Prescription drug abuse

Diagnosis

Doctors generally base a diagnosis of prescription drug abuse on medical history and answers to other questions. In some cases, certain signs and symptoms also provide clues.

Blood or urine tests can detect many types of drugs. These tests can also help track the progress of a person who's getting treatment.

Treatment

Treatment options for prescription drug abuse vary, depending on the type of drug used and your needs. But counseling is usually a key part of treatment. Treatment may also require withdrawal, also called detoxification, addiction medicine and recovery support.

Counseling

A licensed alcohol and drug counselor or other addiction specialist can provide individual, group or family counseling. This can help you:

• Determine what factors may have led to the prescription drug abuse, such as an underlying mental health problem or relationship problems
• Learn the skills needed to resist cravings, avoid abuse of drugs and help prevent recurrence of prescription drug problems
• Learn strategies for developing positive relationships
• Identify ways to become involved in healthy activities that aren't related to drugs
• Learn the steps to take if a relapse happens

Withdrawal

Depending on the prescription drug and usage, detoxification may be needed as part of treatment. Withdrawal can be dangerous and should be done under the guidance of a health care provider.

• Opioid withdrawal. Opioid tapering involves gradually decreasing the dose of medicine until it's no longer used. Other medicines — such as clonidine (Catapres), a drug mainly used for high blood pressure — can help manage opioid withdrawal symptoms. In the United States, health care providers prescribe buprenorphine, buprenorphine-naloxone (Suboxone) or methadone under specific, legally regulated and monitored conditions to ease symptoms of withdrawal from opioid painkillers. Drugs given by injection once a month by a health care professional may help people stay off opioids during their recovery. Examples include naltrexone (Vivitrol) and buprenorphine (Sublocade).
• Withdrawal from anti-anxiety medicines and sedatives. If you've used prescription sedatives or anti-anxiety drugs for a long time, it may take weeks to slowly taper off them. Because of withdrawal symptoms, it can take that long for your body to adjust to low doses of the medicine and then get used to taking none at all. You may need other types of medicine to make your moods more stable, manage the final phases of tapering or help with anxiety. You'll need to work closely with your health care provider.
• Stimulant withdrawal. The U.S. Food and Drug Administration has not approved any drugs for the treatment of stimulant withdrawal. Treatment usually focuses on tapering off the medicine and relieving withdrawal symptoms — such as sleep problems, tiredness and depression.

Coping and support

Overcoming prescription drug abuse can be challenging and stressful, often requiring the support of family, friends or organizations. Here's where to look for help:

• Trusted family members or friends
• Your health care provider, who may be able to recommend resources
• Self-help groups, such as a 12-step program
• Your church or faith group
• School counselor or nurse
• Support groups, either in person or from a trustworthy website
• An employee assistance program, which may offer counseling services for substance abuse problems

You may be embarrassed to ask for help or afraid that your family members will be angry or judgmental. You may worry that your friends will distance themselves from you. But in the long run, the people who truly care about you will respect your honesty and your decision to ask for help.

Helping a loved one

It can be difficult to approach your loved one about prescription drug abuse. Denial and anger are common reactions, and you may be concerned about creating conflict or damaging your relationship with that person.

Be understanding and patient. Let the person know that you care. Encourage your loved one to be honest about drug use and to accept help if needed. A person is more likely to respond to feedback from someone who is trusted. If the problem continues, more intervention may be necessary.

Intervention

It's challenging to help a loved one struggling with drug abuse or other destructive behavior. People who struggle with addictive behaviors are often in denial or unwilling to seek treatment. And they may not realize how their behavior is affecting themselves and others. An intervention can motivate someone to seek help for addictive behaviors.

An intervention is a carefully planned process involving family and friends and others who care about a person struggling with addiction. Consulting an intervention professional, an addiction specialist, a psychologist or a mental health counselor can help you plan an effective intervention.

This is an opportunity to confront the individual about the consequences of addiction and ask the person to accept treatment. Think of an intervention as giving your loved one a clear opportunity to make changes before things get really bad.

Preparing for your appointment

Your primary care provider may be able to help you overcome prescription drug abuse. But if you have an addiction, your provider may refer you to an addiction specialist or to a facility that specializes in helping people withdraw from drugs.

What you can do

To prepare for your appointment, make a list of:

• All the medicines you're taking, including over-the-counter drugs, herbs and supplements, as well as the dose and frequency
• Any symptoms you're experiencing
• Key personal information, including any major stresses or recent life changes
• Questions to ask your doctor

Questions to ask your doctor may include:

• What are my treatment options?
• How long does it take for treatment to work?
• Should I see a specialist?
• How can we manage my other health conditions during treatment?
• Do you have any brochures or other printed material I can have? What websites do you recommend?

What to expect from your doctor

Your health care provider may ask these questions:

• What prescription medicines do you take? How much and how often do you take them?
• How long have you had this problem?
• What, if anything, prompted it?
• How severe are your symptoms?
• Do you have a past history of drug abuse or addiction?
• Do you use recreational or illegal drugs? Do you smoke?
• Has anyone in your family had a history of drug abuse or addiction?

Be ready to answer these questions so that you can focus on points you want to spend more time on. Preparing and anticipating questions will help you make the most of your time with the health care provider.