Pill addiction as it is commonly called, but properly prescription drug abuse leading to pill withdrawal, has been common since doctors started prescribing drugs, and has become more common since the concept of the ‘repeat prescription’ or ‘refill’ allowed patients to have a prescription renewed simply by posting a form or filling one in at the pharmacy, stating the drug that they need. The form is returned to the surgery by the pharmacist where the doctor generates the prescription. If the doctor does not consider the need for the drug involved, and simply signs the prescription as routine, prescription drug abuse is made simpler. This frequently occurs because the doctor will often have a bundles of such repeat requests to deal with and may not have time to check every one out properly.
If a certain patient were requesting repeats too often would it be noticed? Probably not, at least until the next review. Since up to twelve repeats may be allowed before the patient has to see the doctor personally for a review, it is no wonder that prescription drug abuse and pill addiction are relatively common. The resulting pill withdrawal symptoms, are generally overlooked by the medical profession.
Common drugs which can lead to pill addiction are not only restricted to the well know tranquillizers such as diazepam and nitrazepam (Vallium and Mogadon respectively), but also to a range of painkillers. Painkillers commonly subject to prescription drug abuse are alkaloids derived from the poppy such codein and those containing codein. Codein, like morphine, is derived from the poppy and has similar properties to morphine, though milder. Common codein based drugs are cocodamol, the stronger of which are prescriptive, and even over-the-counter drugs such as Solpadeine, addicts to which have their own support group. Most prescription drug abuse is of either of these two types of drug: painkillers or tranquillisers. Tranquiliser pill withdrawal is quite common in developed countries.
People involved in prescription drug abuse display any of several symptoms common to patients suffering from pill withdrawal.
A major symptom of pill addiction is an increased tolerance to the drug. This means that the patient requires increasingly larger doses of the drug to maintain the same effects. Four times is not uncommon. This can lead to many problems, including an increasing difficulty to control the symptom for which the drug was originally prescribed. Thus, for example, it becomes increasingly difficult to control pain.
Patients who suffer from pill addiction have not done so deliberately. Other drug addicts start their habit to get a ‘buzz’, but not so those suffering from pill addiction. Their prescription drug abuse has crept up on them gradually while they have been taking the same drugs to treat their condition. Cocodamol is commonly used in the treatment of arthritis, for example, and its effectiveness can reduce as the body becomes accustomed to the drug. Prescription drug abuse in such cases is hardly abuse in the real meaning of the word.
The pain-killing effect recedes as the body becomes used to the drug, and the patient has to take more or suffer the increasing pain. This results in pill addiction. It is not deliberate, but once started the patient can do little about it because the pill withdrawal symptoms compel them to keep taking increasing doses. They know it is not right, but they can do little about it, and they try to hide their problem from their family. They reach a stage where they are scared to admit it, and are absolutely terrified to tell their doctor in case he stops the drugs altogether.
Prescription drug abuse almost invariably leads to physical dependence, and the patient can function normally only when taking the drug. The body adapts to its presence and can function while it is being supplied, but once the course of treatment has ended, the patient suffers from pill withdrawal symptoms. Such symptoms can be severe, including mood swings and aggression, physical illness and depression. Pill addiction can ultimately lead to death through overdose. To overdose on painkillers such as cocodamol, which contain codeine and paracetamol, is very dangerous. They contain codeine which is what the body requires, but also contain paracetamol which can cause severe liver damage over a period of time, and eventual death, if not taken strictly according to instructions.
A major sign of prescription drug abuse is that the patient cannot stop taking them. They will
Try to present their repeat prescriptions on a more frequent basis, with an excuse such as that they need an extra supply for some reason such as an impending holiday. They may also resort to doctor hopping or the internet. The internet has made it easy to purchase prescription drugs online, without requiring a prescription from the patients own physician. This type of pill addiction is not their fault and more could be done to control the circumstances which cause it.
Doctors, and in some cases the dispensing pharmacists, should be more aware of the possible problems of extended use of such drugs, and give help and advice when the time comes to stop them. The dose should be reduced gradually rather than the supply suddenly being cut off. Prescription drug abuse and pill withdrawal are becoming a increasingly serious problem for otherwise law-abiding innocent people.
A means of rotating drugs should be found, so that a patient is not taking the same chemical substance for extended periods. This may help reduce the body’s dependence on specific chemicals and reduce the possibility of this type of pill addiction.
However, if dependence has been confirmed, or preferably admitted by the patient, steps can be taken to treat the addiction. Kicking prescription pill addiction is difficult and doctors should help make it easier to achieve by using gradual withdrawal techniques.