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Substance abuse
Dangers of over-the-counter and prescription drugs
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.

 
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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.

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.

One of the most famous is 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.

Withdrawal symptoms
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.

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