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Stimulants, Opioids and Benzodiazepines: The Most Commonly Misused Prescription Drugs

By Arnold I. Pallay, M.D., F.A.A.F.P., Vanguard Medical Group

I don’t always prescribe medication for my patients. But when I do, I spend considerable time to educate them on a drug’s benefits, side effects and contraindications. These are important considerations when taking any drug, and especially one that could be addictive if not used as prescribed. Additionally, these drugs can be addictive to a percentage of the population even if they are taken as prescribed. It is important to follow all instructions for taking a particular medication and to report any side effects to your doctor immediately.

According to the National Institute on Drug Abuse, “Increases in prescription drug misuse over the last 15 years are reflected in increased emergency room visits, overdose deaths associated with prescription drugs, and treatment admissions for prescription drug use disorders – the most severe form of which is an addiction.”

Education is key in stopping addiction before it starts. In this blog post, we take a closer look at three classes of commonly misused prescription drugs. Knowing their intended uses and contraindications is the first line of defense in staying healthy.

Prescription Stimulants

Examples: Adderall®, Dexedrine®, Ritalin®, Concerta®

Prescribed to treat: ADHD, treatment-resistant depression, obesity andneurological disorders

What it is: Stimulants increase energy, attention, alertness, and suppress sleep and appetite. That’s why they’re popular on college campuses, and often shared among friends, especially around exam time.

How it works: Stimulants enhance chemicals in the brain, such as norepinephrine and dopamine, which induce euphoria. They also increase blood sugar and constrict blood vessels.

Contraindications: Mixing stimulants and over-the-counter cold medications with decongestants could cause irregular heart rhythms and raise blood pressure to dangerous levels. Misuse of stimulants also may cause a high body temperature, heart attack or fatal seizure.

Prescription Opioids

Examples: OxyContin®, Percocet®, Vicodin®

Prescribed to treat: Pain following surgery or dental work, sports injuries and cancer

What it is: Opioids have historically been prescribed for moderate to severe pain relief, especially following surgery. They can cause euphoria when taken at high doses.

How it works: Opioids react with receptors on nerve cells in the spinal cord and the brain to inhibit the transmission of pain signals. They interact with the brain stem to slow down breathing. Opioids also affect the areas of the brain associated with emotion.

Contraindications: Opioids taken in conjunction with alcohol or antihistamines can cause life-threatening respiratory depression. Over the long term, opioids can induce heart and lung infections, muscle pain and pneumonia. Ironically, they also may cause increased sensitivity to pain.

Prescription Benzodiazepines

Examples: Valium®, Xanax®, Klonopin®, Librium®, Ativan®

Prescribed to treat: Anxiety, panic attacks, insomnia, seizures and neurological disorders

What it is: Benzodiazepines are central nervous system (CNS) depressants. They inhibit brain activity, creating a calming, drowsy effect. Benzodiazepines are among the most prescribed drugs in America, despite their addiction rates.

How it works: This drug increases gamma-aminobutyric acid (GABA), a tranquilizing chemical in the central nervous system. GABA blocks nerve impulses in the brain to create that calming effect.

Contraindications: Mixing benzodiazepines with alcohol or opioids can be fatal. This drug also comes with side effects that include memory loss (e.g. “blacking out”), depression and mood swings. Over time, the body builds up a tolerance for benzodiazepines and “needs” it to establish normalcy. Those who are addicted must seek professional help to wean away from the drugs. Stopping “cold turkey” could result in life-threatening seizures.


The Takeaway: Use Prescription Medication Responsibly

Prescription medication must be used responsibly. Misuse of such medication can result in serious, and potentially life-threatening, consequences.

  • Three common classes of misused prescription medication include stimulants, opioids and benzodiazepines. All three are highly addictive.
  • Just because a physician prescribed it, doesn’t mean that a medicine is safe to use long term.
  • Know the side effects and the long-term implications of any medicine that you take.
  • Never share your prescription medication with your friends.
  • There are alternatives to these addictive medications. Ask your doctor.


Blog author Arnold I. Pallay, M.D., F.A.A.F.P. is a board-certified family physician, and the Medical Director at the Montville and Lincoln Park, NJ divisions of Vanguard Medical Group primary care practice.


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Source: National Institute on Drug Abuse

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