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Prescription Drug Addiction: Treatment and Rehab

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Many prescription medications have the potential to become drugs of abuse, if they are misused. Misuse of prescription drugs means taking them other than prescribed. This includes taking a larger dose, using them more frequently, or taking them for other purposes than prescribed. Misuse also includes taking a prescription medication that is not intended for you. The misuse of prescription medication can potentially lead to a substance use disorder or addiction and oftentimes, professional treatment is needed. Regardless of how you came to seek treatment for prescription drug addiction, finding a qualified treatment center is key to solidifying your recovery.

Rehab can be highly effective for prescription drug addiction and can help you live a clean and sober life through clinical treatment.1 For example, misusing prescription drugs or any other addictive substance, can mimic the effects of dopamine, a chemical neurotransmitter that produces feelings of happiness, making you want to continue using.1 When you stop misusing prescription drugs, your brain resumes the natural production of dopamine, helping you find pleasure from other sources, and improving your overall mental and physical health.1

Here, we will address which prescription drugs are commonly abused, leading treatment approaches for prescription drug abuse, and how to access that care.


What are the Most Commonly Abused Prescription Drugs?

Prescription drugs are some of the most commonly abused substances in the United States. According to the United States Department of Justice, the most commonly misused prescription drugs are opioids, depressants (such as benzodiazepines, tranquilizers, barbiturates, and sedatives), and stimulants.2

Opioids are a category of painkillers that include Fentanyl, Vicodin (Hydrocodone), OxyContin (Oxycodone), Dilaudid (Hydromorphone), and Demerol, among others. Even with a doctor’s prescription, they are highly addictive, as about 80% of people using heroin used prescription opioids first.3 Opioid abuse is also highly dangerous; nearly 70% of drug overdose deaths in 2019 (equivalent to about 50,000 fatalities) were caused by an opioid.4

Between May 2019 and 2020, the Centers for Disease Control and Prevention (CDC) reported that 37 of 38 United States jurisdictions tracking opioid abuse data noted increases in opioid-related overdose fatalities.5 Of those jurisdictions, 18 out of 38 reported a greater than 50% increase in fatalities.5

Data from the CDC indicate that patients who are prescribed opioids are the highest-risk group for developing opioid addiction.6 As awareness of the opioid epidemic has increased, more physicians have considered alternative treatments for chronic pain in order to reduce addiction risk for pain patients.7

Valium and Xanax, are in the class of benzodiazepines and can have a high addiction potential if misused. These medications are prescribed for anxiety related disorders and sleep disorders over a short-term time period.8

Prescription drug addiction can worsen if 2 or more drugs are taken together, for example if Xanax is used with Vicodin. Since 2016, benzodiazepines have carried a “black box warning” against taking them with opioids due to their highly addictive properties when combined.9


How is a Prescription Drug Addiction Treated?

If you are addicted to prescription drugs, recovery is an important part of leading a drug-free life. A key element of this is finding supportive clinical treatment for prescription drug addiction. Addiction is often defined as the inability to control drug use despite the negative consequences it may have on your life. Drug addiction affects your behavior, thoughts, and emotions. The American Society of Addiction Medicine (ASAM) defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.”10

Decisions about clinical treatment are made based on your diagnosis, your current physical and mental health symptoms, and the level of care necessary to treat them.11 Typically, prescription drug abuse treatment uses 2 approaches: medical intervention and behavioral treatment.12

The ASAM has published standards of care to help determine the appropriate treatment plan for patients with substance use disorders based on their physiological, psychological, and other needs.13 The ASAM breaks down the various options for treatment from lowest intensity (outpatient services) to highest (medically managed intensive inpatient services).

Treatment for prescription drug addiction might require medically managed detoxification as the first step, due to the high risk of withdrawal symptoms that need to be treated by a professional.13 After detox, you most likely will enter into a longer term treatment program that focuses on behavioral management, triggers, coping skills, and relapse prevention.13 It is important to remember that no single treatment approach is right for every person—what you may need is specific to you. For this reason, it is a good idea to talk with a doctor, substance abuse counselor, or other treatment professional to make the best decisions possible.14

Prescription Drug Rehab

There are many factors to consider when choosing a treatment center to begin your recovery journey, but your safety and well-being are most important. If you are misusing prescription drugs like opioids or benzodiazepines, you may be at risk for withdrawal if you stop using or cut back, which can be very dangerous without medically supervised detoxification.15 Individuals often enter detox with prescription drugs still in their system, and over the course of several days, they are supervised by medical professionals until they are stable.15

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines detox as “a set of interventions aimed at managing acute intoxication and withdrawal.”15 Detox focuses on managing physiological withdrawal symptoms and stabilizing the patient before they can step down into behavioral treatment.15 Detox is considered the first stage of recovery from prescription drug abuse, and to be most effective, should be followed by appropriate medical and behavioral treatment.15

If you have co-occurring mental health and substance use disorders, you may choose a rehab with dual diagnosis treatment, consisting of individual or group therapy to address both conditions. Of the 20.3 million adults in the United States with diagnosed substance use disorders, 7.7 million have a co-occurring mental illness (about 37%).16 Some individuals may learn that they have a co-occurring mental illness in the evaluation stage of detox and seek rehab with dual diagnosis counseling as a next step.

Treatment programs may differ in their setting, focus, approach, and length. You may also consider finding a rehab center where you can complete multiple stages of treatment, including inpatient, outpatient, and aftercare.

Inpatient Treatment

During inpatient treatment for prescription drug addiction, you reside at the rehab center full-time for 28 to 90 days. It is important to commit to staying for the full length, as there is evidence to suggest that positive treatment outcomes are associated with retention in treatment.14

One benefit of inpatient rehab is that it offers 24/7 care and support. You will participate in group and individual therapy sessions, see doctors or other medical professionals, and have access to other wellness activities to help you create healthy habits and maintain your sobriety. Inpatient programs might include ancillary services to help you find stable housing, re-enter the workforce, or navigate the criminal justice system.14

Inpatient rehab can also be a highly effective option for individuals with complex medical or mental health needs as well.13 It is important to choose a prescription drug rehab center that is accredited by an organization like Joint Commission (JCAHO), which provides guidance on safety and quality improvement to medical facilities and has licensed medical and mental health care professionals on staff.17 If you are entering inpatient rehab with a complex medical history such as a difficult withdrawal, severe mental health issues, or prior relapse, then inpatient rehab may be a good option.

Outpatient Treatment

The main factor separating outpatient treatment from inpatient is that outpatient rehabs are non-residential. If you participate in an outpatient prescription drug rehab program, you can live at home and attend treatment several days of the week for several hours per day. This may be a step down from inpatient rehab for some people, or it could be an option if you have a strong support network at home but are unable to take a leave of absence from work or school while completing treatment.

There can be a lot of variation in the approach and intensity of outpatient treatment services. The highest level of outpatient care is a partial hospitalization program (PHP), which can involve up to 20 hours per week of group and/or individual counseling combined with medical services. You might benefit from a PHP program if you have had prior relapses, difficult withdrawal symptoms from prescription drug abuse, or need the structure of a daily group setting to aid in early recovery.

A step down from PHP is an Intensive Outpatient Program (IOP), sometimes also called an intensive day treatment program (IDT).13 While a PHP might consist of daily sessions Monday through Friday, an IOP typically meets 3-4 times per week for only 2-3 hours at a time. Depending on your needs, you may want to find an IOP with hours during the day or evening.

During the time you are in PHP or IOP, you may also participate in individual counseling with a psychologist, psychiatrist, licensed professional counselor, licensed social worker, or licensed chemical dependency counselor. Counseling sessions for prescription drug abuse typically focus on behavioral health topics like understanding what led you to misuse prescription drugs, how to manage cravings or urges, and how to prevent future relapse.18

Finally, many rehab programs include aftercare.13 Aftercare is usually held in group sessions, just like PHP and IOP, but with less frequency, and for only an hour or so at a time. The purpose of aftercare is to help you solidify coping skills and maintain sobriety, after completing a rehab treatment program. Many people continue going to 12-Step meetings like Narcotics Anonymous (NA) as part of aftercare.


Types of Therapy for Prescription Drug Addiction

Therapy for prescription drug abuse can take many forms, including:

Therapy for prescription drug abuse often draws influence from the 12-Step model of Alcoholics Anonymous (AA), and participants are encouraged to attend meetings for support outside of counseling sessions.19 AA is a peer support group led by others who went through treatment, and it welcomes people at all stages in recovery.20 There are also sub-groups of AA for specific drugs of choice, including NA for people in recovery from prescription drug abuse.21

Therapists also typically use modalities like Cognitive Behavioral Therapy (CBT), an approach that focuses on the interplay between thoughts, feelings, and behaviors to treat prescription drug abuse and co-occurring mental illness.22

Another approach used in prescription drug addiction treatment is Contingency Management (CM), which uses tangible rewards (like prizes or vouchers for goods and services) to reinforce maintaining abstinence.23


How to Pay for Rehab

When choosing a prescription drug rehab program, it is important to consider the financial aspect. Whether you are paying out-of-pocket, attending a publicly-funded program, or using your health insurance benefits, you should ensure that treatment will be paid for so that cost does not become a barrier to care.

Before incurring out-of-pocket costs, it is always recommended that you first verify your insurance benefits. Under the Affordable Care Act (ACA), health insurance plans must cover some amount of mental health and substance abuse treatment services, but this varies between plans.24 If you have a Health Maintenance Organization plan (HMO) you must choose a provider/facility for prescription drug abuse treatment that is within your network, but services are covered at a higher rate with less out-of-pocket cost.25 If you have a Preferred Provider Organization Plan (PPO), you have more choice in facilities or providers, but if they are not in-network according to your plan, you may pay more out-of-pocket after your insurance coverage.25

If you do not have health insurance, or are concerned about out-of-pocket costs, you may also seek a publicly funded treatment center.26 These programs receive funding through Medicaid and other government programs to provide services to people in their community.27 Publicly funded treatment programs typically have more restrictive admission criteria, as they have limited funding available per fiscal year.


Find a Prescription Drug Rehab Program

If you or someone you know suffers from a prescription drug abuse problem, you can receive the help you need 24 hours a day and 7 days a week by calling our Drug Abuse Helpline at 1-888-744-0069 Our friendly staff can help you find the best program or support group for your specific needs. All calls are toll-free and confidential.

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Kristen Fuller, MD, enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine and contributes to medicine board education. Her passion lies in educating the public on the stigma associated with mental health. Dr. Fuller is also an outdoor activist, an avid photographer, and is the founder of an outdoor women's blog titled, GoldenStateofMinds. In her free time, she enjoys hiking, backpacking, skiing, camping, and paddle boarding with her dogs in Mammoth Lakes, California, where she calls home.
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