Developed A Problem?
Well, the first thing is – please do not stop taking the medication without seeking medical advice first. Some prescription medications can be dangerous to stop suddenly.
The next step is to seek out an assessment with a treatment professional to look at the magnitude of your problem. Without know what you are taking, how much you are taking and how frequent it is exceedingly difficult to formulate a plan to go forward. The treatment professional will also ask you other things, so they have a comprehensive overview of what is occurring.
As indicated in most cases it is not safe to suddenly stop taking prescribed medication so usually the next step is to look at a tapering down programme which is overseen by a medical provider. In some cases, some medications may be switched or altered so that the tapering down procedure can be handled more safely. In most cases this can be done in the community as tapering down can be a long process and, in many cases, not achievable in the 28-day type stays that most residential rehabs offer. But also, at £15,000 – 28,000 a residential stay it is out of most people’s pockets.
There are incidences, for instance with opiate prescription misuse, that no tapering is required, and we have written about this here https://www.helpmestop.org.uk/blog/opiate-dependence-treatment
However, alongside this medical approach there does need to be a psychological input as the whole issue of how and why the prescription problem manifested in the first place needs to be explored and dealt with otherwise the problem will never go away and will return in force.
Stopping and staying stopped is a about a psychological shift and lifestyle change which best comes about through psychological therapies and peer support. Peer support like SMART or NA is great and is highly recommended, but they are not a replacement for psychotherapy or are psychotherapy. Neither are run by trained addiction psychotherapists and neither will get to the fundamental bottom of your use from a psychological perspective. Getting to the psychological reasons why you misuse prescriptions drugs and doing something about this is fundamental to long term behaviour change and staying stopped.
There is no magic pill or magic wand to stopping and staying stopped. There is no quick fix, it takes the right levels and types of support, time, motivation, and hard work.
Giving up prescription drug use after prolonged use can be extremely difficult because the body is so used to functioning with the substance. Dealing with the withdrawal is one thing but learning to stop and stay stopped is another.
If you are concerned about your prescription drug use, or someone else’s, and want to know what the options are for stopping and staying stopped or want to undertake a free assessment then call us now on 0208 191 9191 or jump onto Live Chat/email us directly at https://www.helpmestop.org.uk/contact-us/
Help Me Stop’s intensive non-residential outpatient Dayhab prescription drug treatment programme is an effective psychological solution that also offers 12 months of free accessible aftercare and family support options. Treatment is delivered face to face either in the mornings or afternoons over 6 weeks.
For those adults who are working and can’t access services in the day or get to our centre in West London we offer a 6-week evening online outpatient ketamine treatment programme, run by the same therapists that provide the face to face programme.
Chris Cordell is Help Me Stop’s General Manager and is a senior associate member of the Royal Society of Medicine, Certified International Recovery Specialist, member of the International Society of Addiction Medicine and a member of the Federation of Drug and Alcohol Professionals.