Prescription drugs – when drug abuse is legal

Drug abuse is no longer limited to illegal drugs or hard drugs like heroine, tik or cocaine. One of the most dangerous and rising forms of drug abuse is legal, over-the-counter (OTC) medicines. From cough syrups and painkillers to sleep medicine and prescription tranquilisers; these socially accepted drugs are cheap, accessible and addictive – making them all the more dangerous.

How are they addictive?

Drug addiction is a complex disorder that is characterised by compulsive drug use. Every drug produces different physical effects, but the common result is that repeated use can alter the way the brain looks and functions.

When it comes to most prescription or OTC medicines, repeated abuse floods the system with dopamine, which gives the user that euphoric rush. Some experts believe the receptor cells in the brain actually change. So when someone with a predisposition to addiction uses these drugs repeatedly it causes the reward system to learn that drugs are essential to their survival and they should get it at any cost.

Dependence versus addiction

Many people can use recreational or prescription drugs without ever experiencing negative consequences or addiction. For many others, continuous use of these substances quickly leads to abuse and then addiction. It’s not always easy to tell when the line has been crossed, but some common behaviours indicating drug addiction include:

  • neglecting responsibilities to family and friends
  • performing poorly at work
  • losing interest in sex.

Dependency is much more commonplace. Anyone who takes prescription medicine for more than a few weeks will develop some physical dependence on the drug for the relief it brings, be it to pain or insomnia. Usually, people are on stable, generally lower doses of the medicine. If they do stop suddenly, they will probably have some mild withdrawal symptoms, which will go away once they have ‘detoxed’. If people seek out further reasons to take the drug, they may be developing an addiction. People that tend towards addiction usually abuse the drug with the intention of lessening their anxiety or getting high (escaping their feelings or reality). The pleasure of getting high and the fear of withdrawal instruct the brain to compulsively seek out the drug, at any cost, and to crave its continued use despite the negative consequences.

Some commonly abused prescription drugs

Barbiturates or sedatives: High doses can cause trouble breathing, especially if taken with alcohol.

Benzodiazepines: Another type of sedative that helps with anxiety, panic attacks and sleep problems.

Sleep medicines: Help people who suffer from insomnia but, when abused, addicts start to believe they need them to sleep.

Codeine and morphine: Painkillers, specifically opioids, are some of the most commonly abused OTC medicines. In small doses these drugs dull pain, but in large doses they can cause a euphoric high and some dangerous side effects like drowsiness, constipation and breathing problems.

These readily available OTC drugs are especially popular with teenagers:

Diet pills: Teenagers are prone to “going on diets” and will often try anything which claims to make them thinner or prettier. The abuse of diet pills often starts with teenagers just taking “a couple” to lose weight. In large doses, these pills can create a mild buzz and false “energy”, a feeling that can be addictive in itself. Continued misuse of diet pills can signal a serious eating disorder or lead to many physical side effects.

Amphetamines: Often used to help people with ADHD, some people (often teenagers) use amphetamines to increase energy and alertness, or to keep their weight down. High doses can cause a rise in body temperature, irregular heartbeat and sometimes cardiac arrest.

Dextromethorphan (DXM): Is a common ingredient in over-the-counter cold and cough medicines, which in large doses can cause a high, hallucinations, vomiting, rapid heart rate, and brain damage.

Pseudoephedrine: A decongestant in many non-prescription cold medicines that helps to clear up stuffy noses; it is also an ingredient in the illegal methamphetamine or “meth”.

Getting help for yourself or others

South Africa has many private drug rehabilitation centres around the country. Your first step is to educate yourself on the right questions to ask and to identify the route to follow. Here are some useful organisations and websites that offer free advice and information:

Narcotics Anonymous: or 083 900 69 62

How Discovery Health Medical Scheme covers drug and alcohol rehabilitation

There are various treatments that healthcare providers use to assist with alcohol and/or drug abuse. Rehabilitation for alcohol and/or drug abuse is aimed at rehabilitating a person dependent on alcohol and/or drugs to live a life free of substance abuse. Treatment for this condition can take place in-or-out of hospital. You have access to cover for 21 days in-hospital treatment or 15 days out-of-hospital treatment, subject to authorisation and meeting the Scheme’s clinical entry criteria.

This article contains opinions and facts and references to other information sources. You should always consult a registered healthcare professional for any personal advice.