Prescription Drug Addiction

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Many prescription medicines that treat pain, anxiety, sleep problems and ADHD can lead to addiction when they are misused. The signs, the withdrawal risks and the treatments available differ for each of the three drug classes.

In This Article

• What Is Prescription Drug Addiction?
• Types of Prescription Drugs That Are Misused
• Signs and Symptoms of Prescription Drug Addiction
• Prescription Drug Withdrawal: Symptoms, Timeline and Safety
• Treatment for Prescription Drug Addiction
• Risks and Long-Term Effects of Prescription Drug Misuse
• Frequently Asked Questions About Prescription Drug Addiction

What Is Prescription Drug Addiction?

Taking a medicine other than as the prescriber directed is prescription drug misuse, and misuse of certain medications can result in addiction, diagnosed by clinicians as a substance use disorder. MedlinePlus names four common forms of misuse: taking medicine prescribed for someone else, taking a larger dose than prescribed, taking the medicine in a different way than directed, and using it for another purpose, such as getting high. MedlinePlus adds that the drugs where misuse can lead to addiction are opioids, sedatives, tranquilizers and stimulants, and lists risk factors that include a lack of knowledge about the drug and its risks, a previous addiction to other substances and certain mental health conditions.

The National Institute on Drug Abuse (NIDA) groups the most commonly misused prescription drugs into three classes. Opioids are usually prescribed to treat pain, and misusing them can lead to opioid addiction. Central nervous system (CNS) depressants are a category that includes tranquilizers, sedatives and hypnotics. Stimulants are most often prescribed to treat attention-deficit hyperactivity disorder (ADHD). Dependence is not the same as addiction: the Centers for Disease Control and Prevention (CDC) explains that tolerance and withdrawal are not counted toward a diagnosis for people taking opioids solely under appropriate medical supervision. Many people who develop a substance use disorder began with a valid prescription from their own provider.

Types of Prescription Drugs That Are Misused

Opioid pain relievers, CNS depressants including benzodiazepines, sleep medications and barbiturates, and stimulants prescribed for ADHD are the three classes the National Institute on Drug Abuse uses for the prescription drugs people misuse most. Each class affects the brain in a different way, so the signs of misuse, what withdrawal involves and the treatment that helps differ from one class to the next.

Within the opioid class, fentanyl is 50 to 100 times more potent than morphine, according to the Centers for Disease Control and Prevention. Among the CNS depressants, MedlinePlus notes that the sleep medication zolpidem may be habit forming.

Many of the opioids and stimulants in these classes are controlled substances. The Drug Enforcement Administration places oxycodone (OxyContin), fentanyl, methadone, hydrocodone combination products such as Vicodin, Adderall and Ritalin in Schedule II, the class for drugs with a high potential for misuse and use potentially leading to severe psychological or physical dependence.

One medication outside these three classes, gabapentin, can also be misused.

Signs and Symptoms of Prescription Drug Addiction

The signs of an addiction to a prescription medicine include taking more of it than the prescriber directed, taking pills prescribed for someone else, using the medicine to get high, feeling strong cravings for it, and trying to cut back without success. Someone who takes a medicine exactly as prescribed is not misusing it. The physical signs depend on the class: opioids tend to cause drowsiness and slowed breathing, sedatives cause sleepiness and poor coordination, and stimulants can bring a pounding heart, trouble sleeping and restless energy.

Behavioral signs

Behavioral signs show up in what a person does. Mayo Clinic and the Centers for Disease Control and Prevention (CDC) name signs such as:

• Trying to get prescriptions from more than one prescriber
• Forging, stealing or selling prescriptions
• Making poor decisions
• Spending a great deal of time getting, using or recovering from the medicine
• Falling behind at work, at home or at school because of it
• Giving up activities that used to matter
• Taking it in situations where it is dangerous

Physical signs by drug class

The National Institute on Drug Abuse (NIDA) and MedlinePlus list the signs by class:

Mayo Clinic also names these sedative signs: drowsiness and confusion, slurred speech, unsteady walking, trouble with memory and slowed breathing.

Psychological signs

The psychological signs include:

• Cravings, or strong urges to keep taking the medicine (CDC)
• Hostility or mood swings (Mayo Clinic, 2022)
• Continuing to take it even though it is causing physical or psychological problems (CDC)

When these signs cluster together, a clinician can check them against the criteria for a substance use disorder. For opioid addiction, the CDC explains that a diagnosis means meeting at least two of the 11 criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) within a year. Severity runs from mild, at 2 to 3 criteria, to moderate, at 4 to 5, to severe, at 6 or more. The scale applies beyond opioids: according to the Substance Abuse and Mental Health Services Administration, among people with a CNS stimulant use disorder in the 2025 National Survey on Drug Use and Health, about half (47.9%) had a severe disorder and 29.8% had a mild disorder.

If You’re Worried About Someone

Seeing these signs in someone you love lands differently than suspecting them in yourself. Learning how to help a loved one starts with knowing what these signs can mean, and when a direct conversation has not changed anything, some families bring in a professional to plan interventions. One sign on its own does not prove an addiction, but a pattern of them is a reason to talk with a doctor or the prescriber.

For a closer look at one class, go deeper on opioid addiction signs, Xanax addiction or Adderall addiction signs.

If you or someone you love is experiencing a substance use disorder, help is available.

800-681-1058

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Prescription Drug Withdrawal: Symptoms, Timeline and Safety

How risky withdrawal is depends on the drug class. Opioid withdrawal is very uncomfortable but usually not life-threatening on its own, MedlinePlus and the World Health Organization (WHO) say. Dehydration is a danger, and overdose risk is high if use begins again after tolerance drops. Withdrawal from benzodiazepines and other sedatives is dangerous: an abrupt stop can cause seizures. Stimulant withdrawal is usually not physically dangerous, though severe depression and extreme tiredness can come with it. Never stop or cut a prescribed dose without talking to the prescriber.

Do not stop a benzodiazepine or another sedative all at once. Quitting too fast can trigger seizures, and seizures can be life-threatening. Speak with the prescriber before any dose change, and call 911 for a seizure.

Fully developed opioid withdrawal occurs at 1 to 3 days (short-acting) and 72 to 96 hours (long-acting) after last use, the Substance Abuse and Mental Health Services Administration (SAMHSA) says. MedlinePlus reports most opioid overdose deaths in people who just finished detox.

The National Institute on Drug Abuse (NIDA) explains that continued use of central nervous system (CNS) depressants can lead to dependence, and stopping abruptly can bring withdrawal, sometimes seizures as a rebound effect. Benzodiazepine symptoms may last weeks or as long as 12 months, the Food and Drug Administration (FDA) adds. MedlinePlus lists alprazolam withdrawal signs (sleep problems, ringing in the ears, muscle twitching, seizures) and says not to stop sleep medication zolpidem without the prescriber, particularly after more than 2 weeks.

Stopping a prescription stimulant rarely threatens the body: NIDA names fatigue, depression and disturbed sleep as the symptoms, StatPearls calls them mild with no mortality tied to stimulant withdrawal, and SAMHSA has found no consistent physiologic disruptions requiring a gradual withdrawal. MedlinePlus warns that suddenly stopping dextroamphetamine and amphetamine can bring severe depression and extreme tiredness, and StatPearls notes a protracted phase can include depression with suicidal thoughts. Call or text 988, the 988 Suicide & Crisis Lifeline, for thoughts of suicide.

Barbiturates, phenobarbital among them, belong to the CNS depressants as well, and NIDA warns that withdrawal from certain medications in this group can be severe and potentially life-threatening.

Every range in the table is typical, not exact: onset and duration vary by person with the drug’s half-life, the dose and the length of use. For someone facing withdrawal from a medicine they depend on, medical detox is the supervised setting for this stage; withdrawal timelines by substance show how widely the clock differs between drugs.

When to get medical help:

• Call 911 for a seizure, unresponsiveness or slowed breathing.
• Call or text 988 for suicidal thoughts or any mental health crisis. The line is available 24/7/365, conversations are free and confidential, and alcohol or drug use concerns are covered.
• Talk to the prescriber before any change in dose, and before stopping any of these medicines.

Treatment for Prescription Drug Addiction

The class of drug involved decides the treatment. Opioid addiction has three FDA-approved medications, used together with counseling. There are none for addiction to CNS depressants or to prescription stimulants, so care for those classes centers on a supervised dose reduction where needed and on behavioral therapies such as cognitive behavioral therapy (CBT) and contingency management.

Opioid pain relievers

The Food and Drug Administration (FDA) has approved three medications for opioid use disorder: methadone, buprenorphine and naltrexone. All three have been shown to be safe and effective, and a treatment guide from the Substance Abuse and Mental Health Services Administration (SAMHSA) covers the same three. The National Institute on Drug Abuse (NIDA) describes how each works: methadone is a synthetic opioid agonist that prevents withdrawal symptoms and relieves cravings, buprenorphine is a partial opioid agonist, and naltrexone keeps other opioids from binding to and activating opioid receptors. A separate medication, lofexidine, reduces the physical symptoms of withdrawal rather than treating the addiction itself; StatPearls notes that in May 2018 the FDA approved lofexidine hydrochloride as the first non-opioid medication for managing opioid withdrawal syndrome, and its FDA labeling approves it for adults who are stopping opioids. These medications are combined with counseling in opioid addiction treatment.

Sedatives and tranquilizers (CNS depressants)

For CNS depressants such as benzodiazepines, sleep medications and barbiturates, NIDA reports there are no FDA-approved medications for treating the addiction. When someone has become dependent on one of these drugs, the dose is tapered gradually under a prescriber’s management. NIDA also notes that cognitive behavioral therapy has been used successfully to help people adapt to discontinuing benzodiazepines, and it is a core part of benzodiazepine addiction treatment.

Prescription stimulants

There are likewise no FDA-approved medications for stimulant addiction, NIDA reports, so treatment is based on behavioral therapies that are effective for cocaine and methamphetamine addiction, including contingency management and cognitive behavioral therapy. When someone has been taking a prescription stimulant, the first steps in care may be to taper the dosage and to ease withdrawal symptoms. Most of these medications are prescribed for ADHD, so the relationship between ADHD and addiction is worth understanding when misuse began with a legitimate prescription.

Treatment for any of these classes can take place at several levels of care, from medical detox through inpatient rehab to outpatient programs a person attends while living at home.

Anyone concerned about a prescription should talk with the prescriber before changing how they take it. To explore treatment programs, you can search the rehab directory by state and city. SAMHSA also runs the National Helpline at 1-800-662-HELP (4357), a free, confidential treatment referral and information service available 24 hours a day, 365 days a year, in English and Spanish.

Risks and Long-Term Effects of Prescription Drug Misuse

Prescription drug misuse is common, and it spans every drug class. In 2025, 2.4% of people aged 12 or older, or 6.9 million people, misused prescription opioids in the past year, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). That survey also found prescription tranquilizers or sedatives misused by 1.5 percent of people, or 4.2 million, and prescription stimulants by 1.4 percent, or 3.9 million people, SAMHSA reports.

The most serious immediate risk is overdose. Opioids slow breathing, and the National Institute on Drug Abuse warns that taking opioids with alcohol or sedatives increases this risk. The sedatives in that warning include benzodiazepines, and a benzodiazepine overdose can slow breathing the same way. With stimulants, the danger centers on the heart: MedlinePlus reports that overusing dextroamphetamine and amphetamine may also cause serious heart problems or sudden death. Pills bought outside a pharmacy carry one more risk, because the Centers for Disease Control and Prevention reports that illegally made fentanyl is increasingly pressed into counterfeit pills made to look like oxycodone or alprazolam.

The harm does not stop with a single dose. Mayo Clinic lists these long-term effects of prescription drug misuse by drug class:

• Opioids: a slowed breathing rate and the potential for breathing to stop, constipation, nausea, and worsening or increased sensitivity to pain with higher doses.
• Stimulants: an increase in body temperature, heart problems and high blood pressure.
• Anti-anxiety medicines and sedatives: memory problems, low blood pressure and slowed breathing.

Frequently Asked Questions About Prescription Drug Addiction