Prescription drugs are rapidly becoming primary drugs of abuse in the United States and throughout the world. There are many commonly held misconceptions of the abuse potential for powerful substances such as oxycontin, because such substances can be obtained legally, and have legitimate use in the medical profession.

Glossary

Addiction: A chronic, relapsing disease, characterized by compulsive drug seeking and use and by neurochemical and molecular changes in the brain.

Barbiturate: A type of central nervous system (CNS) depressant often prescribed to promote sleep.

Benzodiazepine: A type of CNS depressant prescribed to relieve anxiety; among the most widely prescribed medications, including Valium and Librium.

Buprenorphine: A new medication awaiting FDA approval for treatment of opioid addiction. It blocks the effects of opioids on the brain.

Central nervous system (CNS): The brain and spinal cord.

CNS depressants: A class of drugs that slow CNS function, some of which are used to treat anxiety and sleeping disorders; includes barbiturates and benzodiazepines.

Detoxification: A process that allows the body to rid itself of a drug while at the same time managing the individual's symptoms of withdrawal; often the first step in a drug treatment program.

Dopamine: A neurotransmitter present in regions of the brain that regulate movement, emotion, motivation, and feelings of pleasure.

LAAM (levo-alpha-acetyl-methadol): An approved medication for the treatment of opioid addiction, taken 3 to 4 times a week.

Methadone: A long-acting synthetic medication that is effective in treating opioid addiction.

Narcolepsy: A disorder characterized by uncontrollable episodes of deep sleep.

Norepinephrine: A neurotransmitter present in some areas of the brain and the adrenal glands; decreases smooth muscle contraction and increases heart rate; often released in response to low blood pressure or stress.

Opioids: Controlled drugs or narcotics most often prescribed for the management of pain; natural or synthetic chemicals based on opium's active component - morphine - that work by mimicking the actions of pain-relieving chemicals produced in the body.

Opiophobia: A health care provider's unfounded fear that patients will become physically dependent upon or addicted to opioids even when using them appropriately; can lead to the underprescribing of opioids for pain management.

Physical dependence: An adaptive physiological state that can occur with regular drug use and results in withdrawal when drug use is discontinued.

Polydrug abuse: The abuse of two or more drugs at the same time, such as CNS depressant abuse accompanied by abuse of alcohol.

Prescription drug abuse: The intentional misuse of a medication outside of the normally accepted standards of its use.

Prescription drug misuse: Taking a medication in a manner other than that prescribed or for a different condition than that for which the medication is prescribed.

Psychotherapeutics: Drugs that have an effect on the function of the brain and that often are used to treat psychiatric disorders; can include opioids, CNS depressants, and stimulants.

Respiratory depression: Depression of respiration (breathing) that results in the reduced availability of oxygen to vital organs.

Stimulants: Drugs that enhance the activity of the brain and lead to increased heart rate, blood pressure, and respiration; used to treat only a few disorders, such as narcolepsy and attention-deficit hyperactivity disorder.

Tolerance: A condition in which higher doses of a drug are required to produce the same effect as experienced initially.

Tranquilizers: Drugs prescribed to promote sleep or reduce anxiety; this National Household Survey on Drug Abuse classification includes benzodiazepines, barbiturates, and other types of CNS depressants.

Withdrawal: A variety of symptoms that occur after chronic use of some drugs is reduced or stopped.

References

American Psychiatric Association. Benzodiazepine Dependence, Toxicity, and Abuse: A Task Force Report of the American Psychiatric Association. Washington, DC: American Psychiatric Association, 1990.

Center for Substance Abuse Treatment (CSAT). Detoxification from Alcohol and Other Drugs, Treatment Improvement Protocol (TIP) #19. Department of Health and Human Services (DHHS) Pub. No. BKD172. Substance Abuse and Mental Health Services Administration (SAMHSA),1995.

CSAT. Substance Abuse Among Older Adults, TIP #26. DHHS Pub. No. BKD250. SAMHSA, 1997.

CSAT. Substance Abuse Among Older Adults (TIP #26): Physicians Guide. DHHS Pub. No. (SMA) 00-3394. SAMHSA, 2000.

Hardman, J.G.; Limbird, L.E.; Molinoff, P.B.; Ruddon, R.W.; and Gilman, A.G., eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics 9th Ed. New York: McGraw-Hill, 1996.

Isaacson, J.H. Preventing Prescription Drug Abuse. Cleveland Clinic Journal of Medicine 67(7): 473-475, 2000.

Johnston, L.D.; O'Malley, P.M.; and Bachman, J.G. Monitoring the Future: National Survey Results on Drug Use, 1975-1999, 2 Vols. NIH Pub. No. 00-4803. National Institute on Drug Abuse (NIDA), NIH, DHHS, 2000.

Joransson, D.E.; Ryan, K.M.; Gilson, A.M.; and Dahl, J.L. Trends in medical use and abuse of opioid analgesics. Journal of the American Medical Association 283(13):1710-1714, 2000.

Longo, L.P., and Johnson, B. Addiction: Part I. Benzodiazepines-side effects, abuse risk, and alternatives. American Family Physician 61:2121-2131, 2000.

Longo, L.P.; Parran, T.; Johnson, B.; and Kinsey, W. Addiction: Part II. Identification and management of the drug-seeking patient. American Family Physician 61:2401-2408, 2000.

National Center on Addiction and Substance Abuse at Columbia University (CASA). Missed Opportunity: National Survey of Primary Care Physicians and Patients on Substance Abuse. New York: CASA, 2000.

NIDA. NIDA Infofax #13553, Pain Medications, 1999.

NIDA. Principles of Drug Addiction Treatment: A Research-Based Guide. NIH Pub. No. 99-4180. NIDA, NIH, DHHS, 1999.

NIDA NOTES. Research eases concerns about use of opioids to relieve pain, NIDA NOTES 15(1):12-13, 2000.

Office of Applied Studies. Substance Use Among Women in the United States. DHHS Pub. No. (SMA) 97-3162. SAMHSA, 1997.

Office of Applied Studies. Summary of Findings from the National Household Survey on Drug Abuse. DHHS Pub. No. (SMA) 00-3466. SAMHSA, 2000.

Office of Applied Studies. Year-End 1999 Emergency Department Data from the Drug Abuse Warning Network. DHHS Pub. No.(SMA) 00-3462. SAMHSA, 2000.

Patterson, T.L., and Jeste, D.V. The potential impact of the baby-boom generation on substance abuse among elderly persons. Psychiatric Services 50:1184-1188, 1999.

Phillips, D.M. JCAHO pain management standards are unveiled. Journal of the American Medical Association 284(4):428-429, 2000.

Simoni-Wastila, L. The use of abusable prescription drugs: The role of gender. Journal of Women's Health and Gender-based Medicine 9(3):289-297, 2000.

Snyder, S.H. Drugs and the Brain. New York: Scientific American Library, 1996.

Wilford, B.B; Finch, J.; Czechowicz, D.J.; and Warren D. An overview of prescription drug misuse and abuse: Defining the problem and seeking solutions. Journal of Law, Medicine & Ethics 22(3):197-203, 1994.