Health Tips

Prescription medicines used correctly can cure diseases and improve lives. However, it’s not uncommon for people to use prescription medicines in ways that are different from how they were meant to be taken. 

This is known as prescription medicine misuse. People sometimes also call this “prescription drug abuse”. However, drug misuse and abuse are different. The key difference between a person who misuses drugs and a person who abuses drugs is their intent. The former takes a drug to treat a specific ailment, whereas the latter uses a drug to elicit certain feelings.

People who misuse prescription medicines might:

• Take medicines that are not prescribed to them

• Take more of the medicines than what the label says

• Crush pills and inhale them, or inject them into a vein instead of swallowing them as directed

What are the most commonly misused prescription medications?

According to the US National Institute on Drug Abuse, the three classes of medicines most commonly misused are:

• opioids—usually prescribed to treat pain

• central nervous system [CNS] depressants (this category includes tranquilizers, sedatives, and hypnotics)—used to treat anxiety and sleep disorders

• stimulants—most often prescribed to treat attention-deficit hyperactivity disorder (ADHD)

These medications can be obtained only with a doctor’s prescription, and they’re often prescribed after a thorough examination and history taking. Nonetheless, people still find ways to misuse them. Some even bypassed the medical outlets to obtain such medicines from illegal channels, such as the internet.

Non-prescription medications

To digress slightly, medications which one can buy without a doctor’s prescription are also subjected to misuse. Their abuse is even more common because not only they don’t require a doctor’s prescription, they’re also cheaper, easier to access, and are often perceived to be relatively safer than prescription medications (which, of course, is not necessarily true). Here are some non-prescription medications that tend to be misused:

• Codeine or dextromethorphan-containing cough syrups

• Pseudoephedrine-containing decongestants

• Loperamide, a common medication for stopping diarrhoea. However, in our body it can behave similar to opioid medication, and people abuse loperamide recreationally to achieve a euphoric state, informally referred to as “lope high”.

• Chlorphenamine, a cheap and commonly medication used for allergy and runny nose, is used as a cheap sleep aid or anxiolytic (eases anxiety). Its abuse has been related to pleasurable feelings such as euphoria, which reinforces the repetitive use of the drug and the possibility of developing drug dependence, but might also cause psychotic symptoms in certain individuals, such as those with mental illnesses or individuals concomitantly abusing other drugs. 

Consequences of prescription medication misuse

Misusing prescription medicines may seem like a good ‘quick fix’ at first, but its long-term health consequences can be severe. Prescription medication misuse can lead to emergency room visits, overdose deaths associated with prescription medications and drug dependence. It’s even more dangerous if a person is misusing multiple medications at the same time. 

Detect potential prescription medication misuse

Warning signs of prescription medication misuse include:

• Sudden changes in mood or behavior

• Being more irritable than normal

• Being more sleepy than normal

(These signs look a lot like PMS, but they are more intense and noticeable)

People who misuse prescription medication might tell their doctor they need more medication than they actually do. That way, they can get more of the drug they are misusing. They might also try to get the same prescription medicine from more than 1 doctor. Some people order drugs on the internet, too. But most people who misuse prescription drugs get them from a friend or relative, not a doctor.

If you are worried that you have a prescription medicine misuse problem, talk to your doctor or nurse, or to a mental health counselor. They can recommend treatments to help you overcome your problem. Treatments for medicines misuse include counselling, switching to other types of medicines that have less misuse potential and medicines that help to treat addiction.

For more information on drug addiction treatment and rehabilitation programmes organized by the Malaysian government, visit https://www.adk.gov.my/en/

If you think someone close to you is misusing prescription medicines, ask them if they are taking medicines differently from how they are meant to be taken. If they are, encourage them to speak to the doctor who prescribed the medicines. You can also ask your own doctor or counselor for advice. 

If you’re a parent, this topic deserves your attention, as drug abuse and misuse are on an increasing trend among teenagers in Malaysia. If you think your children might be having a drug misuse problem, speak to their doctors.

Prevent prescription medicines misuse

Drug misuse and abuse can snowball into a bigger problem, therefore it’s best to prevent it from happening in the first place. Here are things you can do to prevent prescription medicines misuse from happening:

• Tell your doctor about all the medicines you take, including over-the-counter medicines.

• Take medicine only as prescribed.

• Get proper instructions from the pharmacist before taking your medicine.

• Ask your doctor or pharmacist about your medicine if you are unsure about how it will affect you.

• Store medicines in a safe place, such as a locked cabinet. This will prevent other people from getting to them.

• Once your health problem is better, get rid of any leftover pills that were prescribed to treat the problem. You can flush them down the toilet, or mix them with something like dirt or cat litter before putting the mixture in the trash. Some government health clinics also take unused or leftover medicines.

A word from Doc2Us

If you have any questions related to your prescription medicines, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download Doc2Us app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

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Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

1. UpToDate - Patient education: Prescription drug misuse (The Basics)

2. The Pharmaceutical Journal - Misuse of prescription and over-the-counter drugs to obtain illicit highs: how pharmacists can prevent abuse

3. Over-the-counter medicine abuse – a review of the literature

4. Abuse of over-the-counter medicines: a pharmacist’s perspective

Written By

Ms Joyce Toh

Reviewed By

Doc2us Medical Board