Angie overheard her parents talking about how her brother's ADHD medicine was making him less hungry. Because Angie was worried about her weight, she started sneaking one of her brother's pills every few days.

Todd found an old bottle of painkillers that had been left over from his dad's operation. He decided to try them. Because a doctor had prescribed the pills, Todd figured that meant they'd be OK to try.

Both Todd and Angie are taking risks. Prescription painkillers and other medications help lots of people live more productive lives, freeing them from the symptoms of medical conditions like depression or attention deficit hyperactivity disorder (ADHD). But that's only when they're prescribed for a particular individual to treat a specific condition.

Taking prescription drugs in a way that hasn't been recommended by a doctor can be more dangerous than people think. In fact, it's drug abuse. And it's just as illegal as taking street drugs.

Why Do Some People Abuse Prescription Drugs?

Some people experiment with prescription drugs because they think they will help them have more fun, lose weight, fit in, and even study more effectively. Prescription drugs can be easier to get than street drugs: Family members or friends may have them. But prescription drugs are also sometimes sold on the street like other illegal drugs.

A 2009 survey from the Centers for Disease Control and Prevention shows that prescription drug abuse is on the rise, with 20% of teens saying they have taken a prescription drug without a doctor's prescription.

Why? Some people think that prescription drugs are safer and less addictive than street drugs. After all, these are drugs that moms, dads, and even kid brothers and sisters use. To Angie, taking her brother's ADHD medicine felt like a good way to keep her appetite in check. She'd heard how bad diet pills can be, and she wrongly thought that the ADHD drugs would be safer.

But prescription drugs are only safe for the individuals who actually have prescriptions for them. That's because a doctor has examined these people and prescribed the right dose of medication for a specific medical condition. The doctor has also told them exactly how they should take the medicine, including things to avoid while taking the drug — such as drinking alcohol, smoking, or taking other medications. They also are aware of potentially dangerous side effects and can monitor patients closely for these.

Other people who try prescription drugs are like Todd. They think they're not doing anything illegal because these drugs are prescribed by doctors. But taking drugs without a prescription — or sharing a prescription drug with friends — is actually breaking the law.

Which Drugs Are Abused?

The most commonly used prescription drugs fall into three classes:

1. Opioids

• Examples: oxycodone (OxyContin), hydrocodone (Vicodin), and meperidine (Demerol)
• Medical uses: Opioids are used to treat pain or relieve coughs or diarrhea.
• How they work: Opioids attach to opioid receptors in the central nervous system (the brain and the spinal cord), preventing the brain from receiving pain messages.

2. Central Nervous System (CNS) Depressants

• Examples: pentobarbital sodium (Nembutal), diazepam (Valium), and alprazolam (Xanax)
• Medical uses: CNS depressants are used to treat anxiety, tension, panic attacks, and sleep disorders.
• How they work: CNS depressants slow down brain activity by increasing the activity of a neurotransmitter called GABA. The result is a drowsy or calming effect.

3. Stimulants

• Examples: methylphenidate (Ritalin) and amphetamine/dextroamphetamine (Adderall)
• Medical uses: Stimulants can be used to treat narcolepsy and ADHD.
• How they work: Stimulants increase brain activity, resulting in greater alertness, attention, and energy.

Over-the-Counter Drugs

Some people mistakenly think that prescription drugs are more powerful because you need a prescription for them. But it's possible to abuse or become addicted to over-the-counter (OTC) medications, too.

For example, dextromethorphan (DXM) is found in some OTC cough medicines. When someone takes the number of teaspoons or tablets that are recommended, everything is fine. But high doses can cause problems with the senses (especially vision and hearing) and can lead to confusion, stomach pain, numbness, and even hallucinations.

What Are the Dangers of Abusing Medications?

Whether they're using street drugs or medications, drug abusers often have trouble at school, at home, with friends, or with the law. The likelihood that someone will commit a crime, be a victim of a crime, or have an accident is higher when that person is abusing drugs — no matter whether those drugs are medications or street drugs.

Like all drug abuse, using prescription drugs for the wrong reasons has serious risks for a person's health. Opioid abuse can lead to vomiting, mood changes, decrease in ability to think (cognitive function), and even decreased respiratory function, coma, or death. This risk is higher when prescription drugs like opioids are taken with other substances like alcohol, antihistamines, and CNS depressants.

CNS depressants have risks, too. Abruptly stopping or reducing them too quickly can lead to seizures. Taking CNS depressants with other medications, such as prescription painkillers, some over-the-counter cold and allergy medications, or alcohol can slow a person's heartbeat and breathing — and even kill.

Abusing stimulants (like some ADHD drugs) may cause heart failure or seizures. These risks are increased when stimulants are mixed with other medicines — even OTC ones like certain cold medicines. Taking too much of a stimulant can lead a person to develop a dangerously high body temperature or an irregular heartbeat. Taking several high doses over a short period of time may make a drug abuser aggressive or paranoid. Although stimulant abuse might not lead to physical dependence and withdrawal, the feelings these drugs give people can cause them to use the drugs more and more often so they become a habit that's hard to break.

The dangers of prescription drug abuse can be made even worse if people take drugs in a way they weren't intended to be used. Ritalin may seem harmless because it's prescribed even for little kids with ADHD. But when a person takes it either unnecessarily or in a way it wasn’t intended to be used such as snorting or injection, Ritalin toxicity can be serious. And because there can be many variations of the same medication, the dose of medication and how long it stays in the body can vary. The person who doesn't have a prescription might not really know which one he or she has.

Probably the most common result of prescription drug abuse is addiction. People who abuse medications can become addicted just as easily as if they were taking street drugs. The reason many drugs have to be prescribed by a doctor is because some of them are quite addictive. That's one of the reasons most doctors won't usually renew a prescription unless they see the patient — they want to examine the patient to make sure he or she isn't getting addicted.

How Do I Know if I'm Addicted?

Many different signs can point to drug addiction. The most obvious is feeling the need to have a particular drug or substance. Changes in mood, weight, or interests are other signs of drug addiction.

If you think you — or a friend — may be addicted to prescription drugs, talk to your doctor, school counselor, or nurse. They can help you get the help you need. It's especially important for someone who is going through withdrawal from a CNS depressant to speak with a doctor or seek medical treatment. Withdrawal can be dangerous when it's not monitored.

If someone has become addicted to prescription drugs, there are several kinds of treatment, depending on individual needs and the type of drug used. The two main categories of drug addiction treatment are behavioral and pharmacological.

Behavioral treatments teach people how to function without drugs — handling cravings, avoiding drugs and situations that could lead to drug use, and preventing and handling relapses. Pharmacological treatments involve giving patients a special type of medication to help them overcome withdrawal symptoms and drug cravings.

Tips for Taking Prescription Medication

What if a doctor prescribed a medication for you and you're worried about becoming addicted? If you're taking the medicine the way your doctor told you to, you can relax: Doctors know how much medication to prescribe so that it's just enough for you. In the correct amount, the drug will relieve your symptoms without making you addicted.

If a doctor prescribes a pain medication, stimulant, or CNS depressant, follow the directions exactly. Here are some other ways to protect yourself:

• Keep all doctor's appointments. Your doctor will want you to visit often so he or she can monitor how well the medication is working for you and adjust the dose or change the medication as needed. Some medications must be stopped or changed after a while so that the person doesn't become addicted.
• Make a note of the effects the drug has on your body and emotions, especially in the first few days as your body gets used to it. Tell your doctor about these.
• Keep any information your pharmacist gives you about any drugs or activities you should steer clear of while taking your prescription. Reread it often to remind yourself of what you should avoid. If the information is too long or complicated, ask a parent or your pharmacist to give you the highlights.
• Don't increase or decrease the dose of your medication without checking with your doctor's office first — no matter how you're feeling.

Finally, never use someone else's prescription. And don't allow a friend to use yours. Not only are you putting your friend at risk, but you could suffer, too: Pharmacists won't refill a prescription if a medication has been used up before it should be. And if you're found giving medication to someone else, it's considered a crime and you could find yourself in court.

Reviewed by: Steven Dowshen, MD
Date reviewed: June 2010
Originally reviewed by: Michele Van Vranken, MD