There’s a thin line between prescription drug use, misuse, and abuse. So, when taking prescription drugs, it’s not always easy to know if you may have crossed the line from use to misuse or abuse. You or someone you care about may have a problem and not even know it. That’s why it is important to understand exactly what is meant by misuse and abuse ... and how you can avoid them. Be aware of the most commonly misused prescription drugs to watch out for. See how to recognize misuse when it occurs. Determine if you should reach out for help or intervene with someone else. Get all the facts.

What is prescription drug misuse and abuse?

Prescription drug misuse is taking a medication in a way not directed by your doctor, but still trying to treat a health problem. Misuse may include taking more of a medication than prescribed or taking an old prescription for a new injury. Misuse also includes offering your medication to a pal in pain.

Abuse is misuse, but abuse also includes taking a medication without a prescription or for the experience of feeling euphoric or getting "high." Misuse can lead to abuse, which can result in many adverse effects, including addiction.

Misuse and abuse can cross the line into addiction.

  • Taking a drug in a way not prescribed (but for an actual medical issue)
  • Taking more of a medication than prescribed or for longer than needed
  • Sharing a medication prescribed to you with someone else
  • Taking a drug not prescribed to you
  • Taking a drug to get “high”
  • Taking a drug in a way not prescribed (such as by crushing or snorting)
  • Mixing more than one medication
  • Taking a drug with alcohol to increase the effects
  • Being physically dependent/needing more of the drug to feel the effects
  • Seeking the drug despite negative effects on your life or body
  • Engaging in risky or illegal behaviors to get more drugs
If you have prescription drugs you no longer need you should get rid of them. Learn how to properly dispose of leftover prescription medication.

Can I become addicted?

Know the risk factors. You could be more vulnerable to addiction if you are at high risk. But even if you aren't at high risk, you could become addicted to your medication, unintentionally, if you don't follow your doctor's instructions exactly. When you take a prescription drug like a painkiller, the medication sends a pleasure signal to the brain—the same reward signals triggered by food, love, and stimuli the body needs to survive. Prescription painkillers act the same way as they help the body suppress pain. But over time, your body may need more of the drug to achieve the same level of relief. Don't do it. Your doctor has specified how much and how often your medication should be taken to keep you from becoming addicted. Contact your doctor if you are not experiencing relief or if your condition has gotten worse, don't change your dosing on your own. Always take your medication as prescribed.

What does it mean to be addicted?

Addiction may include a physical dependence on a drug, needing more to feel the drug’s effects. Being addicted also means that you may compulsively seek out more drugs even though there are negative consequences, and even break the law to get more. Many people addicted to prescription drugs will “doctor shop,” or see several doctors to get multiple prescriptions of the same drug.

The Army emphasizes readiness and personal responsibility, and improper use of medications can affect a Soldier’s level of performance. Prescription drug misuse and abuse is inconsistent with Army Values; the Warrior Ethos; and the standards of performance, discipline, and readiness necessary to accomplish the Army’s mission. Both the Department of Defense and Headquarters, Department of the Army have drug-testing policies in place to identify Soldiers who may be misusing or abusing prescription drugs. Soldiers are expected to use their medication responsibly and not step over that line.

Commonly misused prescription drugs

Some prescription drugs are more risky than others. People most often misuse the following types of drugs:

  • Opioid painkillers for pain relief, such as oxycodone, hydrocodone, morphine, codeine, Percocet, Tylox, OxyContin, Vicodin, Tylenol 3, Lortab, Demerol, and Kadian
  • Depressants for anxiety and sleep disorders, such as sedatives and tranquilizers like Valium, Xanax, Fiorinal, Lunesta, and Ambien
  • Stimulants for attention deficit disorders and narcolepsy, such as Ritalin, Concerta, and Adderall

Consequences for Soldiers

If you misuse or abuse prescription drugs, your actions could lead to serious consequences, including separation, dishonorable discharge, court-martial, and loss of military benefits. You could be hurting your family and losing a chance at future job opportunities.

Should you decide to be proactive and self-refer, you may be able to avoid the more serious consequences that usually follow if someone else reports your prescription drug misuse.

If you are suspected of using or misusing prescription drugs, your medical records will be reviewed. Should you be found to be using drugs illegitimately, you will be referred to the Army Substance Abuse Program (ASAP). If you need to be detoxified, you will automatically be referred to ASAP.

Once you are referred to ASAP, you will be evaluated by an ASAP counselor and a rehabilitation team. Your Commander will be heavily involved in determining the consequences of your actions. The team may recommend that you remain in the Army and go through mandatory rehabilitation. Or it may recommend rehabilitation with separation.

If you misuse or abuse prescription drugs, you will face an oral or written reprimand, suspension of access to classified information, separation from the Army, and/or court-martial. Once you are separated from the Army, you may face additional, ongoing consequences such as loss of benefits.

Voluntary Self-Referral

If you are having a problem with prescription drug misuse or abuse, the Army encourages you to seek medical help.

When you self-refer, you are protected by the Army’s Limited Use Policy, which means that protective evidence collected from you cannot be used against you in court or to define your service. It also means that you may still be eligible for an honorable discharge.

Non-Self-Identifying Referral

If you decide not to report your drug misuse or abuse, you are likely to experience more severe consequences, including a loss of protection from the Army’s Limited Use Policy. Misuse and abuse can be identified in four ways:
  • Command Identification/Referral. Your Commander becomes aware of your drug misuse or abuse.
  • Drug-Testing Identification. Your urinalysis drug test is positive for a drug, and you don’t have a current prescription.
  • Medical Identification/Referral. A doctor or health care provider finds signs of drug misuse or abuse during routine or emergency medical treatment.
  • Investigation and Apprehension. Military or civilian law enforcement identifies your drug misuse or abuse.

Army National Guard

If you are serving in the Army National Guard and you misuse or abuse prescription drugs, you are likely to be subject to the same procedures and consequences. Some differences may apply when you are on State versus Federal duty.

U.S. Army Reserve

If you are serving in the Army Reserve and you misuse or abuse prescription drugs, you are likely to be subject to the same procedures and consequences. Some differences may apply when you are on active duty versus on reserve duty.

Consequences of Separation

Misuse and abuse of prescription drugs can lead to separation from the Army, including other-than-honorable (OTH), bad-conduct (BCD), or dishonorable discharge (DD). Any of these can result in the loss of veteran benefits for yourself and your family, including disability compensation, GI Bill, and home loans. Misuse and abuse can also cause loss of civil rights, including future ownership of a firearm, employment opportunities, food stamps or temporary assistance for needy families, and education grants or loans.

How to avoid misuse and abuse

Always follow these guidelines when taking a prescription drug
Never take prescription drugs differently than your doctor directed. This can include taking too much of the drug, taking it too often, or taking leftover drugs to self-medicate when symptoms of an earlier injury return. This can also include taking the drug with alcohol, or crushing and snorting a drug to enhance its effect.

Never share your medication with others. Too often, people share prescription drugs to help a family member or friend. But whenever you give someone your pain medication, you are misusing prescription drugs. Giving someone else your medication could keep him from going to the doctor to treat a serious condition. That’s not only a bad idea, but it could also land you and the other person in a lot of trouble.

Never take medication that wasn’t prescribed to you. Taking someone else’s drugs could cause side effects, such as allergies and interactions with other drugs, even if you have been prescribed the same medication before.

Never take a prescription drug to get high or for the feeling it causes. That’s considered abuse, and abuse of certain prescription drugs—opioids, central nervous system depressants, and stimulants—can lead to addiction.

Always store and dispose of prescription drugs properly. Safe storage and disposal of these drugs is a big part of preventing drug misuse. Check out these tips on how to correctly store and dispose of your prescription drugs.

Effects of misuse and abuse

The misuse of prescription medication has led to a sharp rise in drug overdose and death rates in the last decade. These rates have reached alarming numbers in both Army and civilian communities.

More people are dying from prescription drug overdose than ever before

  • Drug overdose has been the country’s second leading cause of unintentional injury deaths since 2002.
  • More people die from drug overdose than from motor vehicle crash injuries.
  • Each day, 100 Americans die from drug overdose.
  • Drug overdose rates have more than tripled since 1999.
  • Most drug overdoses are from prescription medication, with prescription painkillers as a common source.
  • Nearly 15,000 people die each year in the United States from prescription painkiller overdoses.
  • More Americans die from prescription painkiller overdoses than from heroin and cocaine overdoses combined.

Emergency room visits due to prescription drug misuse are on the rise

  • In 2011, nearly half (49 percent, or 2.5 million) of all drug-related emergency room visits in the United States were due to the misuse of prescription drugs.
  • Such visits increased by 13 percent from 2004 to 2011.
  • Misuse of antianxiety and insomnia medications (prescription and over-the-counter combined) were the most common reasons for such visits, followed closely by prescription painkiller misuse.
  • Most of these visits (51 percent) involved a single drug, and 25 percent resulted in hospital admission.

Signs and symptoms

The following conditions and behaviors could signal that someone is misusing prescription drugs:
  • Showing anger or hostility, or having mood swings.
  • Sleeping a lot or not very much.
  • Seeming very revved up.
  • Seeming drowsy or sedated.
  • Showing up late to work often or suddenly having performance problems.
  • Having problems with money, family, or friendships.
  • Overdosing or taking more pills at once than were prescribed.
  • Asking to take someone else’s prescription drugs.
  • Taking the drug with alcohol.
  • Crushing, snorting, or injecting the drug to enhance its effects.
  • Hiding drug use.
  • Trying to refill a prescription early, or claiming that the pills were lost or stolen.
  • Going to different or multiple doctors to get the drug.
  • Faking symptoms to get the drug.
  • Craving the drug.
  • Illegally purchasing the drug.
  • Stealing the drug.
If you think you may have a problem with prescription drug use, talk with your doctor right away. Don’t wait. Your problem could become worse and lead to addiction or other issues. The earlier you ask for help, the better. See tips for talking with your doctor. To contact a local ASAP office or other support resource, visit the Service Locator.

It can be hard to tell, but if you think someone you know is misusing prescription drugs, learn how to intervene so he can get the help he needs.

Tips for Proper Use

Knowing how to use your prescription drug correctly is critical in preventing misuse. For safe use, follow these helpful tips:
  • When your doctor prescribes a medication, make sure you understand his or her instructions for when, how, and how long to take it.
  • Note the name of the medication that your doctor prescribes.
  • At the pharmacy, check that you receive the correct medication.
  • Take note of your new medication. Read the label, directions, and additional information before you start taking it. Be sure to review the following:
    • Your name, to make sure you’re given the medication that is meant for you.
    • What it looks like (for example, shape, color, size, marks).
    • Your dosage.
    • When to take it.
    • How to take it (for example, with food or on an empty stomach).
    • How long to take it.
    • The expiration date. This will let you know when you should no longer use your medication and when to properly dispose of any remaining drugs.
    • How it should be stored (for example, keep in the fridge, at room temperature, away from light). Be sure to follow proper storage tips.
    • The health risks, side effects, and whether your medication will interact with alcohol, over-the-counter pills, dietary supplements (vitamins, minerals, herbal medicine), or even food.
  • Call your doctor or pharmacist if the directions are unclear.
  • When you start taking a new prescription, monitor how you feel. Know how the medication affects you and write down the changes you experience. Does it make you drowsy? Is your stomach upset if you take it without eating first?
  • Call your doctor right away if you feel any side effects or have an allergic reaction.
  • Keep your medication in its original container. Never store in a container with other pills, vitamins, minerals, or herbal supplements. You may become confused, or the pills could interact with each other.
  • If using multiple medications, keep a tracking sheet so you have a handy list of all the prescription and nonprescription medications, vitamins, herbals, and other supplements you are taking.