Alcohol and drugs

• Stay away from alcohol, cigarettes and drugs during pregnancy.
• These substances can seriously harm you and your baby.
• Talk to your health provider and seek help to quit.

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When your health care provider orders a prescription medicine for you, she tells you what it is for and how to take it. The label on the bottle and sometimes a piece of paper inside the package give you more instructions. Using a prescription in any other way than instructed can lead to prescription drug abuse.

Prescription drug abuse can take different forms. Here are some examples:

• Using more than the amount ordered by a provider
• Taking the medicine with alcohol or certain narcotics
• Using a friend or loved one’s prescribed medication to relieve your back pain or headache
• Using a medicine not prescribed for you

Sadly, prescription drug abuse is on the rise. According to the National Institute on Drug Abuse, these drugs have become easier to get and are being abused more often. In fact, prescriptions for pain relievers, such as oxycodone and hydrocodone, jumped from 40 million in 1991 to 180 million in 2007.

Everyone needs to be careful about using prescription medicines outside of a health provider’s orders. This is especially true for pregnant women. Some medications can hurt your baby, causing birth defects, premature birth and other health risks. Pregnant moms should always talk to their health provider before taking any medication, including over-the-counter products.

Availability of prescription drugs
Prescription medicines are for people who need them. But many homes have medicine cabinets and drawers filled with leftover prescription medications. This makes it easy for other household members to obtain medicines that can be harmful.

Even more alarming, some medications can be obtained easily over the Internet. Some countries don't require a health provider's prescription to order medicines online. This allows anyone to buy medications by simply using a computer.

Health risks
Abuse of prescription drugs can cause many health problems, including making a person physically dependent or addicted to these medications. Certain prescription drugs can also cause other health concerns.

For example, opioid painkiller medications are usually prescribed to relieve pain after surgery or chronic pain. They include medications like oxycodone (OxyContin, Percocet) or hydrocodone (Vicodin). When a person abuses these painkillers, she may experience:

• Irregular, or loss of, menstrual periods
• Fertility issues 
• Trouble breathing, such as slowed or stopped breathing

Sedatives or tranquilizers are usually prescribed for anxiety, panic attacks or sleep disorders. They include medications such as diazepam (Valium), alprazolam (Xanax) or lorazepam (Ativan). When a person abuses these medications, she may experience:

• Memory trouble
• Irregular body temperature
• Coma or death

Stimulant drugs are typically prescribed for attention deficit hyperactivity disorder (ADHD). They include medications like methylphenidate (Ritalin) or dextroamphetamine (Dexedrine or Adderall). These medications may also be given to someone with narcolepsy, a condition in which the brain has trouble controlling when to sleep and when to wake. When a person abuses these medications, she may experience:

• Seizures
• Delusions or hallucinations
• An increased risk of stroke

Prescription drug abuse can be especially dangerous during pregnancy. Some of these drugs can affect the blood flow from a mother to her unborn baby. Certain prescription drugs can cause a baby to be born too small or too soon, birth defects, or learning and behavioral problems.

The Food and Drug Administration (FDA) gives prescription drugs a letter grade of A, B, C, D or X to show which medications are safe to take during pregnancy. You can learn more about this letter grade system by visiting the FDA Web site, or by talking to your health provider or pharmacist.

For example, painkillers, tranquilizers and stimulant medications usually receive a grade of C or D. This means that while some research has shown that these medications can put an unborn baby's health at risk, the benefits these drugs have for an expecting mom's health may be more important than the risks to the baby. That's why it's important for a woman who is taking a prescribed medication to talk to her health provider; they can decide together what she can take during pregnancy.

Symptoms of prescription drug abuse
Unfortunately, it's not uncommon for a person to become addicted to prescription medications. These drugs turn on the reward center in the brain, making it hard for someone to give up the feelings these drugs temporarily provide. This helps explain why addicts may continue to abuse prescription medications even though the drugs can hurt their bodies and harm parts of their lives (relationships, jobs, etc.).

Some behaviors can be warning signs that you may be abusing prescription medications. Signs to watch for include:

• You tell your provider that you've "lost" medications and always ask for more.
• You visit several health providers to get more prescriptions.
• You steal medicines or fake prescriptions.

Depending on the kind of medicine being abused, certain physical symptoms may be a clue that you could be abusing prescription drugs.

Opioid painkillers
You may have:

• Depression or confusion
• Low blood pressure and breathing trouble
• Constipation

Sedatives, tranquilizers
You may have:

• Frequent sleepiness
• Confusion or impaired judgment
• Unbalanced, wobbly walk

Stimulants
You may experience:

• Weight loss
• Trouble sleeping
• Irritability
• Hypertension (high blood pressure) or irregular heartbea

Seek help
If you think you may be addicted to a prescription medicine, seek help. You may feel ashamed or embarrassed. Remember: This is a common problem. You are not alone. The sooner you seek treatment, the faster the road to recovery.

Talk to your health provider

• Tell your health provider about all the medicines you're taking and how often you take them.
• Tell your provider about any symptoms you have and any recent life changes or stresses
• Ask your health provider how to manage any medical conditions you have while seeking treatment for addiction.

Other options

• Confide in a trusted friend, family member or clergy member who can help you find support.
• Join a Narcotics Anonymous group in your area. The telephone number is in the white pages or community service pages of your local telephone book.

December 2008