These include painkillers, cough mixtures, Valium and other sedatives, Rohypnol, and many others.
Over-the-counter drugs such as painkillers and cough mixtures can be bought anywhere by anyone. They come in tablet form, in capsule form, in syrup form and in powder form.
No questions are asked by anyone and people who are addicted to over-the-counter drugs can buy them in vast quantities from the same pharmacy or supermarket. Painkillers and cough mixtures that contain alcohol seem to be the most commonly abused over-the-counter medication. Over-the counter medicines are usually cheap and this makes them doubly attractive.
Prescription drugs are generally a little more difficult to procure as addicts need doctor’s prescriptions in order to get these. Some addicts have been known to use two or more doctors and pharmacists to feed their addictions, resorting to the devious behaviour which is characteristic of drug addicts generally. Prescription drugs come in many different forms – usually tablets or capsules.
They are usually prescribed legitimately in the beginning for existing medical conditions. Very often people overdose on prescribed medication and sometimes continue taking it after the condition for which it was prescribed is cleared.
The most commonly abused prescription drugs are painkillers, sedatives or sleeping tablets and stimulants. The combination painkillers that contain paracetamol, codeine and caffeine seem to be very popular amongst people who abuse analgesics.
Medication abuse in South Africa
As with most drug abuse, it is very difficult to get accurate figures of how many people are addicted or what they are addicted to.
South African society has undergone enormous change in the last decade or two. South Africans live under stress, as is the case with all societies in flux. As a result, there’s always an increase in substance abuse, whether of legal or illegal substances. The prevention of possible stress and pain is often a motivating factor in continuing to take prescription medication after it has served its purpose.
Medication abuse is the most prevalent among women, elderly people and adolescents worldwide. Studies in America have shown that most people who abuse medication would never dream of taking street drugs. They are also often in denial about their addiction.
Large numbers of people take prescription medication for non-medical purposes. Analgesics, also called opioids or painkillers, top the list, followed by sedatives and stimulants – in that order.
Laxatives are also abused on great scale by elderly people and young women, who take them in order to lose weight.
These are almost all taken orally. They are either taken after they are no longer needed and often obtained fraudulently, or they are taken in excess of the prescription.
“Medication taken over a period of time loses its effectiveness and greater doses of the same need to be taken in order to achieve the same result. When doses are increased without the knowledge of the doctor and medication is taken as a preventative measure, addiction has become a reality”, says Cape Town doctor, Dr Bridget Farham.
Effects of medication abuse
Initially, medication serves a purpose, but in its continued or excessive use that problems arise. There are so many different types of medication that get abused that they cannot all be mentioned here.
Some of the most famous are ‘Roofies’, the date-rape drug Rohypnol that gets sold on the black market for large sums of money. This is available on prescription as a sleeping tablet.
Addiction to any substance means that some natural bodily function is suppressed or hampered. For instance, if something is taken which stimulates serotonin production, the body gradually loses its ability to produce serotonin without the stimulus of this drug. If laxatives are taken over a long period of time, the body’s ability to evacuate the bowels decreases without the help of a laxative.
Long term addiction to any form of medication, whether over-the-counter or prescription drugs, can lead to liver and kidney damage, and in some cases heart and blood pressure problems. There are many other unpleasant side effects depending on which medication is abused.
These can vary tremendously from vague irritability and a slight headache, to withdrawal from prescription medication such as Pethidene, for which one has to be under medical care. From certain substances the withdrawal can be every bit as traumatic as withdrawal from street drugs such as heroin.
Psychological dependence on medication is sometimes a greater problem than the physical dependence, says Dr Farham. Someone who takes a painkiller at breakfast in case they might get a headache and two every night in order to sleep is most probably using the medication to mask other non-physical problems. The denial that their medication abuse is problematic is typical of all people who have a substance abuse problem, however small.
Most people do not want to admit that there is some underlying psychological cause to their addiction or that they are addicted at all. For them the term ‘drug addict’ conjures up an image of someone injecting heroin in a public toilet, not of an old lady taking six painkillers a day.
Headaches are the most frequent symptom of withdrawal – even from substances such as caffeine, says Farham. Ironically, frequent use of painkillers actually causes headaches, although it is not clear why.