Taking drugs outside of prescription

While the convenience of having your medicine available at the click of a button is awesome, it's becoming more common for people to set their own rules with prescription drugs, and we want to talk about it.

What are prescription drugs/ what are pharmaceuticals? 

Pharmaceuticals are manufactured drugs that you can get via prescription or in a pharmacy. People mostly use pharms for their intended purpose. Long-term use of prescription drugs can be beneficial for helping to treat pain, but there’s also a risk that this can lead to prescription drug addiction. That’s why it’s key to have an honest conversation with your GP about the exact medicines you need.

Drugs that are commonly used outside of prescription usually include sedatives and sleeping tablets, opioids and some treatments for mental illnesses. 

What happens if you take prescription drugs outside of your prescription? We break it down for you.

Ritalin 

There are some cases of people using Ritalin (methylphenidate) outside of prescription and this runs the risk of forming an addiction. Ritalin is a drug used to treat Attention Deficit Hyperactivity Disorder (ADHD). 

It’s sometimes used outside of prescription by students, who may feel under pressure regarding their academic performance, because it can offer a boost of energy and confidence and can allow students to work faster and concentrate better at tasks they would otherwise find hard (such as revision). Some students use it to fuel ‘all night cramming sessions’.

There are also reports of ritalin being sold very cheaply, for 50p to £1 per tablet. Side-effects of ritalin include sleeplessness, anxiety and paranoia

If you’re worried about your school or uni work, remember there are lots of ways you can get support for this that don’t involve taking ritalin or other ‘study drugs’. Take a look at our study tips content and get in touch with our team to talk through how you’re feeling.

Benzodiazepines

Benzodiazepines (including Valium (diazepam), Xanax (alprazolam), lorazepam, etizolam and many others) have a depressant effect. They can induce calmness, relaxation and soothe emotional pain. This means that they are dangerous when taken with alcohol and other drugs which depress the central nervous system, such as opiates, ketamine and GHB. In fact, the combined depressant effects can cause fatal overdose.

Benzodiazepines can also cause a lowering of inhibitions, especially when mixed with booze. This combination can also inhibit memory formation – so combining the two leads to “black outs” where people lose their memory. Although some people do just take benzos to get wasted, it can lead to really dangerous behaviour. This includes being violent or having unsafe sex.

Valium

In the 60s, people nicknamed Valium the sexist term, ‘mother’s little helper’; so called because it was widely prescribed to women as a form of anti-anxiety medication. Sadly at the time there was no awareness of how addictive Valium was, and lots of women formed a dependency on it which was really difficult to overcome. Valium is part of the drug group benzodiazepines. People sometimes use ‘benzos’ to come down from drugs such as ecstasy or speed (amphetamines). 

Dependence on benzos

The no.1 problem with benzos is that they are highly dependency forming – long term use causes serious physical dependency which can cause seizures and death on withdrawal. Many people who are dependent really, really struggle to reduce their dose without very unpleasant side effects such as panic attacks, severe insomnia and agitation. If someone becomes dependent on benzos they need to slowly taper their dose down over a number of months – and sometimes years.

Painkillers & other ‘pharms’ 

Weak opioids

These are prescription only painkillers which are usually prescribed, short term, for moderate pain. They include drugs like codeine, dihydrocodeine and tramadol. Although these drugs are sometimes referred to as “weak opioids”, they are still highly dependency forming and can cause addiction. If someone takes too many, or mixes them with alcohol or other drugs, they can overdose. They are usually only prescribed short term because there is evidence that they sometimes make chronic pain worse.

Strong opioids

These include morphine, oxycodone and fentanyl and can be very addictive. Strong opioids are usually prescribed for severe pain, such as after an operation, or in the end of life care of people with terminal illnesses. They include drugs like morphine, oxycodone and fentanyl. Strong opioids are very dependency forming and can cause addiction. Some, such as fentanyl, are really strong and can cause an overdose after only taking a tiny amount. If you are struggling with your use of strong opioids, visit your local drugs service who will be able to help you slowly reduce your intake.

Gabapentinoids (gabapentin and pregabalin)

These are drugs which are used to treat nerve pain and anxiety and some mental health issues. They act in a similar way to benzodiazepines, although are a different class of drugs. They can cause dependence and addiction when used longer term and can cause overdose, especially when mixed with other CBS depressants like alcohol and opiates.

Steroids 

Athletes commonly use steroids to build muscle. The side-effects include excessive aggression due to hormone imbalance. They are also linked with cardiovascular disease as well as reduced fertility. You can click here to find out more about them.

Antidepressants

Taking antidepressants outside of your prescription, or when they haven’t been prescribed at all can be dangerous as you can risk unpleasant side effects and overdosing. If you take more than the amount prescribed by your doctor you may experience symptoms such as nausea, vomiting and blurred vision. 

If you stop taking your course of antidepressants suddenly, this can also be harmful as you can get nasty withdrawal symptoms such as disturbed sleep, stomach problems and anxiety. If you decide to come off antidepressants you should do so slowly (usually over four weeks) and with the advice of your GP. Find out more from the NHS site.

If you’re taking antidepressants for low mood or anxiety, illicit drugs may make the symptoms worse. Below is some more information about some of the drugs that can cause risk when mixed with antidepressants:

Cannabis

• Using monoamine oxidase inhibitors (MAOIs) with high THC cannabis products can put the heart at risk, changing blood pressure, heart rate and rhythm
• Using cannabis with antidepressants can also extend the cannabis comedown
• If the cannabis you’re using has high THC levels then this can sometimes lead to increased anxiety when combined with antidepressants

MDMA

• MDMA can be high risk with antidepressants. Because they limit the serotonin surge that you usually get with MDMA, they stop you from getting the euphoric feeling you expect, and some people end up taking more MDMA
• This can lead to your body becoming flooded with serotonin, leaving you experiencing nausea, irritability, muscle rigidity and spasms. It can even be fatal.

Cocaine 

• Cocaine can be dangerous to combine with antidepressants as it can limit the effect they have
• Cocaine is a stimulant and taking it whilst on antidepressants can flood your body with too much serotonin
• The combination can make the comedown from coke really difficult, with more anxiety than usual

Is it illegal to use mediaction outside of a prescription?

If you are using pharms, it’s worth understanding the law. Medicines and drugs are controlled under either the Medicines Act 1968, or the Misuse of Drugs Act 1971, or both. Some pharms, like Ketamine, are restricted under 1971. Others, like anabolic steroids, are covered by both the acts.

However, a lot of prescription drug problems happen when people who are legitimately prescribed drugs use in ways other than their prescription recommends. People who do this aren’t breaking the law, but could still come to harm.

To get more information about the legal status of pharmaceutical drugs, access a drugs information service such as Release.

The Mix would like to thank Adam Waugh, a senior scientist at The Loop, for reviewing this article.