What Is Prescription Drug Addiction

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KEY TAKEAWAYS

Prescription drug addiction is:

The continued use of prescription medication without a medical requirement, or the medical requirement has ceased
Misuse of prescription medication due to tolerance, with a desire to achieve effects beyond the intended use
Occurs when prescription drugs are used for emotional stability, even when the original symptoms no longer exist

What Is Prescription Drug Addiction?

Addiction to prescription medication:

Occurs when a higher volume of medication is taken at one time or the dosing frequency increases to achieve the same effects
Occurs when a medication is being used beyond its original intent, or there is no prescription or medical reason
Unlike heroin addiction, it typically begins with legal use, followed by misuse
Is less noticeable than heroin addiction due to no injection paraphernalia, and being able to justify its use serves a medical purpose
Progresses to renewing prescriptions prematurely or changing healthcare providers to access medication, with or without a medical need
Consistent seeking of alternative prescriptions from medical professionals when requests are rejected
Asking known users with a legitimate prescription to obtain drugs or use the black market despite the risks

What Types Of Prescription Drugs Are Misused?

Prescription Drug	Why Addiction Develops
Oxycodone	Binds to mu receptors, causing a dopamine rush Habituation to mu receptors requires more to experience pain relief/euphoria
Diazepam	GABA receptors become habituated, needing more to experience relaxation
Methylphenidate	Dopamine and norepinephrine receptors become habituated
Phenobarbital	GABA receptors become habituated Psychologically addictive to sedative effects
Zolpidem	Habituation to GABA-A receptors
Gabapentin	Voltage-gated calcium channels become habituated More gabapentin is required to modulate glutamate
Carisoprodol	Carisoprodol metabolises into meprobamate, binding to GABA-A GABA-A receptors become habituated

Prescription Drug	Why Addiction Is Maintained
Oxycodone	Oxycodone cravings Users become addicted to the numbing effects when used for pain relief
Diazepam	Self-medicate anxiety or depression Avoid re-bound anxiety Withdrawal seizures encourage use
Methylphenidate	Conditions users to believe productivity cannot be achieved without it Cravings for methylphenidate Self-medicate ADHD
Phenobarbital	To avoid benzodiazepine withdrawal seizures
Zolpidem	Self-medicate insomnia Continued to prevent rebound insomnia
Gabapentin	Sedative effects become psychologically addictive
Carisoprodol	More Carisoprodol is needed to regulate stress Self-medicate depression and anxiety

Physical Indicators Of Prescription Drug Addiction

Although the following physical indicators may present in prescription drug addiction, exact symptoms may differ depending on the user and the prescription drug being misused.

Constipation

Constipation is reported in 40% of prescription narcotics users with nonmalignant pain and is caused by inhibition of gastrointestinal peristalsis [1].

Constipation in hydrocodone users occurs 39% more than in oxycodone users due to its binding affinity to mu receptors in the gastrointestinal tract [2].

Muscle Weakness And Impaired Motor Coordination

Impaired motor coordination and muscle weakness in benzodiazepine addiction are caused by GABAergic activation that inhibits motor function and control.

Imbalanced posture occurs in anxiolytic addiction due to inhibitions of spinal cord reflexes and reduced muscle tone.

Unsteadiness and imbalance occur in benzodiazepine addiction because this drug binds to (−)PK 14067 and (+)PK 14068, inhibiting CaCl₂muscular contractions and movement [3].

Convulsions are a physical indicator of dextroamphetamine abuse and occur from 2 hours to 37 hours after use, causing first-time convulsions in 4% [4] [5].

(Read about amphetamine rehab here.)

Fatigue, Reduced Libido, And Mood Changes

Low libido and fatigue occur in prescription narcotics addiction, resulting in 57% of male users experiencing hypogonadism [6].

Low energy and inability to focus are indicators of narcotics addiction, caused by inhibition of the hypothalamic-pituitary-adrenal (HPA) axis and release of corticotropin-releasing hormone (CRH) [7].

Heart Palpitations And Arrythmias

Case studies indicate that anxiolytic addiction causes Takotsubo cardiomyopathy, resulting in heart palpitations, shortness of breath and chest pain [8].

Case studies indicate that prescription amphetamine abuse causes ~84% lowered left ventricular output, resulting in shortness of breath and chest pain [9].

Ventricular tachycardia occurs in users taking Adderall with underlying heart complications caused by an influx of norepinephrine that speeds up heart rate > 100 bpm [10].

The ejection fraction of the heart in Adderall users decreases to <30% compared to a healthy level (50-70%), resulting in an irregular heartbeat and shortness of breath [11].

Psychological Indicators Of Prescription Drug Addiction

Learning And Memory Impairments

Forgetting recent events is a psychological indicator of anxiolytic addiction and is caused by impaired formation of new memories in the hippocampus [12].

Poor executive functioning and learning are psychological indicators of sedative use disorder caused by a 25.5-47.8% decrease in P300 amplitudes [13].

Justifying Health Symptoms

Obsessively justifying anxiety despite ongoing use of anxiolytics is a psychological indicator of addiction because it indicates the drug is necessary for coping despite its effects on mental health.

Justifying drowsiness is a psychological indicator of oxycodone addiction as it validates continued use without confronting dependency or seeking professional help.

Users addicted to sedatives may discount alternative SSRIs for anxiety and claim that anxiolytics are the only medication that works despite it losing effectiveness over time.

Attentional deficits are justified when users are physically and psychologically dependent, as users convince themselves that medication alleviates symptoms, not adds to them.

Viewing medical diagnoses as part of personal identity indicates psychological addiction due to the ongoing attachment to the diagnosis, reinforcing the perceived need for medication.

How Does Prescription Drug Addiction Develop?

	User A - Prescribed drugs and becomes addicted	User B - Prescribed drugs, becomes addicted and then uses the substance illicitly alongside prescribed use
Prescribed Or Illicit?	Prescribed	Prescribed and illicit
Pattern Of Use	Doses increase over time due to tolerance	Begins with a regular prescription drug dose Doses increase over time Hoarding and bingeing Illegally obtaining the drug
Substances Used	Prescription drug only	Prescription drug only
Treatment Approach	Gradual tapering Changing medication type Cognitive behavioural therapy	Gradual tapering Inpatient rehabilitation for severe addiction Changing medication
Hiding Or Lying About Drug Use?	Can go unnoticed	Yes

	User C - uses prescribed drugs to augment primary illicit drug use (e.g oxycodone alongside heroin)
Prescribed Or Illicit?	Prescribed and illicit
Pattern Of Use	Begins with using both prescribed and illicit substances Cycle substances to enhance effects
Substances Used	Prescription drug + other illicit substances
Treatment Approach	Dual-dependency rehabilitation Medication + cognitive behavioural therapy
Hiding Or Lying About Drug Use?	Yes

What Changes Prescription Drug Addiction?

Location

In the US, Adderall is the 14th most prescribed drug, whereas, in the UK, this substance is not legally distributed in medical care regardless of diagnosis or foreign prescription [14].

3.3% more Americans misuse prescription anxiolytics than in the UK due to consumer pharmaceutical advertisements driving demand for use and subsequent addiction [15].

Access to prescription anxiolytics and narcotics in the UK is more controlled compared to the US, as the NHS only allows GPs, consultants and nurse prescribers to prescribe medication.

US healthcare privatisation drives users to seek illegal variants due to the financial costs of prescriptions, leading to misuse and dependence.

Reformulation To Prevent Misuse

The introduction of Oxycontin reduced recreational use and dependence by 19% because it cannot be crushed and turns into a gel when tampered with [16].

38% of users report transitioning to using heroin concurrently with oxycontin to chase euphoria - prescribed medication is therefore assessed on an individual risk basis [17].

Post- Operative Drug Use

50-85% of post-operative amputation pain transitions to chronic pain, therefore increasing the timeframe for opioid dependence to develop [18].

20% of post-surgery patients report sharing prescription medication with others, resulting in a potential for dependence in those without a prescription [19].

4% of bariatric surgery patients become addicted to opioids in the year following surgery, indicating this population is vulnerable to developing opioid dependence [20].

Why Is Prescribed Drug Use Increasing?

Prescription drug usage is increasing because:

1/3 of the UK's population is affected every year by chronic pain, requiring prescription medication [21]
In the last 40 years, there has been a 52% increase in those aged 65+ ageing population requiring pain management for age-related diseases [22]
There is a lack of awareness surrounding the addictive capability of prescribed medication; notably, 29% of Americans do not believe these medications are addictive [23]
There has been a two-fold increase in the number of attentional deficit diagnoses, thus increasing the demand and availability of stimulant medications [24].

The NHS invested £50 million to combat prescription medication dependence, resulting in an 8% reduction in opiate prescriptions nationally and is estimated to have prevented over 2100 hospitalisations [24].

References

[1] DePriest, Anne Z., and Katie Miller. “Oxycodone/Naloxone: Role in Chronic Pain Management, Opioid-Induced Constipation, and Abuse Deterrence.” Pain and Therapy, vol. 3, no. 1, May 2014, pp. 1–15. “Constipation is the most commonly reported adverse effect of ... of patients with nonmalignant pain and 70–95% of patients with cancer pain.”
[2] Marco, C. A. “Comparison of Oxycodone and Hydrocodone for the Treatment of Acute Pain Associated with Fractures: A Double-Blind, Randomized, Controlled Trial.” Academic Emergency Medicine, vol. 12, no. 4, Apr. 2005, pp. 282–88. “There was no difference between the groups in nausea, vomiting... 21%, difference in proportions 21%, 95% CI = 3% to 39% more with hydrocodone).”
[3] French, John F., et al. “Possible Mechanism of Benzodiazepine-Induced Relaxation Of... : Journal of Cardiovascular Pharmacology.” LWW, 2024. Accessed 9 Dec. 2024. “Further investigation of the mechanism of ben-zodiazepine-induced relaxation showed that (−)PK 14067 and (+)PK 14068 inhibited CaCl2-induced contractions.”
[4] Brown, J. William L., et al. “Amphetamine-Associated Seizures: Clinical Features and Prognosis.” Epilepsia, Jan. 2011, p. no-no. “occurred within 2 h of ingestion in 7 patients (16%) and between 2 and 24h in 37 patients (84%).”
[5] Brown, J. William L., et al. “Amphetamine-Associated Seizures: Clinical Features and Prognosis.” Epilepsia, Jan. 2011, p. no-no. “Forty-four of 1,019 patients (4%) with first-ever...identified between 2000 and 2007 had AAS (median age 22 years, range 15–41).”
[6] Wehbeh, Leen, and Adrian S. Dobs. “Opioids and the Hypothalamic-Pituitary-Gonadal (HPG) Axis.” The Journal of Clinical Endocrinology & Metabolism, vol. 105, no. 9, Aug. 2020, pp. e3105–13. Accessed 1 Apr. 2021. “more likely to cause hypogonadism compared with short-acting opioids (57% vs 35%, P < 0.001; OR 3.39; 95% CI, 2.39,4.77).”
[7] Fountas, Athanasios, et al. “Opioid-Induced Endocrinopathies.” The Lancet Diabetes & Endocrinology, vol. 8, no. 1, Jan. 2020, pp. 68–80. Accessed 21 Feb. 2021. “Hypogonadism is the most well recognised consequence of ... use, but the inhibitory effects...their negative effects on bone health also require attention.”
[8] Edinoff, Amber N., et al. “Benzodiazepines: Uses, Dangers, and Clinical Considerations.” Neurology International, vol. 13, no. 4, 2021, pp. 594–607. “Several case reports have also linked tapering of different BZD with Takotsubo cardiomyopathy ...in a 63-year-old Caucasian female which resolved after the previous dosage was restarted.”
[9] Al-Juhani, Abdulkreem, et al. “Amphetamine-Dextroamphetamine-Induced Cardiomyopathy: A Case Report on Heart Failure in a Young Addict.” Cureus, Oct. 2024. Accessed 28 Oct. 2024. “Table 1.”
[10] Mohamed Riad Abouzid. “Amphetamine-Associated Ventricular Tachycardia Leading to Out-of-Hospital Cardiac Arrest in a Patient with ADHD: A Case Report.” Medical Reports, vol. 3, Elsevier BV, Feb. 2024, pp. 100031–31. Accessed 6 June 2024. “Amphetamines, widely recognized for their sympathomimetic properties...increasing the release of norepinephrine and dopamine, they lead to heightened sympathetic activity, resulting in increased heart rate, blood pressure.”
[11] Mohamed Riad Abouzid. “Amphetamine-Associated Ventricular Tachycardia Leading to Out-of-Hospital Cardiac Arrest in a Patient with ADHD: A Case Report.” Medical Reports, vol. 3, Elsevier BV, Feb. 2024, pp. 100031–31. Accessed 6 June 2024. “A left heart catheterization (LHC) was performed, which revealed severe left ventricular systolic dysfunction with an ejection fraction (EF) <30%.”
[12] Venault, Patrice, et al. “Benzodiazepine Impairs and β-Carboline Enhances Performance in Learning and Memory Tasks.” Nature, vol. 321, no. 6073, June 1986, pp. 864–66. Accessed 25 May 2021. “However, they are also known to induce a strong anterograde amnesia in patients.”
[13] Castelnovo, Anna, et al. “Electrophysiological and Neuropsychological Indices of Cognitive Dysfunction in Patients with Chronic Insomnia and Severe... Use Disorder.” Brain Sciences, vol. 13, no. 3, Feb. 2023, p. 375. Accessed 17 Aug. 2023. “Table 2.”
[14] ClinCalc. Dextroamphetamine; Dextroamphetamine Saccharate; Amphetamine; Amphetamine Aspartate - Drug Usage Statistics, ClinCalc DrugStats Database. “Dextroamphetamine; Dextroamphetamine Saccharate; Amphetamine; Amphetamine Aspartate Summary for 2022.”
[15] “In the United States of Adderall.” Psychology Today, 29 Apr. 2023. “Sixteen million adults (6.6 percent of American adults) had tried a prescription stimulant. Five million had obtained the medication illegally (1.9 percent).”
[16] Cicero, Theodore J., and Matthew S. Ellis. “Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States.” JAMA Psychiatry, vol. 72, no. 5, May 2015, p. 424. “Approximately 45% of those entering treatment in 2009 and 2010 indicated that they had used OxyContin for ...in July to December 2012; χ2 = 230.83; P < .001).”
[17] Cicero, Theodore J., and Matthew S. Ellis. “Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States.” JAMA Psychiatry, vol. 72, no. 5, May 2015, p. 424. “Although 10 of the 26 RAPID participants (38%) indicated that the transition to heroin...alternative because it was more readily available and cheaper”
[18] Neil, Michael JE, and William A. Macrae. “Post Surgical Pain- the Transition from Acute to Chronic Pain.” Reviews in Pain, vol. 3, no. 2, Oct. 2009, pp. 6–9. “the incidence of chronic pain varies between ... 50–85% for amputation.”
[19] Nsuworks, Nsuworks, and Kelie Nicholson Vélez. Addiction after Taking Pain Relief Medicine for Post-Surgery Addiction after Taking Pain Relief Medicine for Post-Surgery. 2020. “One in five people...medication reported having shared the medication with friends to help them to manage pain.”
[20] Raebel, Marsha A., et al. “Chronic Opioid Use Emerging after Bariatric Surgery.” Pharmacoepidemiology and Drug Safety, vol. 23, no. 12, Apr. 2014, pp. 1247–57. Accessed 9 July 2022. “Overall, 4.0% (n = 421) of patients became chronic...users the post-surgery year.”
[21] NICE. “Chronic Pain: How Common Is It?” NICE, Apr. 2021. “Between one-third and one-half of the UK population (just under 28 million adults) are affected by chronic pain.”
[22] Centre for Ageing Better. Our Ageing Population | the State of Ageing 2023-24. 2023. “In the last 40 years, the number of people aged 50 and over has increased by over 6.8 million (a 47% increase), and the number aged 65 and over has increased by over 3.5 million (a 52% increase).”
[23] McCarthy, Michael. “Prescription Drug Abuse up Sharply in the USA.” The Lancet, vol. 369, no. 9572, May 2007, pp. 1505–6. “29% believed prescription pain relievers were not addictive.”
[24] Davidovitch, Michael, et al. “Challenges in Defining the Rates of ADHD Diagnosis and Treatment: Trends over the Last Decade.” BMC Pediatrics, vol. 17, no. 1, Dec. 2017. “The prevalence of ... diagnoses rose twofold from 6.8% to 14.4% between 2005 and 2014 (p < 0.001).”

About the author

Philippa Scammell

Philippa Scammell MSci holds an integrated Master's degree in Psychology
from the University of York and has completed undergraduate statistical studies at Harvard University. Philippa has substantial experience in inpatient psychiatric care (Foss Park Hospital York), Research in Psychology at University of York, and group therapy facilitation (Kyra Women's Project). Philippa writes on clinical psychology and addiction recovery. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: January 9, 2026