Materiały źródłowe

• #1 Prescription drug abuse – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

  Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction. […] Prescription drug abuse is highest among teens and young adults. […] Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol. […] Abusing prescription drugs can cause a number of problems. Prescription drugs can be especially dangerous and even lead to death when taken in high doses, when combined with other prescription drugs or certain over-the-counter medicines, or when taken with alcohol or illegal or recreational drugs.

• #2 The Truth about Prescription Drug Abuse

  https://www.heraldopenaccess.us/openaccess/the-truth-about-prescription-drug-abuse

  Abuse of prescription medicines is defined as using them for purposes other than those for which they were intended or in a way that is not authorized by a medical expert. […] Prescription drug abuse can have detrimental effects on a person’s health and wellbeing. Addiction, overdosing, and even death may result from this. […] Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Prescription drug abuse can have several negative effects on the user’s health and well-being. […] The serious misuse of prescription drugs has also resulted in significant increases in health care costs. […] The negative consequences of abused prescription drugs are reflected in key indicators of opioid painkiller abuse that have risen over the years.

• #3 Prescription drug addiction – Wikipedia

  https://en.wikipedia.org/wiki/Prescription_drug_addiction

  Prescription drug addiction is the chronic, repeated use of a prescription drug in ways other than prescribed for, including using someone else’s prescription. […] The classes of medications most commonly abused are opioids, central nervous system (CNS) depressants and central nervous stimulants. […] Prescription drug addiction was recognized as a significant public health and law enforcement problem worldwide in the past decade due to its medical and social consequences. […] Changes in the pain management including more liberal opioids prescription for chronic pain conditions, prescription of higher doses and the development of more potent opioid drugs play an important role contributing to the current epidemic of prescription opioid addiction. […] Key pharmacological factors associated with drug addiction include: high frequency of drug use, high doses administered, rapid rate of onset of action, high drug potency.

• #4 Prescription drug abuse – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

  Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction. […] Prescription drug abuse is highest among teens and young adults. […] Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol. […] Abusing prescription drugs can cause a number of problems. Prescription drugs can be especially dangerous and even lead to death when taken in high doses, when combined with other prescription drugs or certain over-the-counter medicines, or when taken with alcohol or illegal or recreational drugs.

• #5 Prescription drug abuse – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

  Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction. […] Prescription drug abuse is highest among teens and young adults. […] Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol. […] Abusing prescription drugs can cause a number of problems. Prescription drugs can be especially dangerous and even lead to death when taken in high doses, when combined with other prescription drugs or certain over-the-counter medicines, or when taken with alcohol or illegal or recreational drugs.

• #6 Drugs, Brains, and Behavior: The Science of Addiction: Drugs and the Brain | NIDA

  https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

  Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter in the body. This allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brains own chemicals, they dont activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being sent through the network. […] Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals by interfering with transporters. This too amplifies or disrupts the normal communication between neurons. […] Some drugs like opioids also disrupt other parts of the brain, such as the brain stem, which controls basic functions critical to life, including heart rate, breathing, and sleeping. This interference explains why overdoses can cause depressed breathing and death.

• #7 Drugs, Brains, and Behavior: The Science of Addiction: Drugs and the Brain | NIDA

  https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

  Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter in the body. This allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brains own chemicals, they dont activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being sent through the network. […] Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals by interfering with transporters. This too amplifies or disrupts the normal communication between neurons. […] Some drugs like opioids also disrupt other parts of the brain, such as the brain stem, which controls basic functions critical to life, including heart rate, breathing, and sleeping. This interference explains why overdoses can cause depressed breathing and death.

• #8 Drugs, Brains, and Behavior: The Science of Addiction: Drugs and the Brain | NIDA

  https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

  Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter in the body. This allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brains own chemicals, they dont activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being sent through the network. […] Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals by interfering with transporters. This too amplifies or disrupts the normal communication between neurons. […] Some drugs like opioids also disrupt other parts of the brain, such as the brain stem, which controls basic functions critical to life, including heart rate, breathing, and sleeping. This interference explains why overdoses can cause depressed breathing and death.

• #9 How an Addicted Brain Works > News > Yale Medicine

  https://www.yalemedicine.org/news/how-an-addicted-brain-works

  Addiction is now understood to be a brain disease. […] When a person develops an addiction to a substance, its because the brain has started to change. This happens because addictive substances trigger an outsized response when they reach the brain. Instead of a simple, pleasurable surge of dopamine, many drugs of abusesuch as opioids, cocaine, or nicotinecause dopamine to flood the reward pathway, 10 times more than a natural reward. […] The brain remembers this surge and associates it with the addictive substance. However, with chronic use of the substance, over time the brains circuits adapt and become less sensitive to dopamine. Achieving that pleasurable sensation becomes increasingly important, but at the same time, you build tolerance and need more and more of that substance to generate the level of high you crave.

• #10 How an Addicted Brain Works > News > Yale Medicine

  https://www.yalemedicine.org/news/how-an-addicted-brain-works

  Addiction is now understood to be a brain disease. […] When a person develops an addiction to a substance, its because the brain has started to change. This happens because addictive substances trigger an outsized response when they reach the brain. Instead of a simple, pleasurable surge of dopamine, many drugs of abusesuch as opioids, cocaine, or nicotinecause dopamine to flood the reward pathway, 10 times more than a natural reward. […] The brain remembers this surge and associates it with the addictive substance. However, with chronic use of the substance, over time the brains circuits adapt and become less sensitive to dopamine. Achieving that pleasurable sensation becomes increasingly important, but at the same time, you build tolerance and need more and more of that substance to generate the level of high you crave.

• #11 How an Addicted Brain Works > News > Yale Medicine

  https://www.yalemedicine.org/news/how-an-addicted-brain-works

  Addiction is now understood to be a brain disease. […] When a person develops an addiction to a substance, its because the brain has started to change. This happens because addictive substances trigger an outsized response when they reach the brain. Instead of a simple, pleasurable surge of dopamine, many drugs of abusesuch as opioids, cocaine, or nicotinecause dopamine to flood the reward pathway, 10 times more than a natural reward. […] The brain remembers this surge and associates it with the addictive substance. However, with chronic use of the substance, over time the brains circuits adapt and become less sensitive to dopamine. Achieving that pleasurable sensation becomes increasingly important, but at the same time, you build tolerance and need more and more of that substance to generate the level of high you crave.

• #12 Prescription drug abuse – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

  Because commonly abused prescription drugs activate the brain’s reward center, it’s possible to develop physical dependence and addiction. […] Physical dependence, also called drug tolerance, is the body’s response to long-term use of a drug. […] People who are addicted to a drug can have physical dependence, but they also compulsively seek a drug and continue to use it even when that drug causes major problems in their lives.

• #13 Prescription drug abuse – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

  Because commonly abused prescription drugs activate the brain’s reward center, it’s possible to develop physical dependence and addiction. […] Physical dependence, also called drug tolerance, is the body’s response to long-term use of a drug. […] People who are addicted to a drug can have physical dependence, but they also compulsively seek a drug and continue to use it even when that drug causes major problems in their lives.

• #14 Opioid Abuse: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/287790-overview

  Opioids act by binding to opioid receptors on neurons distributed throughout the nervous system and immune system. Four major types of opioid receptors have been identified: mu, kappa, delta, and the more recently identified OFQ/N. […] Understanding the role of endogenous peptides allows us to understand why medications and drugs that bind to opioid receptors have such profound effects on so many organ systems and bodily functions. […] More than 20 clinically available medications bind opioid receptors. Most of these are prototypical mu receptor full agonists (capable of producing a maximal response at mu receptor subtypes in opioid-sensitive systems), and are associated with the following constellation of effects: Pain relief, Mood alteration (often producing euphoria and decreased anxiety), Respiratory depression (can cause death in overdose), Decreased gastrointestinal motility (can cause constipation), Cough suppression, Suppression of corticotropin-releasing factor and adrenocorticotropin hormone, Pinpoint pupils (miosis), Nausea, vomiting, pruritis (less common).

• #15 Opioid Abuse: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/287790-overview

  Opioids act by binding to opioid receptors on neurons distributed throughout the nervous system and immune system. Four major types of opioid receptors have been identified: mu, kappa, delta, and the more recently identified OFQ/N. […] Understanding the role of endogenous peptides allows us to understand why medications and drugs that bind to opioid receptors have such profound effects on so many organ systems and bodily functions. […] More than 20 clinically available medications bind opioid receptors. Most of these are prototypical mu receptor full agonists (capable of producing a maximal response at mu receptor subtypes in opioid-sensitive systems), and are associated with the following constellation of effects: Pain relief, Mood alteration (often producing euphoria and decreased anxiety), Respiratory depression (can cause death in overdose), Decreased gastrointestinal motility (can cause constipation), Cough suppression, Suppression of corticotropin-releasing factor and adrenocorticotropin hormone, Pinpoint pupils (miosis), Nausea, vomiting, pruritis (less common).

• #16 Opioid Abuse: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/287790-overview

  Almost all abused opioids are prototypical mu agonists. The euphoria associated with mu receptor activation is often termed a high. Moreover, when opioids are injected or inhaled, levels in the brain rise rapidly, causing a rush or thrill. The rush is a brief, intense, usually pleasurable sensation, which is followed by a longer-lasting high. When opioids are used chronically, tolerance and physical dependence occur. Over time, those with physiologic dependence often try to avoid unpleasant withdrawal symptoms rather than seeking the pleasurable sensations associated with initial use of opioids. […] Mechanisms of tolerance and withdrawal include but are not limited to the following: In response to long-term exposure to relatively high doses of exogenous opioids, cells internalize their mu and delta opioid receptors. Therefore, increased opioid levels and/or increased opioid potency are necessary to generate the same effect on fewer receptors (tolerance). Similarly, once the exogenous opioids are removed from the system, the remaining endogenous opioids are unable to sufficiently activate the small number of remaining receptors (withdrawal). […] There is evidence that long-term administration of opioids can permanently alter the density of dendritic spines in certain neurons, and these permanent changes may contribute to long-lasting vulnerability to relapse.

• #17 Benzodiazepines: Another prescription drug problem

  https://journalistsresource.org/politics-and-government/benzodiazepines-what-journalists-should-know/

  Benzodiazepines, a class of anti-anxiety drugs, are commonly-prescribed medications with the potential for abuse, addiction and overdose. […] People dont appreciate that benzodiazepines are addictive and that people abuse them, said Dr. Anna Lembke, a psychiatry professor at Stanford Medical School. In a phone call with Journalists Resource, she said that, just as with alcohol, benzodiazepines can be taken to achieve a state of intoxication. […] Benzodiazepines bind to gamma-aminobutyric acid (GABA) receptors in the brain. GABA is an inhibitory neurotransmitter; in other words, it inhibits brain activity. Turning the power down in the brain feels like sleepiness and calm. […] Benzodiazepines are accompanied by a number of side effects, including tolerance (reduced sensitivity) for the drug, cognitive impairment, anterograde amnesia (the inability to remember events that occurred after taking the drug), increased risk of Alzheimers disease, increased risk of falls (particularly among the elderly), and, most notably, dependence, abuse and overdose. Benzodiazepines are similar to opioids, cannabinoids, and the club drug gamma-hydroxybutyrate (GHB) insofar as the same neural mechanism underlies their addictiveness, according to research published in Nature.

• #18 Benzodiazepines: Another prescription drug problem

  https://journalistsresource.org/politics-and-government/benzodiazepines-what-journalists-should-know/

  Benzodiazepines, a class of anti-anxiety drugs, are commonly-prescribed medications with the potential for abuse, addiction and overdose. […] People dont appreciate that benzodiazepines are addictive and that people abuse them, said Dr. Anna Lembke, a psychiatry professor at Stanford Medical School. In a phone call with Journalists Resource, she said that, just as with alcohol, benzodiazepines can be taken to achieve a state of intoxication. […] Benzodiazepines bind to gamma-aminobutyric acid (GABA) receptors in the brain. GABA is an inhibitory neurotransmitter; in other words, it inhibits brain activity. Turning the power down in the brain feels like sleepiness and calm. […] Benzodiazepines are accompanied by a number of side effects, including tolerance (reduced sensitivity) for the drug, cognitive impairment, anterograde amnesia (the inability to remember events that occurred after taking the drug), increased risk of Alzheimers disease, increased risk of falls (particularly among the elderly), and, most notably, dependence, abuse and overdose. Benzodiazepines are similar to opioids, cannabinoids, and the club drug gamma-hydroxybutyrate (GHB) insofar as the same neural mechanism underlies their addictiveness, according to research published in Nature.

• #19 Benzodiazepines: Another prescription drug problem

  https://journalistsresource.org/politics-and-government/benzodiazepines-what-journalists-should-know/

  Even taking benzodiazepines in adherence to a prescribing physicians instructions can lead to dependence. Withdrawal symptoms are likely among patients who have taken benzodiazepines continuously for longer than a few weeks. […] The way that theyre prescribed and continued is contrary to the evidence in the medical literature, Lembke said. She noted that the evidence indicates benzodiazepines are effective and useful only in the short term, and typically at low doses. Theres no evidence that benzodiazepines taken long term work for anxiety, she said. […] Benzodiazepine abuse on its own can lead to overdose and death, but overdose deaths typically occur in combination with other substances generally other central nervous system depressants, which, like benzodiazepines, can lead to the life-threatening effect of slowed or stopped breathing. […] In August 2016, the Food and Drug Administration issued a requirement that opioids and benzodiazepines carry a black-box warning about the risks associated with using these substances together.

• #20 Benzodiazepines: Another prescription drug problem

  https://journalistsresource.org/politics-and-government/benzodiazepines-what-journalists-should-know/

  Even taking benzodiazepines in adherence to a prescribing physicians instructions can lead to dependence. Withdrawal symptoms are likely among patients who have taken benzodiazepines continuously for longer than a few weeks. […] The way that theyre prescribed and continued is contrary to the evidence in the medical literature, Lembke said. She noted that the evidence indicates benzodiazepines are effective and useful only in the short term, and typically at low doses. Theres no evidence that benzodiazepines taken long term work for anxiety, she said. […] Benzodiazepine abuse on its own can lead to overdose and death, but overdose deaths typically occur in combination with other substances generally other central nervous system depressants, which, like benzodiazepines, can lead to the life-threatening effect of slowed or stopped breathing. […] In August 2016, the Food and Drug Administration issued a requirement that opioids and benzodiazepines carry a black-box warning about the risks associated with using these substances together.

• #21 Prescription Drug Abuse (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/prescription-drug-abuse.html

  Taking prescription drugs in a way that hasn’t been recommended by a doctor can be more dangerous than people think. In fact, it’s drug abuse. And it’s illegal, just like taking street drugs. […] Opioids attach to opioid receptors in the central nervous system (the brain and the spinal cord), preventing the brain from receiving pain messages. […] CNS depressants slow down brain activity by making changes in brain chemicals. The result is a drowsy or calming effect. […] Stimulants increase brain activity, resulting in greater alertness, attention, and energy. […] Opioid abuse can lead to mood and behavior changes, trouble thinking clearly, breathing problems, and even a coma or death. […] CNS depressant abuse is risky too. […] Stimulant abuse (like with some ADHD drugs) may cause heart problems, seizures, panic attacks, paranoia, and violent behavior. […] The dangers of prescription drug abuse can be even worse if people take drugs in a way they weren’t intended to be used. […] Probably the most common risk of prescription drug abuse is addiction. People who abuse medicines can become addicted as easily as if they were taking street drugs.

• #22 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Stimulant abuse — for instance, by taking them in higher doses or by crushing pills and snorting them — can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat. […] Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction. […] Experts believe that medication-assisted treatment with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction. […] Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above: Opioids may cause vomiting, breathing problems, a coma, or death. […] Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before.

• #23 Opioid Abuse: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/287790-overview

  Almost all abused opioids are prototypical mu agonists. The euphoria associated with mu receptor activation is often termed a high. Moreover, when opioids are injected or inhaled, levels in the brain rise rapidly, causing a rush or thrill. The rush is a brief, intense, usually pleasurable sensation, which is followed by a longer-lasting high. When opioids are used chronically, tolerance and physical dependence occur. Over time, those with physiologic dependence often try to avoid unpleasant withdrawal symptoms rather than seeking the pleasurable sensations associated with initial use of opioids. […] Mechanisms of tolerance and withdrawal include but are not limited to the following: In response to long-term exposure to relatively high doses of exogenous opioids, cells internalize their mu and delta opioid receptors. Therefore, increased opioid levels and/or increased opioid potency are necessary to generate the same effect on fewer receptors (tolerance). Similarly, once the exogenous opioids are removed from the system, the remaining endogenous opioids are unable to sufficiently activate the small number of remaining receptors (withdrawal). […] There is evidence that long-term administration of opioids can permanently alter the density of dendritic spines in certain neurons, and these permanent changes may contribute to long-lasting vulnerability to relapse.

• #24 Opioid Abuse: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/287790-overview

  Almost all abused opioids are prototypical mu agonists. The euphoria associated with mu receptor activation is often termed a high. Moreover, when opioids are injected or inhaled, levels in the brain rise rapidly, causing a rush or thrill. The rush is a brief, intense, usually pleasurable sensation, which is followed by a longer-lasting high. When opioids are used chronically, tolerance and physical dependence occur. Over time, those with physiologic dependence often try to avoid unpleasant withdrawal symptoms rather than seeking the pleasurable sensations associated with initial use of opioids. […] Mechanisms of tolerance and withdrawal include but are not limited to the following: In response to long-term exposure to relatively high doses of exogenous opioids, cells internalize their mu and delta opioid receptors. Therefore, increased opioid levels and/or increased opioid potency are necessary to generate the same effect on fewer receptors (tolerance). Similarly, once the exogenous opioids are removed from the system, the remaining endogenous opioids are unable to sufficiently activate the small number of remaining receptors (withdrawal). […] There is evidence that long-term administration of opioids can permanently alter the density of dendritic spines in certain neurons, and these permanent changes may contribute to long-lasting vulnerability to relapse.

• #25 Withdrawal Syndromes: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/819502-overview

  Ethanol inhibits excitatory neurons by decreasing the activity of N-methyl-D-aspartate (NMDA, glutamate subtype) receptors. Long-term use results in upregulation of NMDA receptors, an adaptation that causes tolerance. The unmasking of the increased neuroexcitatory tone contributes to withdrawal seizures and other symptoms when alcohol intake is decreased or stopped. […] In the short-term, ethanol inhibits opioid binding to p-opioid receptors, and long-term use results in upregulation of opioid receptors. Opioid receptors in the nucleus accumbens and in the ventral tegmental area of the brain modulate ethanol-induced dopamine release, which produces alcohol craving and explains the use of opioid antagonists to prevent this craving. […] Other GABAA receptor agonists, such as benzodiazepines, barbiturates, and volatile solvents, produce a withdrawal syndrome through some of the same mechanisms implicated in ethanol withdrawal. Modulatory changes in the GABAA receptor results in a decrease in GABA-ergic neurotransmission and decreased inhibitory control of excitatory neurotransmission.

• #26 Withdrawal Syndromes: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/819502-overview

  Opioid withdrawal is mediated at both the receptor level and via downstream cellular and nerve network adaptations. At the receptor level, opioid tolerance induces receptor internalization with decreased receptor expression on the cell surface and receptor densensitization, whereby stimulation of the receptor is less efficiently coupled to second messenger activation. […] At the cellular level, opioid tolerance and withdrawal is modulated by alterations in kinase cascades, which modulate the production and effects of second messengers such as cyclic adenosine monophosphate (cAMP). At the nerve network level, chronic opioid agonism results in homeostatic adaptations to other neurons throughout the neural network; alterations in neuronal, synaptic, and dendritic architecture; and changes in glial function.

• #27 Pregabalin: Potential for Addiction and a Possible Glutamatergic Mechanism | Scientific Reports

  https://www.nature.com/articles/s41598-019-51556-4

  Drug addiction remains a prevalent and fatal disease worldwide that carries significant social and economic impacts. […] Drug seeking behavior and chronic drug use are associated with deficits in glutamate clearance and activation of postsynaptic glutamatergic receptors. […] Glutamate homeostasis is maintained by glutamate transporter type-1 (GLT-1), which plays a vital role in clearing the released glutamate from synapses and drug seeking behavior. […] The nucleus accumbens (NAc) is involved in the reinforcing and rewarding effects of several drugs of abuse. […] Disturbances in glutamate homeostasis in the NAc have been shown to be associated with drug seeking behavior and chronic drug use. […] The release of glutamate from prefrontal cortex (PFC) projections into the NAc has been shown to mediate drug seeking behavior in previous studies.

• #28 Pregabalin: Potential for Addiction and a Possible Glutamatergic Mechanism | Scientific Reports

  https://www.nature.com/articles/s41598-019-51556-4

  Drug addiction remains a prevalent and fatal disease worldwide that carries significant social and economic impacts. […] Drug seeking behavior and chronic drug use are associated with deficits in glutamate clearance and activation of postsynaptic glutamatergic receptors. […] Glutamate homeostasis is maintained by glutamate transporter type-1 (GLT-1), which plays a vital role in clearing the released glutamate from synapses and drug seeking behavior. […] The nucleus accumbens (NAc) is involved in the reinforcing and rewarding effects of several drugs of abuse. […] Disturbances in glutamate homeostasis in the NAc have been shown to be associated with drug seeking behavior and chronic drug use. […] The release of glutamate from prefrontal cortex (PFC) projections into the NAc has been shown to mediate drug seeking behavior in previous studies.

• #29 Pregabalin: Potential for Addiction and a Possible Glutamatergic Mechanism | Scientific Reports

  https://www.nature.com/articles/s41598-019-51556-4

  Drug addiction remains a prevalent and fatal disease worldwide that carries significant social and economic impacts. […] Drug seeking behavior and chronic drug use are associated with deficits in glutamate clearance and activation of postsynaptic glutamatergic receptors. […] Glutamate homeostasis is maintained by glutamate transporter type-1 (GLT-1), which plays a vital role in clearing the released glutamate from synapses and drug seeking behavior. […] The nucleus accumbens (NAc) is involved in the reinforcing and rewarding effects of several drugs of abuse. […] Disturbances in glutamate homeostasis in the NAc have been shown to be associated with drug seeking behavior and chronic drug use. […] The release of glutamate from prefrontal cortex (PFC) projections into the NAc has been shown to mediate drug seeking behavior in previous studies.

• #30 Pregabalin: Potential for Addiction and a Possible Glutamatergic Mechanism | Scientific Reports

  https://www.nature.com/articles/s41598-019-51556-4

  It is noteworthy that glutamate homeostasis is controlled by a number of glutamate receptors and transporters. […] One of these transporters is glutamate transporter type-1 (GLT-1) which can clear the majority of the synaptic glutamate. […] Interestingly, GLT-1 expression was found to be downregulated instantly in cocaine self-administration model. […] The drug seeking effects found in several drugs of abuse have been consistently reported to be mediated by glutamatergic mechanism. […] Our results suggest that pregabalin at higher doses [60mg, and 90mg] may induce addiction partly by downregulating GLT-1 expression and thereby decreasing glutamate uptake at the synaptic cleft. […] Treatment with CEF has been reported to prevent drug seeking behavior caused by, in part, decreased GLT-1 expression in methamphetamine, cocaine, ethanol, nicotine, and heroin dependence. […] Therefore, pregabalin seeking at the addictive doses of [60mg, and 90mg] might be mediated by altering GLT-1 expression as the drug seeking effects of pregabalin was eliminated by CEF pretreatment in the present study.

• #31 Pregabalin: Potential for Addiction and a Possible Glutamatergic Mechanism | Scientific Reports

  https://www.nature.com/articles/s41598-019-51556-4

  It is noteworthy that glutamate homeostasis is controlled by a number of glutamate receptors and transporters. […] One of these transporters is glutamate transporter type-1 (GLT-1) which can clear the majority of the synaptic glutamate. […] Interestingly, GLT-1 expression was found to be downregulated instantly in cocaine self-administration model. […] The drug seeking effects found in several drugs of abuse have been consistently reported to be mediated by glutamatergic mechanism. […] Our results suggest that pregabalin at higher doses [60mg, and 90mg] may induce addiction partly by downregulating GLT-1 expression and thereby decreasing glutamate uptake at the synaptic cleft. […] Treatment with CEF has been reported to prevent drug seeking behavior caused by, in part, decreased GLT-1 expression in methamphetamine, cocaine, ethanol, nicotine, and heroin dependence. […] Therefore, pregabalin seeking at the addictive doses of [60mg, and 90mg] might be mediated by altering GLT-1 expression as the drug seeking effects of pregabalin was eliminated by CEF pretreatment in the present study.

• #32 Prescription drug addiction – Wikipedia

  https://en.wikipedia.org/wiki/Prescription_drug_addiction

  Prescription drug addiction is the chronic, repeated use of a prescription drug in ways other than prescribed for, including using someone else’s prescription. […] The classes of medications most commonly abused are opioids, central nervous system (CNS) depressants and central nervous stimulants. […] Prescription drug addiction was recognized as a significant public health and law enforcement problem worldwide in the past decade due to its medical and social consequences. […] Changes in the pain management including more liberal opioids prescription for chronic pain conditions, prescription of higher doses and the development of more potent opioid drugs play an important role contributing to the current epidemic of prescription opioid addiction. […] Key pharmacological factors associated with drug addiction include: high frequency of drug use, high doses administered, rapid rate of onset of action, high drug potency.

• #33 Prescription drug addiction – Wikipedia

  https://en.wikipedia.org/wiki/Prescription_drug_addiction

  The above over-prescription practices can lead to the aggravation of prescription drug addiction. […] Patients who have been prescribed medications to treat a health condition or disorder are shown to be more vulnerable to prescription drug abuse and addiction, especially when the prescribed medicine falls into the same drug classes of common illicit drugs. […] Misuse of opioid analgesics is frequently associated with mental health disorder, including depression, posttraumatic stress disorder, and anxiety disorders. […] Addiction to pharmaceutical stimulants have been predominantly among adolescents and young adults. […] Addiction may also deteriorate academic or work performance and worsen relationships.

• #34 Drug addiction (substance use disorder) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

  Drug addiction, also called substance use disorder, is a disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medicine. […] The risk of addiction and how fast you become addicted varies by drug. Some drugs, such as opioid painkillers, have a higher risk and cause addiction more quickly than others. […] Physical addiction appears to occur when repeated use of a drug changes the way your brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in your brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after you stop using the drug.

• #35 Prescription drug abuse in Europe is a bigger problem than previously thought

  https://www.biomedcentral.com/about/press-centre/science-press-releases/04-08-16

  Having been prescribed a pain reliever was associated with an eight times higher risk of subsequent nonmedical use of prescription pain relievers. The risk was ten times higher for sedatives and seven times higher for stimulants. […] Identification of the scope and prevalence of nonmedical prescription drug use in the EU is an important first step in building a worldwide system that can be used to monitor trends, track risk and protective factors and to develop targeted interventions aimed at reducing the risk of nonmedical prescription drug use, according to the researchers.

• #36 Prescription drug addiction – Wikipedia

  https://en.wikipedia.org/wiki/Prescription_drug_addiction

  The above over-prescription practices can lead to the aggravation of prescription drug addiction. […] Patients who have been prescribed medications to treat a health condition or disorder are shown to be more vulnerable to prescription drug abuse and addiction, especially when the prescribed medicine falls into the same drug classes of common illicit drugs. […] Misuse of opioid analgesics is frequently associated with mental health disorder, including depression, posttraumatic stress disorder, and anxiety disorders. […] Addiction to pharmaceutical stimulants have been predominantly among adolescents and young adults. […] Addiction may also deteriorate academic or work performance and worsen relationships.

• #37 CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm

  In 2007, approximately 27,000 unintentional drug overdose deaths occurred in the United States, one death every 19 minutes. Prescription drug abuse is the fastest growing drug problem in the United States. The increase in unintentional drug overdose death rates in recent years has been driven by increased use of a class of prescription drugs called opioid analgesics. […] Persons who have mental illness are overrepresented among both those who are prescribed opioids and those who overdose on them. Further defining populations at greater risk is critical for development and implementation of effective interventions. The two main populations in the United States at risk for prescription drug overdose are the approximately 9 million persons who report long-term medical use of opioids, and the roughly 5 million persons who report nonmedical use (i.e., use without a prescription or medical need), in the past month.

• #38 Prescription Drug Abuse Recovery | NCTC

  https://newchoicestc.com/blog/prescription-drug-abuse/

  Mental health conditions often coexist with prescription drug abuse, creating a complex interplay that can complicate treatment and recovery. Conditions like anxiety, depression, and post-traumatic stress disorder (PTSD) can lead people to self-medicate with prescription drugs. […] Effective treatment for prescription drug abuse must address both the substance use and the underlying mental health conditions. Integrated treatment plans that combine medication management with therapy can provide a comprehensive approach to recovery.

• #39 Prescription Drug Abuse Recovery | NCTC

  https://newchoicestc.com/blog/prescription-drug-abuse/

  Mental health conditions often coexist with prescription drug abuse, creating a complex interplay that can complicate treatment and recovery. Conditions like anxiety, depression, and post-traumatic stress disorder (PTSD) can lead people to self-medicate with prescription drugs. […] Effective treatment for prescription drug abuse must address both the substance use and the underlying mental health conditions. Integrated treatment plans that combine medication management with therapy can provide a comprehensive approach to recovery.

• #40 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Stimulant abuse — for instance, by taking them in higher doses or by crushing pills and snorting them — can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat. […] Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction. […] Experts believe that medication-assisted treatment with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction. […] Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above: Opioids may cause vomiting, breathing problems, a coma, or death. […] Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before.

• #41 Prescription Drug Abuse Recovery | NCTC

  https://newchoicestc.com/blog/prescription-drug-abuse/

  Prescription drug abuse has become a significant public health crisis in recent years. This issue involves the misuse of medications that are legally prescribed for various health conditions. […] Prescription drug abuse occurs when someone takes medication in a way that is not prescribed or for reasons other than its intended purpose. […] This problem is complex and can have various consequences. It can lead to addiction, which is a chronic disorder characterized by compulsive drug seeking and use despite harmful consequences. […] The misuse of prescription drugs can also result in physical dependence, where the body adapts to the drug. This leads to withdrawal symptoms when not taking it. Tolerance can develop as well, meaning people need higher doses to achieve the same effect. […] Healthcare providers may prescribe more medication than necessary, often due to the pressure to manage pain or other conditions quickly. This practice can lead to an excess of unused medications, increasing the risk of misuse.

• #42 CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm

  Persons who abuse opioids have learned to exploit this new practitioner sensitivity to patient pain, and clinicians struggle to treat patients without overprescribing these drugs. […] These data suggest that prevention of opioid overdose deaths should focus on strategies that target 1) high-dosage medical users and 2) persons who seek care from multiple doctors, receive high doses, and likely are involved in drug diversion. […] Evidence-based guidelines can educate prescribers regarding the under-appreciated risks and frequently exaggerated benefits of high-dose opioid therapy. Such guidelines especially are needed for emergency departments because persons at greater risk for overdose frequently visit emergency departments seeking drugs. […] A public health approach to the problem of prescription drug overdose also should include secondary and tertiary prevention measures to improve emergency and long-term treatment. Overdose „harm reduction” programs emphasize broader distribution (to nonmedical users) of an opioid antidote, naloxone, that can be used in an emergency by anyone witnessing an overdose.

• #43 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician’s office, the retail pharmacy, or the patient. […] Diversion can occur in many ways, including: the illegal sale of prescriptions by physicians and those who are referred to on the street as loose pharmacists; doctor shopping by individuals who visit numerous physicians to obtain multiple prescriptions; theft, forgery, or alteration of prescriptions by health care workers and patients; robberies and thefts from manufacturers, distributors, and pharmacies; and thefts of institutional drug supplies. […] Furthermore, there is growing evidence that the diversion of significant amounts of prescription opioids and benzodiazepines occurs through residential burglaries as well as cross-border smuggling at both retail and wholesale levels.

• #44 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician’s office, the retail pharmacy, or the patient. […] Diversion can occur in many ways, including: the illegal sale of prescriptions by physicians and those who are referred to on the street as loose pharmacists; doctor shopping by individuals who visit numerous physicians to obtain multiple prescriptions; theft, forgery, or alteration of prescriptions by health care workers and patients; robberies and thefts from manufacturers, distributors, and pharmacies; and thefts of institutional drug supplies. […] Furthermore, there is growing evidence that the diversion of significant amounts of prescription opioids and benzodiazepines occurs through residential burglaries as well as cross-border smuggling at both retail and wholesale levels.

• #45 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician’s office, the retail pharmacy, or the patient. […] Diversion can occur in many ways, including: the illegal sale of prescriptions by physicians and those who are referred to on the street as loose pharmacists; doctor shopping by individuals who visit numerous physicians to obtain multiple prescriptions; theft, forgery, or alteration of prescriptions by health care workers and patients; robberies and thefts from manufacturers, distributors, and pharmacies; and thefts of institutional drug supplies. […] Furthermore, there is growing evidence that the diversion of significant amounts of prescription opioids and benzodiazepines occurs through residential burglaries as well as cross-border smuggling at both retail and wholesale levels.

• #46 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  In addition, recent research has documented diversion through such other channels as: shorting (undercounting) and pilferage by pharmacists and pharmacy employees; recycling of medications by pharmacists and pharmacy employees; medicine cabinet thefts by cleaning and repair personnel in residential settings; theft of guests’ medications by hotel repair and housekeeping staff; and Medicare, Medicaid, and other insurance fraud by patients, pharmacists, and street dealers. […] While doctor shoppers, physicians, and the Internet receive much of the attention regarding diversion, the data reported in this article suggest that there are numerous active street markets involving patients, Medicaid recipients, and pharmacies as well. […] The range of diversion is so broad, furthermore, that answers as to what the major sources of diversion are really depend on who is asked.

• #47 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  In addition, recent research has documented diversion through such other channels as: shorting (undercounting) and pilferage by pharmacists and pharmacy employees; recycling of medications by pharmacists and pharmacy employees; medicine cabinet thefts by cleaning and repair personnel in residential settings; theft of guests’ medications by hotel repair and housekeeping staff; and Medicare, Medicaid, and other insurance fraud by patients, pharmacists, and street dealers. […] While doctor shoppers, physicians, and the Internet receive much of the attention regarding diversion, the data reported in this article suggest that there are numerous active street markets involving patients, Medicaid recipients, and pharmacies as well. […] The range of diversion is so broad, furthermore, that answers as to what the major sources of diversion are really depend on who is asked.

• #48 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  In addition, recent research has documented diversion through such other channels as: shorting (undercounting) and pilferage by pharmacists and pharmacy employees; recycling of medications by pharmacists and pharmacy employees; medicine cabinet thefts by cleaning and repair personnel in residential settings; theft of guests’ medications by hotel repair and housekeeping staff; and Medicare, Medicaid, and other insurance fraud by patients, pharmacists, and street dealers. […] While doctor shoppers, physicians, and the Internet receive much of the attention regarding diversion, the data reported in this article suggest that there are numerous active street markets involving patients, Medicaid recipients, and pharmacies as well. […] The range of diversion is so broad, furthermore, that answers as to what the major sources of diversion are really depend on who is asked.

• #49 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  Federal agencies maintain that diverted drugs enter the illegal market primarily through doctor shoppers, inappropriate prescribing practices by physicians, and improper dispensing by pharmacists. […] By contrast, as a adjunct to a postmarketing surveillance program to monitor the diversion and abuse of oxycodone and a variety of other prescription opioids, in 2005 the authors surveyed diversion investigators in 300 police and regulatory agencies participating in this nationwide surveillance program. […] A primary focus of the groups was to elucidate the sources of abused prescription drugs reaching the streets. […] Among these individuals, the primary sources for acquiring prescription drugs were: street dealers; script doctors; illegal sales in small pharmacies; acquaintances who sell their personal prescriptions; doctor shopping; friends and family members; sex workers’ clients; disability patients; Medicaid recipients; and personal prescriptions intended for the treatment for drug dependence or mental illness.

• #50 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  Federal agencies maintain that diverted drugs enter the illegal market primarily through doctor shoppers, inappropriate prescribing practices by physicians, and improper dispensing by pharmacists. […] By contrast, as a adjunct to a postmarketing surveillance program to monitor the diversion and abuse of oxycodone and a variety of other prescription opioids, in 2005 the authors surveyed diversion investigators in 300 police and regulatory agencies participating in this nationwide surveillance program. […] A primary focus of the groups was to elucidate the sources of abused prescription drugs reaching the streets. […] Among these individuals, the primary sources for acquiring prescription drugs were: street dealers; script doctors; illegal sales in small pharmacies; acquaintances who sell their personal prescriptions; doctor shopping; friends and family members; sex workers’ clients; disability patients; Medicaid recipients; and personal prescriptions intended for the treatment for drug dependence or mental illness.

• #51 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  Federal agencies maintain that diverted drugs enter the illegal market primarily through doctor shoppers, inappropriate prescribing practices by physicians, and improper dispensing by pharmacists. […] By contrast, as a adjunct to a postmarketing surveillance program to monitor the diversion and abuse of oxycodone and a variety of other prescription opioids, in 2005 the authors surveyed diversion investigators in 300 police and regulatory agencies participating in this nationwide surveillance program. […] A primary focus of the groups was to elucidate the sources of abused prescription drugs reaching the streets. […] Among these individuals, the primary sources for acquiring prescription drugs were: street dealers; script doctors; illegal sales in small pharmacies; acquaintances who sell their personal prescriptions; doctor shopping; friends and family members; sex workers’ clients; disability patients; Medicaid recipients; and personal prescriptions intended for the treatment for drug dependence or mental illness.

• #52 Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2879025/

  A repeated theme was the involvement of certain pharmacies in Medicaid fraud. […] Most people wouldn’t think of this but at a methadone clinic, everybody that is either looking to get rid of something, or looking to purchase something, will come around a methadone clinic and will come up to you and say, I’ve got Xanax. […] The vast majority of participants reported problems with adherence to ARV medications either sporadically or on a chronic basis, due to side effects or regimen complexity, and most had been approached on multiple occasions and asked to sell their medications. […] The supply chain for diverted ARV medications includes HIV-positive patients, patient recruiters, pill brokers, street drug dealers, local mom and pop pharmacies who are recycling and reselling various medications, and script doctors, who prescribe medications in exchange for payment, even to non-HIV-positive individuals.

• #53 Prescription drug abuse – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813

  Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction. […] Prescription drug abuse is highest among teens and young adults. […] Prescription drug abuse in older adults is a growing problem, especially when they combine drugs with alcohol. […] Abusing prescription drugs can cause a number of problems. Prescription drugs can be especially dangerous and even lead to death when taken in high doses, when combined with other prescription drugs or certain over-the-counter medicines, or when taken with alcohol or illegal or recreational drugs.

• #54 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Prescription drug abuse is when you take a medication for a reason other than why the doctor prescribed it. […] Abusing drugs — even prescription drugs — can change how your brain works. Most people start by choosing to take these medications. But over time, the changes in your brain affect your self-control and your ability to make good decisions. At the same time, you have intense urges to take more drugs. […] Opioids can cause a mild joyful feeling. Some people using them illegally snort or inject them to get that effect faster. Injecting drugs raises your chances of getting diseases like HIV and hepatitis C. […] Taking CNS depressants for a few days or weeks may help you feel calm and sleepy. But after a while, you may need larger doses to get the same feeling. Using them with alcohol can cause slow heartbeat, slow breathing, and death.

• #55 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Prescription drug abuse is when you take a medication for a reason other than why the doctor prescribed it. […] Abusing drugs — even prescription drugs — can change how your brain works. Most people start by choosing to take these medications. But over time, the changes in your brain affect your self-control and your ability to make good decisions. At the same time, you have intense urges to take more drugs. […] Opioids can cause a mild joyful feeling. Some people using them illegally snort or inject them to get that effect faster. Injecting drugs raises your chances of getting diseases like HIV and hepatitis C. […] Taking CNS depressants for a few days or weeks may help you feel calm and sleepy. But after a while, you may need larger doses to get the same feeling. Using them with alcohol can cause slow heartbeat, slow breathing, and death.

• #56 Prescription Drug Abuse (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/prescription-drug-abuse.html

  Taking prescription drugs in a way that hasn’t been recommended by a doctor can be more dangerous than people think. In fact, it’s drug abuse. And it’s illegal, just like taking street drugs. […] Opioids attach to opioid receptors in the central nervous system (the brain and the spinal cord), preventing the brain from receiving pain messages. […] CNS depressants slow down brain activity by making changes in brain chemicals. The result is a drowsy or calming effect. […] Stimulants increase brain activity, resulting in greater alertness, attention, and energy. […] Opioid abuse can lead to mood and behavior changes, trouble thinking clearly, breathing problems, and even a coma or death. […] CNS depressant abuse is risky too. […] Stimulant abuse (like with some ADHD drugs) may cause heart problems, seizures, panic attacks, paranoia, and violent behavior. […] The dangers of prescription drug abuse can be even worse if people take drugs in a way they weren’t intended to be used. […] Probably the most common risk of prescription drug abuse is addiction. People who abuse medicines can become addicted as easily as if they were taking street drugs.

• #57 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Prescription drug abuse is when you take a medication for a reason other than why the doctor prescribed it. […] Abusing drugs — even prescription drugs — can change how your brain works. Most people start by choosing to take these medications. But over time, the changes in your brain affect your self-control and your ability to make good decisions. At the same time, you have intense urges to take more drugs. […] Opioids can cause a mild joyful feeling. Some people using them illegally snort or inject them to get that effect faster. Injecting drugs raises your chances of getting diseases like HIV and hepatitis C. […] Taking CNS depressants for a few days or weeks may help you feel calm and sleepy. But after a while, you may need larger doses to get the same feeling. Using them with alcohol can cause slow heartbeat, slow breathing, and death.

• #58 The Truth about Prescription Drug Abuse

  https://www.heraldopenaccess.us/openaccess/the-truth-about-prescription-drug-abuse

  Abuse of prescription medicines is defined as using them for purposes other than those for which they were intended or in a way that is not authorized by a medical expert. […] Prescription drug abuse can have detrimental effects on a person’s health and wellbeing. Addiction, overdosing, and even death may result from this. […] Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Prescription drug abuse can have several negative effects on the user’s health and well-being. […] The serious misuse of prescription drugs has also resulted in significant increases in health care costs. […] The negative consequences of abused prescription drugs are reflected in key indicators of opioid painkiller abuse that have risen over the years.

• #59 Prescription Drug Abuse (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/prescription-drug-abuse.html

  Taking prescription drugs in a way that hasn’t been recommended by a doctor can be more dangerous than people think. In fact, it’s drug abuse. And it’s illegal, just like taking street drugs. […] Opioids attach to opioid receptors in the central nervous system (the brain and the spinal cord), preventing the brain from receiving pain messages. […] CNS depressants slow down brain activity by making changes in brain chemicals. The result is a drowsy or calming effect. […] Stimulants increase brain activity, resulting in greater alertness, attention, and energy. […] Opioid abuse can lead to mood and behavior changes, trouble thinking clearly, breathing problems, and even a coma or death. […] CNS depressant abuse is risky too. […] Stimulant abuse (like with some ADHD drugs) may cause heart problems, seizures, panic attacks, paranoia, and violent behavior. […] The dangers of prescription drug abuse can be even worse if people take drugs in a way they weren’t intended to be used. […] Probably the most common risk of prescription drug abuse is addiction. People who abuse medicines can become addicted as easily as if they were taking street drugs.

• #60 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Stimulant abuse — for instance, by taking them in higher doses or by crushing pills and snorting them — can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat. […] Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction. […] Experts believe that medication-assisted treatment with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction. […] Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above: Opioids may cause vomiting, breathing problems, a coma, or death. […] Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before.

• #61 The Truth about Prescription Drug Abuse

  https://www.heraldopenaccess.us/openaccess/the-truth-about-prescription-drug-abuse

  Abuse of prescription medicines is defined as using them for purposes other than those for which they were intended or in a way that is not authorized by a medical expert. […] Prescription drug abuse can have detrimental effects on a person’s health and wellbeing. Addiction, overdosing, and even death may result from this. […] Prescription drug abuse is the use of a prescription medicine in a way not intended by the prescriber. […] Prescription drug abuse may become ongoing and compulsive, despite the negative consequences. […] Prescription drug abuse can have several negative effects on the user’s health and well-being. […] The serious misuse of prescription drugs has also resulted in significant increases in health care costs. […] The negative consequences of abused prescription drugs are reflected in key indicators of opioid painkiller abuse that have risen over the years.

• #62 Withdrawal Syndromes: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/819502-overview

  Opioid withdrawal is mediated at both the receptor level and via downstream cellular and nerve network adaptations. At the receptor level, opioid tolerance induces receptor internalization with decreased receptor expression on the cell surface and receptor densensitization, whereby stimulation of the receptor is less efficiently coupled to second messenger activation. […] At the cellular level, opioid tolerance and withdrawal is modulated by alterations in kinase cascades, which modulate the production and effects of second messengers such as cyclic adenosine monophosphate (cAMP). At the nerve network level, chronic opioid agonism results in homeostatic adaptations to other neurons throughout the neural network; alterations in neuronal, synaptic, and dendritic architecture; and changes in glial function.

• #63 Benzodiazepines: Another prescription drug problem

  https://journalistsresource.org/politics-and-government/benzodiazepines-what-journalists-should-know/

  Even taking benzodiazepines in adherence to a prescribing physicians instructions can lead to dependence. Withdrawal symptoms are likely among patients who have taken benzodiazepines continuously for longer than a few weeks. […] The way that theyre prescribed and continued is contrary to the evidence in the medical literature, Lembke said. She noted that the evidence indicates benzodiazepines are effective and useful only in the short term, and typically at low doses. Theres no evidence that benzodiazepines taken long term work for anxiety, she said. […] Benzodiazepine abuse on its own can lead to overdose and death, but overdose deaths typically occur in combination with other substances generally other central nervous system depressants, which, like benzodiazepines, can lead to the life-threatening effect of slowed or stopped breathing. […] In August 2016, the Food and Drug Administration issued a requirement that opioids and benzodiazepines carry a black-box warning about the risks associated with using these substances together.

• #64 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Stimulant abuse — for instance, by taking them in higher doses or by crushing pills and snorting them — can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat. […] Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction. […] Experts believe that medication-assisted treatment with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction. […] Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above: Opioids may cause vomiting, breathing problems, a coma, or death. […] Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before.

• #65 Oral Manifestations of Commonly Prescribed Drugs | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p613.html

  Drugs are being prescribed with more frequency and in higher quantities. A serious adverse drug event from prescribed medications constitutes 2.4% to 16.2% of all hospital admissions. Many of the adverse drug events present intraorally or periorally in isolation or as a clinical symptom of a systemic effect. Clinical recognition and treatment of adverse drug events are important to increase patient adherence, manage drug therapy, or detect early signs of potentially serious outcomes. Oral manifestations of commonly prescribed medications include gingival enlargement, oral hyperpigmentation, oral hypersensitivity reaction, medication-related osteonecrosis, xerostomia, and other oral or perioral conditions. […] The main categories of oral or perioral manifestations attributable to prescribed medications are gingival enlargement, oral hyperpigmentation, oral hypersensitivity reaction, osteonecrosis, xerostomia, and other oral or perioral conditions such as angioedema and chemical burns.

• #66 Oral Manifestations of Commonly Prescribed Drugs | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p613.html

  Drugs are being prescribed with more frequency and in higher quantities. A serious adverse drug event from prescribed medications constitutes 2.4% to 16.2% of all hospital admissions. Many of the adverse drug events present intraorally or periorally in isolation or as a clinical symptom of a systemic effect. Clinical recognition and treatment of adverse drug events are important to increase patient adherence, manage drug therapy, or detect early signs of potentially serious outcomes. Oral manifestations of commonly prescribed medications include gingival enlargement, oral hyperpigmentation, oral hypersensitivity reaction, medication-related osteonecrosis, xerostomia, and other oral or perioral conditions. […] The main categories of oral or perioral manifestations attributable to prescribed medications are gingival enlargement, oral hyperpigmentation, oral hypersensitivity reaction, osteonecrosis, xerostomia, and other oral or perioral conditions such as angioedema and chemical burns.

• #67 Oral Manifestations of Commonly Prescribed Drugs | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p613.html

  Gingival enlargement (or gingival hyperplasia/hypertrophy or overgrowth) is the enlargement of gum tissue in the mouth. Classic drugs associated with medication-induced gingival enlargement include calcium channel blockers, anticonvulsants, and cyclosporine (Sandimmune). Erythromycin and oral contraceptives have also been implicated in gingival enlargement. The increased overgrowth of gingival tissue is related to the disruption of the degradation of collagen, which leads to a larger amount of extracellular collagen tissue within the gums. […] Medication-related osteonecrosis occurs most commonly in the mandible, yet in rare cases can present extraorally or on the maxilla. The alveolar process (the portion of the jawbone that houses the teeth) is constantly remodeling through resorption (osteoclast activity) and apposition (osteoblast activity). The risk of osteonecrosis is increased in patients receiving drugs that cause osteoclast apoptosis, inhibit osteoclastic activity, or reduce blood flow that supports bone remodeling processes.

• #68 Oral Manifestations of Commonly Prescribed Drugs | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p613.html

  Xerostomia is the perceived sensation of a dry mouth. The parotid, submandibular, and sublingual salivary glands account for most of the salivary production. […] Drug-induced xerostomia occurs most commonly in older people (older than 65 years) and particularly in those patients who are prescribed more than one medication.

• #69 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Stimulant abuse — for instance, by taking them in higher doses or by crushing pills and snorting them — can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat. […] Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction. […] Experts believe that medication-assisted treatment with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction. […] Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above: Opioids may cause vomiting, breathing problems, a coma, or death. […] Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before.

• #70 Prescription Drug Abuse: Addiction, Types, and Treatment

  https://www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs

  Stimulant abuse — for instance, by taking them in higher doses or by crushing pills and snorting them — can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat. […] Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction. […] Experts believe that medication-assisted treatment with methadone, naltrexone, or suboxone and cognitive behavioral therapy is the best treatment for most patients who have an opioid addiction. […] Prescription drug abuse can have dangerous or deadly effects, especially if you take them along with the drugs listed above: Opioids may cause vomiting, breathing problems, a coma, or death. […] Some experts think that more people are abusing prescription medications because there are more drugs available. Doctors report writing more prescriptions than ever before.

• #71 NIDA’s medication development priorities in response to the Opioid Crisis: ten most wanted | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-018-0292-5

  The mechanisms listed in Table 1 are NIDAs DTMC highest priority pharmacological targets for the development of novel therapeutics to treat opioid overdose and OUD in the near term. […] While the existing medications (e.g., buprenorphine, methadone, naloxone, naltrexone, lofexidine) have demonstrable utility in the treatment of OUD, they are not without limitations. Indeed, problematic residual symptoms and discontinuation rates plague these treatments, leaving a deceptively cavernous un-met medical need that could be addressed, at least in part, by new medications. […] An important component of this list are allosteric modulators. Based on their suppression/augmentation of endogenous responses, negative allosteric modulators (NAMs) and positive allosteric modulators (PAMs) may provide more physiologically relevant effects compared with agonists and antagonists acting on the same receptor, which may ultimately result in improved clinical outcomes.

• #72 NIDA’s medication development priorities in response to the Opioid Crisis: ten most wanted | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-018-0292-5

  The mechanisms listed in Table 1 are NIDAs DTMC highest priority pharmacological targets for the development of novel therapeutics to treat opioid overdose and OUD in the near term. […] While the existing medications (e.g., buprenorphine, methadone, naloxone, naltrexone, lofexidine) have demonstrable utility in the treatment of OUD, they are not without limitations. Indeed, problematic residual symptoms and discontinuation rates plague these treatments, leaving a deceptively cavernous un-met medical need that could be addressed, at least in part, by new medications. […] An important component of this list are allosteric modulators. Based on their suppression/augmentation of endogenous responses, negative allosteric modulators (NAMs) and positive allosteric modulators (PAMs) may provide more physiologically relevant effects compared with agonists and antagonists acting on the same receptor, which may ultimately result in improved clinical outcomes.

• #73 NIDA’s medication development priorities in response to the Opioid Crisis: ten most wanted | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-018-0292-5

  It is important to note that due to the complexity of the addiction cycle, different stages of the disease (e.g., transition from sporadic to chronic use, acute withdrawal, delayed relapse) are likely to have different (albeit overlapping) pathophysiologies. […] Thus, there is unlikely to be a silver bullet among these mechanisms for the treatment of OUD and medications with these mechanisms-of-action are likely to be useful at different stages of the addiction cycle. […] Ultimately, we anticipate multiple medications, integrated with both psychosocial interventions and potentially devices, employed in an orchestrated fashion, will be needed to achieve truly effective treatments tailored for maximal efficacy in different individuals.

• #74 NIDA’s medication development priorities in response to the Opioid Crisis: ten most wanted | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-018-0292-5

  It is important to note that due to the complexity of the addiction cycle, different stages of the disease (e.g., transition from sporadic to chronic use, acute withdrawal, delayed relapse) are likely to have different (albeit overlapping) pathophysiologies. […] Thus, there is unlikely to be a silver bullet among these mechanisms for the treatment of OUD and medications with these mechanisms-of-action are likely to be useful at different stages of the addiction cycle. […] Ultimately, we anticipate multiple medications, integrated with both psychosocial interventions and potentially devices, employed in an orchestrated fashion, will be needed to achieve truly effective treatments tailored for maximal efficacy in different individuals.

• #75 What is the mechanism of action for naltrexone?

  https://www.drugs.com/medical-answers/mechanism-action-naltrexone-3571077/

  Naltrexone is a pure opiate receptor antagonist and works by primarily binding at the mu opioid receptors. By binding to these receptors, it blocks the euphoric (pleasurable or „high”) effects linked with alcohol use or opioids. Naltrexone itself has little or no effect in the absence of alcohol or opiates. […] Naltrexone works in opioid use disorder by producing a complete but reversible block of the effects of the opioid, such as physical dependence, respiratory depression, miosis (pinpoint pupils), analgesia (pain relief), euphoria (pleasurable effects), drug craving and tolerance. […] Naltrexone is thought to work in alcohol use disorder by blocking the effects of endogenous opiates made naturally by the body (like endorphins) which making alcohol ingestion less pleasurable. This action helps to reduce alcohol consumption. […] Naltrexone (and its active metabolite 6-beta-naltrexol) are competitive antagonists to the mu opioid receptors, but also have action at the kappa and delta receptors to a lesser extent. In alcohol use disorder it works by blocking endogenous endorphins at the opioid receptor site.

• #76 What is the mechanism of action for naltrexone?

  https://www.drugs.com/medical-answers/mechanism-action-naltrexone-3571077/

  Naltrexone is a pure opiate receptor antagonist and works by primarily binding at the mu opioid receptors. By binding to these receptors, it blocks the euphoric (pleasurable or „high”) effects linked with alcohol use or opioids. Naltrexone itself has little or no effect in the absence of alcohol or opiates. […] Naltrexone works in opioid use disorder by producing a complete but reversible block of the effects of the opioid, such as physical dependence, respiratory depression, miosis (pinpoint pupils), analgesia (pain relief), euphoria (pleasurable effects), drug craving and tolerance. […] Naltrexone is thought to work in alcohol use disorder by blocking the effects of endogenous opiates made naturally by the body (like endorphins) which making alcohol ingestion less pleasurable. This action helps to reduce alcohol consumption. […] Naltrexone (and its active metabolite 6-beta-naltrexol) are competitive antagonists to the mu opioid receptors, but also have action at the kappa and delta receptors to a lesser extent. In alcohol use disorder it works by blocking endogenous endorphins at the opioid receptor site.

• #77 What is the mechanism of action for naltrexone?

  https://www.drugs.com/medical-answers/mechanism-action-naltrexone-3571077/

  Naltrexone is a pure opiate receptor antagonist and works by primarily binding at the mu opioid receptors. By binding to these receptors, it blocks the euphoric (pleasurable or „high”) effects linked with alcohol use or opioids. Naltrexone itself has little or no effect in the absence of alcohol or opiates. […] Naltrexone works in opioid use disorder by producing a complete but reversible block of the effects of the opioid, such as physical dependence, respiratory depression, miosis (pinpoint pupils), analgesia (pain relief), euphoria (pleasurable effects), drug craving and tolerance. […] Naltrexone is thought to work in alcohol use disorder by blocking the effects of endogenous opiates made naturally by the body (like endorphins) which making alcohol ingestion less pleasurable. This action helps to reduce alcohol consumption. […] Naltrexone (and its active metabolite 6-beta-naltrexol) are competitive antagonists to the mu opioid receptors, but also have action at the kappa and delta receptors to a lesser extent. In alcohol use disorder it works by blocking endogenous endorphins at the opioid receptor site.

• #78 NIDA’s medication development priorities in response to the Opioid Crisis: ten most wanted | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-018-0292-5

  It is important to note that due to the complexity of the addiction cycle, different stages of the disease (e.g., transition from sporadic to chronic use, acute withdrawal, delayed relapse) are likely to have different (albeit overlapping) pathophysiologies. […] Thus, there is unlikely to be a silver bullet among these mechanisms for the treatment of OUD and medications with these mechanisms-of-action are likely to be useful at different stages of the addiction cycle. […] Ultimately, we anticipate multiple medications, integrated with both psychosocial interventions and potentially devices, employed in an orchestrated fashion, will be needed to achieve truly effective treatments tailored for maximal efficacy in different individuals.

• #79 CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm

  Persons who abuse opioids have learned to exploit this new practitioner sensitivity to patient pain, and clinicians struggle to treat patients without overprescribing these drugs. […] These data suggest that prevention of opioid overdose deaths should focus on strategies that target 1) high-dosage medical users and 2) persons who seek care from multiple doctors, receive high doses, and likely are involved in drug diversion. […] Evidence-based guidelines can educate prescribers regarding the under-appreciated risks and frequently exaggerated benefits of high-dose opioid therapy. Such guidelines especially are needed for emergency departments because persons at greater risk for overdose frequently visit emergency departments seeking drugs. […] A public health approach to the problem of prescription drug overdose also should include secondary and tertiary prevention measures to improve emergency and long-term treatment. Overdose „harm reduction” programs emphasize broader distribution (to nonmedical users) of an opioid antidote, naloxone, that can be used in an emergency by anyone witnessing an overdose.

• #80 Prescription Drug Abuse Recovery | NCTC

  https://newchoicestc.com/blog/prescription-drug-abuse/

  Mental health conditions often coexist with prescription drug abuse, creating a complex interplay that can complicate treatment and recovery. Conditions like anxiety, depression, and post-traumatic stress disorder (PTSD) can lead people to self-medicate with prescription drugs. […] Effective treatment for prescription drug abuse must address both the substance use and the underlying mental health conditions. Integrated treatment plans that combine medication management with therapy can provide a comprehensive approach to recovery.

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