Prescription Drugs


Intro to Prescription drugs 

Presented on this page is a description of prescription drug abuse and dependence, information about Opioids/Pain Relievers (Narcotics), some Common Narcotic Withdrawal Symptoms, a list of Commonly Abused Prescription Narcotics, what common Prescription Drugs Contain, information about depressants, narcotics and stimulants.

 

Dr. Frank discusses the dangers of prescription drug abuse on

It’s Your Call with Lynn Doyle on the Comcast Network

 

Prescription Drugs

Drug addiction-The compulsive use of a substance, despite its negative or dangerous effects. (PubMed Health)

Tolerance– Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects. Needing a higher dose to attain the same effect. (PubMed Health)

Withdrawala.The act or process of giving up the use of a narcotic drug to which one has become addicted, typically accompanied by distressing physiological and mental effects. b. The physiological and mental readjustment that accompanies such discontinuation. (American Heritage Medical Dictionary @2007)

DependenceWhen a person needs a drug to function normally. Withdrawal symptoms usually occur when the drug is abruptly stopped (PubMed Health).

Chemical Dependence– A physical and psychological habituation to a mood- or mind-altering drug, such as alcohol or cocaine (The American Heritage® Medical Dictionary @2007)

Physical (Physiological) Dependence-  in which the drug is used to prevent withdrawal symptoms or in which it is associated with tolerance, or both (American Heritage Medical Dictionary @2007). Physical addiction and dependency on a substance is defined by the appearance of characteristic withdrawal symptoms when the drug is suddenly discontinued. While physical dependency can be a major factor in the psychology of addiction, the primary attribute of an addictive drug is its ability to induce euphoria while causing harm (PubMed Health).

Psychological Dependence-   A person’s need to use a drug or engage in a behavior to gain relief from tension or emotional discomfort (American Heritage Medical Dictionary @2007). This usually develops out of habits that relieve symptoms of loneliness, anxiety, depression, and feelings of worthlessness.  As the drug and/or behavior is indulged, it becomes associated with the release of pleasure and avoidance of pain, and a cycle is started that is similar to physiological addiction (PubMed Health).

 

Opioids/Pain Relievers (Narcotics)

(Drugs.com)

Narcotics: The United States legal definition of narcotics refers to opium, opium derivatives, and their synthetic substitutes. There are two types of narcotics and four main classes. The types are “Natural” narcotics and “man-made” narcotics. Codeine and Morphine are two of the most commonly known natural narcotics and both are derived directly from the sap of the unripe seed pods of the opium poppy. The four classes of narcotics with their examples are “endogenous opioid peptides” which are produced by the body, “opium alkaloids” such as morphine & codeine, “semi-synthetic opioids” like heroin & oxycodone, and “fully synthetic opioids” such as pethidine & methadone. Pain and cough reduction and the cessation of diarrhea are common reasons why narcotics are medically prescribed.

 

Narcotics work to reduce pain by chemically binding to receptors in the brain thus blocking the transmissions of nerve impulses. Because the nerve impulse is blocked the perception of the person’s pain is altered, thus narcotics do not cure the source of the pain.  When narcotics are in the body the Central Nervous System (comprised of the brain and spinal cord) is depressed because the nerve impulses that regulate the cardiovascular (heart rate) and respiratory systems (breathing rate) are blocked. When the CNS is depressed loss of consciousness, coma or death may occur.

 

When used to treat cough or diarrhea, the narcotic slows or blocks muscle contractions resulting in the cessation of cough. Diarrhea results when the gastrointestinal system (GI) operates too quickly so when the CNS is depressed the GI tract is also slowed.

 

In order to prevent withdrawal symptoms, the dose of narcotics may be tapered until the drug can be discontinued without unpleasant effects. Physicians may also prescribe other drugs to relieve withdrawal symptoms.

 

Common Narcotic Withdrawal Symptoms:

Anxiety           Irritability

Runny nose     Sweating

Vomiting         Diarrhea

Confusion       Shaking

Decreased appetite

Rapid breathing

 

 

 

 

 

 

Commonly Abused Prescription Narcotics

(drugs.com); (Wikipedia.com)

 

         Generic Name                               Brand/Trade Name                       Street Name

Oxymorphone

Opana, Numorphone, Oxymorphine

Hillbilly Heroin

Morphine

Drugs containing Morphine: Avinza, Kadian, Roxanol, MSIR

Dreamer, Emsel, First Line, Hows, Miss Emma, Mister blue

Hydromorphone

Dilaudid, Palladone

Dust, Smack, Dilly

Meperidine

Demorol

Demmie

Hydrocodone

Vicodin, Vicoprofen, Lortab, Norco, Lorcet-HD, Hycodan,  Zydone, Hydrocet

Nikes, Hydro, Norco, Vics

Oxycodone

Oxycontin, Roxicodone, Percocet, Percodan

O.C., Killer, Oxy

Codeine

N/A

Dice, Sparkle, Zoom, Glitter

Propoxyphene (withdrawn from US market in 2010)

Darvocet, Balacet, Propacet 100

Bennies, Bumble Bees, China White, Yellow Football

Fentanyl

Actiq, FentoraTM, Duragesic

Goodfellas, Great bear, Jackpot, King ivory

 

             

 

What do the Prescription Drugs Contain?

 

Drug                                                   Drug Contents                       Function of Drug

Hydrocodone Acetaminophen or AsprinNarcotic analgesic (aka pain reliever)Cough-suppressant w/ a non-narcotic analgesic For the relief of moderate to moderately severe pain; Acetaminophen increases the effectiveness of Hydrocodone
Lortab Hydrocodone (pain reliever)Acetaminophen (analgesic) For the relief of moderate to severe pain; Acetaminophen increases the effectiveness of Hydrocodone
Lorcet HydrocodoneAcetaminophen For the relief of moderate to severe pain
Vicoprofen HydrocodoneIbuprofen For the relief of moderate to moderately severe pain
Zydone HydrocodoneAcetaminophen For the relief of moder to severe pain
Darvocet AcetaminophenPropoxyphene Removed from U.S. drug market in 2010 due to very high probability of dependence
Oxycodone (opioid agonist) Synthesized from ‘thebaine’, a constituent of opium. Thebaine is chemically similar to both morphine and codeine Increased analgesic effect.  The more you take the greater the pain control
Percodan AsprinOxycodone For the relief of moderate to severe pain; Related to Codeine
Codeine Non-narcotic analgesic of some type Suppresses a non-productive cough;
Hydrocet HydrocodoneAcetaminophen Smaller amounts of Hydrocodone and Acetaminophen are combined to provide a stronger analgesic effect than either of the two drugs can do alone.
Hydromorphone Similar to Morphine High potential for dependence and tolerance
Fentanyl Synthetic opioid compound Treatment of breakthrough cancer pain.  Used when other narcotics have failed. Heroin or Cocaine is often combined when sold illicitly. 100X more potent than Morphine.
Morphine Found in the unripe seedpods of the opium (poppy) For the relief of acute and chronic severe pain

 

A more detailed description of the drugs may be found by going to www.Explainingmedicine.com.

 

 

 

Depressants

(Drugs.com)

DepressantsTending to lower the rate of vital physiological activities; An agent, especially a drug that decreases the rate of vital physiological activities. (American Heritage Medial Dicitonary @2007)

Benzodiazapines– This class of drugs behaves like tranquilizers and results in relaxation, calmness, and relief from anxiety and tension. It falls under the drug category of “Depressants,” and is a Schedule II drug as per the Controlled Substances Act.  They are the most prescribed Depressant medication (Webster New Medical Dictionary). For a drug to be classified as a Benzodiazepine it must possess one or more of the following drug action(s): anxiety relief, hypnotic, muscle relaxant, anti-convulsant, or an amnesiatic. Each of the drugs will fall into one of two sub-categories. Long-acting drugs will either accumulate in the bloodstream and/or will take a longer amount of time to leave the body when compared to the short-acting drugs. Short-acting drugs are cleared from the body in a short amount of time. The potential for tolerance, dependence, and abuse varies with short and long-acting benzodiazapines. (Center for Substance Abuse Research).  Effects of the drug will vary based upon the amount of the drug taken.

Benzodiazapines affect the neurotransmitter known as gamma-amino butyric acid or GABA. Normally, GABA inhibits the motor neurons in the brain causing the neurons to decrease or stop neuronal activity. When Benzo’s are introduced to the body they cause an increase GABA activity resulting in the slowing of the nerve impulses throughout the entire body. The body has two types of receptors that respond to GABA. One results in providing anti-anxiety and the  second in sedation.

 

Common Withdrawal Symptoms

Drowsiness                               Mood Swings            Altered Vision

Tremors                                     Slurred Speech          Respiratory Depression

Euphoria                                    Hostile Behavior       Slowed Reflexes                                 Abdominal Discomfort                                          Impaired Thinking & Memory

Impaired Motor Coordination

                                                           

 

 

 

 

 

 

Common Abused Depressants

         Generic Name                               Brand/Trade Name                       Street Names

Alprazolam Xanex Z-bars; Handlebars (White pills); School bus (yellow pills); Footballs (blue pills)
Diazepam Valium Vs; Yellow Vs (5 mg); Blue Vs (10 mg) Benzos; Dead flower powers
Haloperidol            Haloperidol lactate Haldol  
Thioridazine Mellaril-S  

 

Common Drugs falling into this category are Valium and Xanax which are considered Minor Tranquilizers while Haldol, Thorazine, are Major tranqulizers.
The most commonly known forms of tranquilizers are the benzodiazepines (or “benzos”).
Major tranquilizers are called “anti-psychotics” because they are generally used to treat symptoms of paranoia, psychosis, or serious distortions in the perception of reality such as hallucinations or delusions. While they are not useful in normal alcohol withdrawal, they can be useful for the psychosis and agitation associated with Delirium Tremens (DTs).

Minor tranquilizers seem to have direct depressant effects on brain areas that regulate wakefulness and alertness, very similar in effect to alcohol and sedative barbiturates. They enhance the action of receptors that inhibit central nervous system stimulation, and conversely, inhibit the action of receptors that stimulate the nervous system. In other words, if the nervous system were a car, these drugs help press down the brakes but make it harder to press down on the gas.

Since the minor tranquilizers of the benzodiazepine family have an effect similar to alcohol on the nervous system, they are useful in treating alcohol withdrawal. Those with a longer duration of action, such as Librium and Valium, are used most often.

Major tranquilizers primarily affect specific receptors in the brain that reduce psychotic thoughts, perceptions and agitation.

 

 

 

 

 

 

Stimulants

Stimulants- Something that temporarily quickens some vital process or the functional activity of some organ or part (American Heritage Medial Dictionary @2007); stimulants are a class of drugs that enhance brain activity – they cause an increase in alertness, attention, and energy that is accompanied by elevated blood pressure and increased heart rate and respiration (www.drug-addiction.com). The increased amount of norepinephrine and dopamine in the brain causes an increase in blood sugar and has a potential for heart attack and/or lethal seizures.

Although the drugs in this class are assigned a Schedule II drug by the Drug Enforcement Administration or (DEA for short) because of its addictive quality, when used as prescribed the risks of addiction is minimal.  Stimulants are prescribed for the treatment of ADHD, narcolepsy, and obesity and are also referred to as “amphetamines” and “methamphetamine.” Both amphetamines, Adderall and Ritalin are the most commonly abused prescription drugs on the market.  Dizoxyn, the only methamphetamine that will be discussed here is reserved as a last result when treating ADHD and morbidly obese individuals and used for a short duration only (www.fda.gov).

Amphetamines and Methamphetamines act on the body in much the same way. Once metabolized by the body methamphetamines become amphetamines. Chemically the only difference between the two is the addition of a second “Methyl” group on Methamphetamines. The extra “methyl” group results in a much stronger and quicker effect on the brain (prescriptiondrugabusehelp.com).   When amphetamine and methamphetamines enter the body they are released into the brain resulting in an increase in the levels of the neurotransmitters, Dopamine and Norepinephrine (neurotransmitters that make us feel good). Once in the nerve terminal the drugs enter vesicles containing dopamine and norepinephrine which causes the releases of these neurotransmitters, thus increasing the “pleasure circuit” area of the brain. Without amphetamine and methamphetamine present the body’s enzymes would destroy excess dopamine and norepinephrine. Instead, the drugs block the enzymes from breaking down the neurotransmitters. The excess dopamine and norepinephrine are carried by transporter molecules from the neuron and into the synapse where the feelings of pleasure and euphoria are initiated.

Like all amphetamines, Adderall has the effect of increasing blood pressure and blood flow making the user alert and focused. It gives off the sense of well-being which is another part of the high that is attractive to so many drug abusers. (adderallabusetreatment.com)

Side effects of Stimulants will vary slightly depending on the specific drug. In general, short-term use may cause or increase anxiety, insomnia, dry mouth, depersonalization, feeling of euphoria, increased heartbeat, crying, dysphoria, decreased appetite, hyperventilation, irritability, depression, nervousness, paranoia, mood swings, restlessness, and shaking .(www.wellness.com)

 

 

 

 

Common Withdrawal Symptoms

(myaddiction.com)

Withdrawal symptoms will vary depending on the drug.  The most common are listed.

Irritability                    Mood swings                          Depression

Headaches                   Anxiety                                   Intense Hunger

Nausea                       Fatigue                                                Mental Confusion

 

                                                 

Common Abused Stimulants

(Ritalinabusehelp.com)

 

         Generic Name                               Brand/Trade Name                       Street Names

 Dextroamphetamine

Adderall

Beans; Black beauties, Dexies, Pep pills; Speed; Uppers

Methylphenidate

                Ritalin; Concerta Kibbles and bits; kiddy cocaine; Diet Coke; R Pop; Uppers

Methamphetamine Hydrochloride

Desoxyn

Speed, Meth, Chalk, Ice, Crystal, Crank

The body responds to amphetamines, such as Adderall, Dexedrine, and Concerta also known as Ritalin, as respiratory and cerebral stimulants. Adderall and Ritalin are prescribed by doctors mostly for Attention Deficit Hyperactivity Disorder (ADHD). When abused, amphetamines enhance the euphoric effects.

Desozyn is one example of a Methamphetamine approved by the FDA. When other treatments have failed it may be prescribed for the treatment of ADHD and exogenous obesity. (teens.drugabuse.gov); National Institute on Drug Abuse; www.drugabuse.gov)

 

References for prescription drugs:

www.prescription-drug-abuse.net/; Opiates.com;  http://prescription-drug-abuse.com;

Addictionsearch.com;  http://www.nlm.nih.gov/medlineplus/druginfo/meds

Drug Enforcement Administration (DEA); Drugfree.org; Medicine.net; fda.gov

 

 

Information

Prescription Drug Abuse and Addiction (PDF File – Feel free to reprint)
This file, part of the National Institute of Drug Abuse’s Research Report Series, discusses prescription abuse, types of prescription drugs commonly abused, short and long-term effects of prescription drug abuse, treatment, and more.

Prescription Drug Abuse
Overview of prescription drug abuse research and information from the National Institutes of Health.

National Coalition Against Prescription Drug Abuse
The National Coalition Against Prescription Drug Abuse (NCAPDA) was established to help reduce the number of deaths and addictions caused by prescription drug abuse, through the implementation of a nationwide awareness campaign, the initiation and support of pertinent legislative action and through partnerships with educational, medical, law enforcement and other appropriate entities.

Articles

Prescription Nation (Kelley, Raina, Newsweek, 08/06/10)
Why we should worry about the quiet epidemic of painkiller abuse.

Non-Medical Prescription Drug Use More Common Among Rural Teens Than City Dwellers (ScienceDaily, 11/02/10)
Rural teens appear more likely than their urban peers to use prescription drugs for non-medical purposes, according to a report posted online that will appear in the March 2011 print issue of Archives of Pediatrics & Adolescent Medicine.

Dramatic Rise In Painkiller Drug Abuse (Ashburn, Emma, Reuters, 07/15/10)
U.S. officials reported a 400 percent increase over 10 years in the proportion of Americans treated for prescription painkiller abuse and said the problem cut across age groups, geography and income.

Videos

Eye To Eye With Katie Couric: Rx Drug Abuse (CBS News)
In the war on drugs the abuse of prescription medication among teens is up. Steve Pasierb of Partnership for a Drug-Free America has more on what parents can do to prevent drug use.

Teen Prescription Drug Addiction
Calif. Rep. Mary Bono Mack talks to Maggie Rodriguez about her son’s plea for help with prescription drug addiction.