Medication Misuse

Medicines: What are they?

A medicine or drug is a chemical substance, which is intended for use in the diagnosis, cure, prevention, or the treatment of a medical condition. Several of these medicines are freely available over the counter at pharmacies, while others need a doctor’s prescription; hence these are known as scheduled drugs or prescription drugs. All scheduled drugs are labeled so because they can be dangerous if taken in high doses, while several of them have an addictive potential. Thus these require a doctor’s prescription. This helps to ensure that they are being consumed as medicines (under the guidance of a physician) and not due to an addiction or chemical dependence that has been developed owing to repeated use.

Prescription drugs

Prescription drugs include certain painkillers, cough syrups, steroids, sleeping pills, and medications for anxiety, depression, psychosis, mania and epilepsy apart from others. If these are taken under medical supervision, they are not harmful. However, if taken in excess, they can alter the neurotransmitter levels in the reward center of the brain, such that the brain likes the effect they produce (although that wasn’t the reason why they were prescribed) and demands the medicine again and again in larger quantities. These are not primarily the drugs that people use for recreation (unlike alcohol, nicotine, opioids, cocaine, LSD, amphetamines etc.) However they do contain compounds that offer a ‘wellness’ feeling. It is this feeling that makes the patient ‘misuse’ them; i.e. the medicine is truly prescribed by the doctor for a valid medical condition but the patient ‘misuses’ it for the other desirable effects.

How medicines are misused

Lets consider the example of a painkiller containing an opioid compound (brown sugar), which tends to give a mental rush and good sleep, besides pain relief. The person begins to like this calming effect on the mind. When one decreases the dose, anxiety and sleeplessness stem up as a withdrawal reaction and this tends to psychologically intensify the pain. The anxiety of course worsens the situation overall. The person now presumes that he needs more medication to control the pain and decrease anxiety. The doctor refuses to prescribe it because its not actually needed. The patients take these themselves and progressively develop addiction and dependence. They fake prescriptions, go to different chemists, choose different brand names and go to multiple doctor’s for obtaining multiple prescriptions to procure the medication.

Are there rules?

Medicines are to be taken as per rules: Right drug at the Right Time in the Right Dose. At MINDFRAMES we help identify factors that predispose to misuse; underlying faulty defenses and wrong cognitions. We emphasize compliance with pharmacological use and motivate change to build a drug free life. Misuse typically promotes itself to abuse and dependence. The aim is to tame the fire while it is flickering and instill lifestyle change at the outset.

Signs of misuse

An index of suspicion should arise when one notices a preoccupation with a particular medicine and an inability to resist the desire to consume it. These signs usually help in diagnosis:

  • Anxiety
  • Irritation
  • Mood swings
  • Vomiting
  • Sweating
  • Red eyes
  • Convulsions
  • Weight loss
  • Forgetfulness
  • Sleepiness
  • Unclear vision

What is Schedule ‘H’?

Drug schedules are laid down by regulatory authorities to help differentiate medicines that carry an an abuse potential. Schedule ‘H’ drugs have addictive potential and always require a qualified doctor’s prescription. These are also commonly known as prescription drugs and can be inadvertently used for recreational purposes.

Why aren’t they banned?

Medical effects of these medicines, are helpful. Sedatives (sleeping pills) if taken rightly help treat insomnia; painkillers that contain opioids mitigate pain relief. Every medicine is a boon if taken in the right dose and at the right time.