The 45 Warning Signs Of Prescription Drug Abuse

Notice the signs and symptoms of abuse before it is too late.

Millions of people go to the doctor every year and receive prescriptions for medications to alleviate symptoms that interfere with their daily lives. However, these life-saving medications are also incredibly dangerous if used incorrectly.

Intentional or accidental abuse of prescription drugs can occur with or without an actual prescription if taken in a dosage or by a method other than what was prescribed. In fact, some people use them for non-medical reasons to seek out the feelings and sensations they can cause when taken in high doses.

This guide was created to help you catch the warning signs of prescription drug abuse in your loved ones – or yourself – before it is too late to get help. This guide discusses the risk factors of addiction, the general warning signs of drug abuse, and specific addiction indicators for many commonly-abused prescription drugs.

  • The Risk Factors – Why do some people become addicted to prescription pills while others do not? Learn more about the risk factors for developing a problem.
  • Behavioral Changes – Most are not able to completely hide an addiction, but are still likely to try to hide it. Although minor, these signals may indicate of a deeper problem.
  • Physical Symptoms – Most commonly abused drugs broken down by the physical symptoms of abuse to help you better identify what medication they may be misusing.
  • How You Can Help – If you are concerned that a loved one might be abusing prescription drugs or might be at risk for developing a problem, there are ways you can help.

How Can So Many Be Abusing Prescription Drugs?

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2014, 15 million people used prescription drugs non-medically, which indicates a growing social issue in the United States. The same report also found that the only substances that are abused more frequently are alcohol and marijuana. This problem is snowballing due to increased availability of these drugs, less oversight on inappropriate prescriptions, and drug users’ perception that the drugs are not as dangerous as they actually are.

Because these drugs are prescribed by doctors, who are highly respected professionals in our society, people tend to perceive them as less harmful than they potentially can be. There are a number of judgment biases in the field of psychology that explain how perceptions of prescription pills become warped in the minds of their users. Prescription drug users may suffer from the risk compensation effect, believing their drug to be safe because they have a prescription from a doctor. They believe they can appreciate the drug for its sensational effects instead of its assistance in daily functionality and adjust their dosage as they please.

“Nobody knew how bad John’s addiction was, until it was too late”

This cycle becomes an easy transition to addiction. For example, the Partnership for Drug-Free Kids shared the story of John who fell victim to drug abuse when he was prescribed Vicodin for a back injury.

He was taking 30-40 pills a day until the stress became too much for his body. His mother had no idea he was addicted to his medication until she admitted him to the hospital shortly before he died of multiple organ failure. Sharing John’s story, she said, “Because he falsely believed he could handle abusing drugs, and because of the embarrassment that he felt, he never asked for help.”

The Risk Factors

The line between drug use and abuse is very thin, and most of the time people cross it without realizing they have done so. As with any drug, tolerance to prescription pills can increase, and the drug user may in turn increase their intake over time. Although some escalate their usage simply because of tolerance issues, others may do so because they find that their prescription pills fill needs other than their intended use.

Some find that their pills allow for easier and more fluid social connections because their inhibitions are lowered and their confidence is artificially inflated. If someone is trying prescription drugs among a group of people taking them recreationally, they may be succumbing to the pressure of fitting in. A person who deals with chronic pain, constant panic attacks, or any other debilitating physical or mental health issue may find themselves taking more pills to cope.

Why do some people become addicted while others are able to quit taking prescription pills? While the full answer to this question is complex, there are certain life factors that predispose someone toward abuse of drugs. If the drug user has previously experimented with drugs, they are more likely to abuse their prescription.

Other factors include:

  • Mental disorders such as depression or anxiety
  • Living in poverty
  • Family history of addiction
  • Suffered from Abuse, neglect or other trauma

Less severe risk factors include drug availability (how easy the drug is to obtain), aggressive behavior as a child, major life changes or transitions, and association with other drug users. These risk factors should not be taken as definitive signs that a person will abuse drugs, however. Many people who have several of these risk factors will never face addiction issues, and many people who do not have any of these risk factors will.

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Behavioral Changes

Whether or not these issues play a part in your loved one’s life, there are certain behavioral signs to watch for if you suspect an addiction to prescription drugs is forming. Most users are not able to completely hide a severe addiction, but they are still likely to try to hide their abuse, so these minor signals may indicate that more investigation is needed.

Keep an eye out for these behavioral changes:

  • Your loved one becomes more irritable or exhibits sudden mood swings or personality change without an obvious cause.
  • They become forgetful or clumsy when it is out of their nature.
  • They skip work, class, or other regular activities, or their performance in these areas suffers.
  • They lie, become more deceitful, and/or avoid eye contact.
  • They lose interest in personal appearance and/or things they once loved.
  • They have either a major loss or increase in appetite.
  • They have an extreme and sudden change in their choice of friends and hang-out locations.
  • They are suddenly asking to borrow money or have extra money with no obvious source.
  • They become angry and abusive, or engage in reckless behavior.

The Physical Symptoms

Some drug abusers display these behaviors, but some don’t. In either case, it is beneficial to know what physical symptoms to watch out for. If they have a prescription, the physical symptoms will likely be easier to spot because you may know what drug they are abusing. If they don’t have a prescription, we have broken down the physical symptoms by drug in the sections that follow to help you better identify what medication they may be misusing.

Opioid Pain Relievers

Opioid pain relievers are one of the most commonly abused prescription drugs. They are prescribed to treat both short- and long-term conditions such as surgery recovery and cancer. These drugs often contain or go by the name of codeine, hydrocodone, oxycodone, fentanyl, or morphine. They have the tendency to be abused because they make the user feel relaxed and intensely happy. Physical symptoms to watch out for include:

  • Confusion and lack of coordination
  • Lowered blood pressure
  • Dry mouth
  • Weakness, dizziness, sleepiness
  • Constricted pupils
  • Watery or droopy eyes
  • Nausea, vomiting, and constipation
  • Respiratory depression (inadequate ventilation)
  • Sleep deprivation or “nodding”
  • Slow, slurred speech
  • Slow gait
  • Dry skin, itching, or skin infections
  • Constant flu-like symptoms
  • Bruises or “track marks” (if injecting)


Depressants are also known as sedatives, sleep aids, tranquilizers, and barbiturates. They are often prescribed to treat anxiety, sleep disorders, and panic attacks. The user may feel a sense of well-being, intense happiness, and/or excitement when using and abusing these types of prescription drugs. Some physical effects to watch out for include:

  • Decreased attention span
  • Impaired judgment
  • Lack of coordination/dizziness
  • Lowered blood pressure
  • Memory problems
  • Slurred speech
  • Respiratory depression
  • Slowed reflexes


Stimulants cause the messages between the body and the brain to move faster so they make the user more alert and physically active. They are prescribed to treat attention deficit disorder or attention deficit hyperactivity disorder (ADD or ADHD), obesity, and narcolepsy. Some of the most commonly-used medications are Adderall, Ritalin, and Concerta. The user experiences increased alertness, attention, mood, and energy.

  • Loss of appetite or weight loss
  • Memory loss and problems thinking clearly
  • External indications of mood or emotional problems (aggressive or violent behavior)
  • High body temperature and skin flushing
  • Anxiety and delusions
  • Dilated pupils
  • Sweating, shaking or tremors
  • Restlessness and hyperactivity
  • Paranoia or nervousness
  • Increased blood pressure, heart rate, or irregular heartbeat
  • Repetitive behaviors

What To Do If You Are Concerned For A Loved One

First of all, do not feel guilty or responsible for your loved one’s behavior. Addiction is a mental illness and nobody is “to blame” when it happens. The most important thing is to recognize when there is a problem and address it immediately.

Tell them your concerns in a loving and non-judgmental way, listing specific examples of their behavior that worries you. Avoid threats, preaching, punishment, bribes, and emotional appeals. These methods will increase the guilt and shame in your loved one, which will only serve to increase their prescription drug abuse. Admitting that they have a problem and taking responsibility for their actions are the first steps on the road to recovery, and offers you both a chance to work toward a solution.

Don’t Wait Until It’s Too Late To Recognize A Problem

If you suspect someone you know is abusing prescription drugs, the first thing you should do is talk to them. Don’t wait until their symptoms become severe! Contact us at for guidance and get you the best help possible.