As a result of a raging opioid epidemic, many people have become aware of the dangers of prescription painkillers like hydrocodone (Vicodin) and oxycodone (OxyContin). But there are several other medicines commonly found in the medicine cabinet that also pose a risk of addiction for your family and anyone else who might be shopping around in your medicine cabinet. Are any of these in your medicine cabinet?
Written by Dr. David Sack, M.D.
Benzodiazepines. These sedative-hypnotic drugs are typically prescribed for generalized anxiety disorder and panic disorder, as well as insomnia and epilepsy. Brand names include Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam) and Klonopin (clonazepam). They can be habit-forming with long-term use.
Hypnotic medicines. Also known as soporifics, these are used to treat sleeping problems such as insomnia. Brand names include Ambien (zolpidem), Sonata (zaleplon), Lunesta (eszopiclone), Rozerem (ramelteon) and Restoril (temazepam). These medicines can be habit-forming but they are not as addictive as benzodiazepines, which are also sometimes prescribed as a sleep aid.
Opiates. These narcotics are used for their analgesic effect (for pain), as well as for their sedative, tranquilizing and soporific properties. They change the way the nervous system experiences pain. Prescribed opiates are controlled substances that can be addictive and should be used as sparingly as possible. Research shows that prescription opiate abuse can lead to heroin use, as well as the street drug version of fentanyl, which has an extremely high incidence of overdose. These medications are known to cause respiratory distress when taken in high doses or when combined with certain other substances, especially alcohol. There are many varieties of prescription painkillers, including:
- Codeine, which is used for pain and to treat coughs
- Oxycodone (OxyContin) as well as the shorter acting forms like Percocet and Percodan
- Vicodin, Lortab and Lorcet which contain a mix of hydrocodone and the non-opioid pain reliever acetaminophen
- Demerol (meperidine) in pill form
- Fentanyl transdermal patches to relieve severe pain, which may be prescribed for people who cannot be treated with other medications
- Morphine, which is sometimes administered post-surgically and prescribed for cancer patients
- Methadone for chronic pain
- Musculoskeletal Conditions
- Muscle relaxants. These are prescribed for muscle spasms and acute musculoskeletal conditions such as severe back pain. They have sedative and relaxant properties that work on the central nervous system. They are meant for short-term use and are often recommended along with physical therapy. Brand names include Rodaxin (methocarbamol), Soma (carisoprodol), Flexeril (cyclobenzaprine) and Lorzone (chlorzoxazone).
- Gabapentin. This is a medication with sedating effects that is approved for seizures and shingles, as well as nerve pain. Historically it was thought to have low abuse potential, but recent research suggests more significant addiction risk. Combined with other drugs, such as marijuana, cocaine or amphetamines, it can be dangerous. Brand names include Neurontin, Gralise and Horizant.
- ADHD drugs. In recent years there has been a proliferation of prescriptions for attention deficit hyperactivity disorder (ADHD) medication for children and adults. While these medications can help people legitimately diagnosed with ADHD, they are also used by people to study and get an edge on the competition in the workplace much in the way steroids have been used in sports. Some people also use these drugs to get high, so the abuse potential is significant. These medicines are well-known by their brand names:
- Ritalin – Largely prescribed for children and young adults with attention deficits and behavioral issues, this medication is also known as methylphenidate. The challenge is many of the young people who are prescribed Ritalin don’t like the way it makes them feel so they’re unlikely to abuse it themselves but they end up selling it to young people who want the amphetamine-like high.
- Adderall – This is increasingly prescribed for adult ADHD and is also used for narcolepsy, which affects an estimated 1 in every 2,000 people in the U.S. Adderall is a stimulant that contains amphetamine and dextroamphetamine. It can improve attention, focus, and organization and listening skills. The problem is that people without ADHD obtain prescriptions or get them illegally, without recognizing that misuse can lead to addiction.
- Dextromethorphan. This is an ingredient in over-the-counter allergy or cold treatments or cough syrups. With street names like DXM, CCC, Triple C, Skittles, Robo and Poor Man’s PC, it is sometimes used in combination with pseudoephedrine. It’s a high school favorite because teens can find it in the family medicine cabinet or in a pharmacy.
- Antidepressants. Medications to treat depression have a low potential for abuse, but consumers should be aware of potentially dangerous drug interactions. For example, taking them with opiates, sedative-hypnotics, benzodiazepines or alcohol can be harmful. A number of antidepressants slow metabolism so if someone takes one of these other medicines it could significantly increase the risk of overdose. In addition, benzodiazepines can reduce the effects of antidepressants.
- How to Safeguard Your Medicine Cabinet
- Understand the dangers. Sometimes an individual drug is not the problem. The danger often lies in the amount taken or the combinations with other drugs. For example, many of the opioid overdoses we are seeing today are related to combining opioids with benzodiazepines. Take medication as prescribed by your doctor and ask questions to be sure you understand if you truly need it and how to take it safely.
- Take inventory. Look at the medicines you have on hand. Are they still needed? Studies show that most people keep unused medication lying around and about 20% share leftover pills with friends and family. If there is a potentially dangerous drug in your cabinet that has expired or you no longer need, dispose of it properly or find a drug disposal program in your community.
- Remove temptation. If there is someone in your household or that visits your home who may be at risk for medication misuse, lock potentially addictive medicines in a secure location.
- Doctors overprescribe potentially addictive medications, but patients play a part too. About half of people who abuse prescription painkillers get them from a friend or family member. Taking steps to safeguard your medicine cabinet can help ensure that you’re part of the solution to our nation’s prescription drug addiction epidemic