Doctor Shopping - Commonly Abused Prescription Drugs

Commonly Abused Prescription Drugs

In the United States, most sedatives can only be legally dispensed with a prescription, because they have some potential for addiction and dependence. If sedatives are prescribed, it is sometimes in small quantities, which will last one week or even less. Examples of such drugs include zolpidem (Ambien), alprazolam (Xanax), and diazepam (Valium). Dependence on such medications usually arises because the patient comes to rely on the effects of the drug to fall asleep, or to prevent anxiety attacks.

Prescription pain medications that contain an opiate or opioid painkiller have a high potential for addiction and abuse, including oxycodone (common brand names Percocet, OxyContin), hydrocodone (Vicodin, Lortab), meperidine (brand name Demerol), hydromorphone (Palladone, Dilaudid), oxymorphone (Opana, Numorphan), and morphine (MS Contin, Kadian, Avinza). Less powerful opiates and opioids (such as codeine, propoxyphene), and tramadol are generally less addictive. Tramadol is a novel, non-scheduled analgesic similar in effect to other narcotic painkillers, but has a high risk of inducing seizures.

Newer medications of abuse include various preparations of the extremely potent and potentially addictive narcotic analgesic fentanyl, including Duragesic (a self-adhesive skin patch, available in five strengths which are 12mcg/hr, 25mcg/hr, 50mcg/hr, 75mcg/hr, and 100mcg/hr each to be applied for 3 days) and Actiq (berry-flavored lollipops that dissolve slowly in the mouth for absorption across the buccal mucosa, available in six strengths). All of these are categorized as Schedule II drugs under the U.S. Controlled Substances Act (with the exception of tramadol and some preparations of codeine and hydrocodone) and have stringent physical security associated with them. They must remain under lock and key at all times; every tablet must be precisely accounted for; no refills are permitted on prescriptions; and no telephone orders are accepted, with the exception of palliative care facilities (i.e., to discourage prescription fraud).