Then you have a moment of panic as you remember you have no refills left. "Gaaaaah!" you think. "I told him that doctor I'm still in pain, but he won’t give me another refill. Time to find a new doctor!"

If this situation sounds familiar, you may be facing a substance abuse problem. If so, you’re not alone – recent statistics from the National Institute of Drug Abuse show "20 percent of Americans ages 12 and older have used prescription drugs for non-medical reasons at least once." Even more troubling are the number of deaths related to prescription drug overdose. The Centers for Disease Control (CDC) says: "Every day, 44 people in the U.S. die from overdose of prescription painkillers, and many more become addicted."

The most commonly abused prescription drugs resulting in death are opium-based drugs (opiates), especially pain relievers such as morphine, codeine, oxycodone, hydrocodone, hydromorphone, and fentanyl. While some of the generic names of these drugs may not be familiar, some of the brand names include OxyContin, Percocet, Vicodin, and Dilaudid. The Centers for Disease Control reports that opiate painkillers are responsible for three-fourths of prescription drug overdose deaths.

Why do some painkillers lead to addiction?

Painkillers, especially those previously mentioned, have a dramatic effect on the brain. Opiates are prescribed to reduce pain, which is often necessary following injury or surgery. However, according to research by the National Institute of Drug Abuse, using an opiate causes the brain to release excessive amounts of dopamine. Dopamine is a chemical that’s naturally present in the brain, released by our brain to reward natural survival behaviors, such as eating food. The release of dopamine gives us a sense of pleasure – which is why some foods can improve our mood.

Unfortunately, opiates over stimulate this system and "produce euphoric effects, which strongly reinforce the behavior of drug use — teaching the user to repeat it," the National Institute of Drug Abuse reports. Additionally, the use of opiates over a long period of time may require the patient to increase their prescription strength in order to have the same pain-relieving effects. Even more concerning is that the patient may begin to rely emotionally on this sense of euphoria. The results are an addiction that’s difficult to overcome and often requires treatment for both its physical and mental components.

Are other prescription drugs commonly abused?

One of the common ways prescription drugs are abused is when patients "share" their medications with someone else. Because each person responds differently to the effects of drugs, heath risks increase when taking a non-prescribed drug, including (but not limited to) the possibility of allergic reactions, incompatibility with other substances such as alcohol, and perhaps a life-threatening drug overdose. Additionally, in the United States, sharing prescription drugs is a felony, as is being in possession of a non-prescribed drug.

Some medicines not typically prescribed for pain but often shared (and even sold) to others are medications for attention deficit disorder, sleeping disorders, or medications designed to treat anxiety: drugs such as Adderall, Ritalin, Ambien, and Xanax. Regardless of the reason for sharing medications, distributing non-prescribed medications to others is considered drug abuse, and can result in prosecution, a criminal record, fines, and even jail time. What is the difference between drug abuse and drug addiction?

The University of Maryland Medical Center defines drug abuse as "the recurrent use of illegal drugs, or the misuse of prescription or over-the-counter drugs with negative consequences."

The National Institute of Drug Abuse defines drug addiction as "a chronic, relapsing brain disease that is characterized by compulsive drug-seeking and use, despite harmful consequences."

Based on these definitions, understand that a person can use a controlled substance in an inappropriate way, and may not necessarily become addicted. However, if a person abuses a drug regularly, it may easily result in the mental illness known as addiction.

What are some of the symptoms of drug addiction?

If you’re wondering if yourself or a loved one may have moved from abusing a drug (using it more than prescribed) into full-blown drug addiction (compulsively using the drug in a harmful way), a guide from the Utah Department of Health’s, titled Prescription Drug Abuse Prevention Toolkit, may help you better understand the following symptoms related to drug addiction:

• Taking higher doses than prescribed
• Continually "losing" prescriptions so more prescriptions must be written
• Seeking prescriptions from more than one doctor
• Stealing, forging, or selling prescriptions
• Appearing to be high, unusually energetic, revved up, or sedated
• Excessive mood swings
• Increase or decrease in sleep

How can you help prevent prescription drug abuse?

Often, prescription drug abuse can be addressed before it turns into addiction. Here are a few common recommendations to help prevent drug abuse:

• Keep all medications out of the reach of children, with the child-proof cap securely in place
• Keep controlled substances (the type of prescription that requires you to show your identification to obtain it from the pharmacy) hidden, or if possible, in a locked container
• Pay close attention to the number of pills you were prescribed and how many you should have left in the pill bottle. If you think someone’s been taking your medication, relocate your medication and keep a record of your usage
• Follow the dosage recommendations when taking your medications
• If you find you’re calling the pharmacy to obtain a refill sooner than allowed, talk to your primary care physician about the situation and whether it’s time to get help
• NEVER share your medications with anyone else
• ALWAYS correctly dispose of your unused medications. There are many safe drop-off sites for unused medications, or ways to make medications un-usable (contact Utah Department of Heath for information regarding Utah drop-offs sites and recommendations on how to dispose of medications)
• Remember to dispose of your family’s unused medications. You don’t want family members fighting a battle with addiction because you forgot that grandma has some medications left in her cabinet

What can you do if you suspect drug addiction?

If you suspect you or someone you know has a drug addiction, help is available. Most drug addictions can be successfully overcome with help from your primary care physician, a support group of friends and family, and outpatient therapy. However, in more severe cases where inpatient treatment is needed, Intermountain Healthcare offers programs such as Summit Day Treatment in Salt Lake City, along with a variety of other treatment programs around Utah. Do we really have a prescription drug abuse problem in Utah?

If you’ve read this far, it’s likely you know of someone who’s struggled with prescription drug abuse or addiction. Despite our efforts to promote and encourage healthy living, Utah is rated eighth in the nation for prescription drug abuse. Data show there was “nearly a five-fold increase in opioid-related DEATHS in Utah” in a span of less than 10 years, according to the Utah Department of Health. In 2012, an average of 21 adults in Utah died as a result of prescription pain medication EACH MONTH.

One death due to prescription drugs is too many. It’s time to act before it’s too late.