Baylor College of Medicine News

Prescription drugs can be prescription for trouble for some

Whether it's patients suffering from chronic pain or young adolescents who rummage through their parents' medicine cabinets, the number of people who abuse prescription drugs is on the rise, according to an expert at Baylor College of Medicine.

"There is more initiation of prescription drug use than there is initiation of marijuana use, meaning that more people are experimenting with prescription drugs than with marijuana," said Dr. Thomas Kosten, who holds the Jay H. Waggoner Endowed Chair in the Menninger Department of Psychiatry and Behavioral Sciences at BCM.

Prescription drugs are attractive to teens because they are easily accessible, Kosten said. For those suffering with chronic pain, the abuse starts after they are put on prescription drugs to treat their pain. About 15 percent of chronic pain patients abuse prescription drugs, but the range can be from 5 percent to 43 percent. AIDS patients who use prescription drugs to treat their chronic pain are in the higher range for prescription drug abuse, and even geriatric adults over age 65 have abused prescription opiates when given them for chronic, non-cancer pain, said Kosten.

Signs of abuse can include going to several physicians to get medications, stealing and taking more medication than required. The danger of this addiction is the risk for overdose. Abusers take more and more medication to feel pain relief or feel a high, which can eventually lead to a drug overdose.

One treatment option for this addiction is to put chronic pain patients on a new maintenance treatment, buprenorphine. This opiate drug is a blocker that prevents patients from overdosing, but still treats their pain. The drug also reverses hyperalgesia, or an increased sensitivity to pain due to chronic use of opiates.

Detoxification is another treatment option in which prescription drug abusers withdraw from the medications. To keep them from relapsing after detoxification, a blocker such as naltrexone should be given to patients to block the effects of opiates. Naltrexone is a particularly attractive treatment option for adolescents who are abusing prescription drugs since they are not trying to alleviate any sort of chronic pain, said Kosten.

"Prescription drug abuse is expanding rapidly, and the demographics have shifted to teenage females," said Kosten.

Detox patients who are suffering from chronic pain can still use non-opiate medications, but more importantly they should use a wide variety of behavioral treatments for pain relief.

Kosten emphasizes the importance of being aware of such drug abuse, since symptoms of abuse are not as obvious as other drugs.