Prescription Drugs
The non-medical use or abuse of prescription drugs remains a serious public health concern. According to the National Institute on Drug Abuse's (NIDA) research report Prescription Drugs: Abuse and Addiction, there are three classes of prescription drugs that are most commonly abused:

• opioids, which are most often prescribed to treat pain,—examples include: codeine, oxycodone (OxyContin and Percocet), and morphine (Kadian and Avinza);
• central nervous system (CNS) depressants, which are used to treat anxiety and sleep disorders—examples include: barbiturates (Mebaral and Nembutal) and benzodiazepines (Valium and Xanax);
  
• stimulants, which are prescribed to treat the sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity—examples include: dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta).
  

Many Americans benefit from the appropriate use of prescription pain killers, but, when abused, they can be as addictive and dangerous as illegal drugs. Prescription drugs should only be taken exactly as directed by a medical professional.

The Synthetic Drug Control Strategy addresses the extent of and problems associated with prescription drug abuse. Prescription drugs account for the second most commonly abused category of drugs, behind marijuana and ahead of cocaine, heroin, methamphetamine, and other drugs. Prescription drug abuse poses a unique challenge because of the need to balance prevention, education, and enforcement, with the need for legitimate access to controlled substance prescription drugs.

Extent of Use
Data from the National Drug Intelligence Center's 2006 National Drug Threat Survey (NDTS) reveal that 78.8% of state and local law enforcement agencies reported either high or moderate availability of illegally diverted pharmaceuticals.
According to the 2005 National Survey on Drug Use and Health (NSDUH), approximately 48.7 million Americans aged 12 or older reported non-medical use of any psychotherapeutic at some point in their lifetimes, representing 20% of the population aged 12 or older. Approximately 6.4 million Americans aged 12 or older reported current (past month) use of psychotherapeutic drugs for non-medical purposes, representing 2.6% of the population. In this report, psychotherapeutics includes any prescription-type pain reliever, tranquilizer, stimulant, or sedative but do not include over-the-counter drugs. Additional data from the 2005 NSDUH show that 2.2 million people, aged 12 or older, initiated nonmedical use of prescription pain relievers within the past year.

Each year, the Monitoring the Future (MTF) study asks drug use and related questions of 8th, 10th, and 12th graders nationwide. MTF provides usage estimates for alcohol, tobacco, illegal drugs, and substances that are only legally available by prescription. The study includes data for the non-medical use of amphetamines, stimulants including Ritalin, and sedatives (barbiturates) including: methaqualone, tranquilizers, the narcotic pain relievers Vicodin and OxyContin, as well as GHB, Ketamine, and Rohypnol, which is not legal for prescription in the United States. Survey respondents were asked to exclude from their responses any use of prescription drugs that occurred under medical supervision. MTF data for 2006 show that lifetime prevalence rates for amphetamine use without a doctor's orders were 7.3% for 8th graders, 11.2% for 10th graders, and 12.4% for 12th graders. Approximately 8.1% of 12th graders surveyed in 2006 reported annual(past year) use of amphetamines without a doctor's orders. According to data from the Bureau of Justice Statistics, approximately 21.3% of State prisoners and 16.9% of Federal prisoners surveyed in 2004 indicated that they abused depressants at some point in their lives. For this report, depressants were defined to include barbiturates, tranquilizers and Quaalude.

Health Effects
The health risks associated with prescription drug abuse vary depending on the drug. For example, abuse of opioids, narcotics and pain relievers can slow or stop breathing. The abuse of depressants, including benzodiazepines and other tranquilizers, barbiturates and other sedatives, can result in seizure, respiratory depression and decreased heart rate. Stimulant abuse can lead to high body temperature, irregular heart rate, cardiovascular system failure and seizure. Inappropriate use of prescription drugs, including use without a prescription or medical supervision, or using in a manner other than exactly as prescribed, can lead to addiction in some cases.

The Drug Abuse Warning Network (DAWN) receives reports of emergency department (ED) episodes involving the non-medical use of legal drugs. These can involve the deliberate abuse of prescribed or legally obtained over-the-counter (OTC) medications or of pharmaceuticals diverted for abuse. Accidental overdoses or adverse reactions to OTC or prescription drugs taken as directed are not reportable to DAWN unless they are present in combination with an illicit drug.


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