What Are the Top Abused Prescription Drugs?

The illegal manufacturing of drugs and counterfeit street drugs is a significant problem in the U.S. today. In fact, drug abuse can happen to millions of people with a legal prescription written by a licensed doctor and filled by a licensed pharmacist. But with more than 20,000 prescription medications approved by the U.S Food and Drug Administration (FDA) on the market today, it can be challenging to understand which of these drugs is especially prone to abuse. Here are some of the top abused drugs from that list.

Ranking Drug Abuse Is Tricky

Many factors come into play when determining how abusive a drug is. For one, we can rank drugs based on their dosage size or their overall potency compared to others. We can also compare drugs based on their drug class, deciding which drug class has a higher abuse potential than others. Some might suggest comparing substances by using the U.S. Drug Enforcement Administration (DEA)’s drug schedule list, which ranks drugs based on their addictive potential and medical use.

Another way of comparison is to take the statistics of drug overdoses and fatalities along with national drug use surveys to discover trends that occur with certain drugs on all lists. However, none of these approaches can provide us with a full picture. Many factors can contribute to drug abuse, including biology, family history, metabolism, and stress factors, which can vary from person to person.

Because of this, it is important to know that this list is not exhaustive or in any particular order. Instead, it will include the main prescription drugs that seem to check most, if not all, the category “boxes” mentioned above for abuse potential.


Benzodiazepines were once the most widely used prescription drug in America. The drugs were developed and promoted in the aftermath of barbiturate drug use and were believed to be a safe alternative to treating a wide variety of symptoms, including anxiety, insomnia, muscle spasms, and seizures. These drugs suppress the central nervous system and produce a relaxing sensation of euphoria, similar to alcohol. Multiple kinds of benzodiazepines are on the market. Most people have heard of Xanax, Klonopin, Ativan, and Valium, to name a few.

Each of these benzos varies in its onset of action (how fast it begins working) and duration of action (how long it works). Depending on what the symptoms are, a doctor will prescribe the benzodiazepine that best treats a particular symptom. Unfortunately, these drugs quickly gained a reputation for causing abuse and addiction that their forerunner barbiturate drugs had already gained. In fact, some medical professionals consider the benzodiazepine abuse problem to be an epidemic.


Opioids have unquestionably been an epidemic-inducing drug in the United States over the years. Opioid use has been around for quite some time, including when morphine was used for pain management after surgery and battlefield wounds. However, the epidemic of opioid use is focused on the 1990s when OxyContin hit the markets.

By 2001, sales exceeded $1 billion, and Purdue Pharma, the company responsible for manufacturing the drug, controlled a third of the U.S. pharmaceutical market. However, the company has faced a relentless number of lawsuits for the abuse potential of this “poor man’s heroin.” Because of this, the popularity and prescription frequency of OxyContin has decreased dramatically over the years.

However, the abuse surrounding opioid use isn’t limited to OxyContin. Other prescription opioids include Vicodin (hydrocodone), Percocet, and methadone. In the era of drug cutting and accidental overdose, we must mention fentanyl when discussing opioids. Legally made and prescribed fentanyl treats severe chronic pain, such as that in cancer patients. However, illegally made or illegally diverted fentanyl sold on the streets is often added to heroin, making the combination drug deadly to users.


Prescription stimulants are another commonly abused drug. Prescription stimulants include the drugs Adderall and Ritalin, and they work differently from central nervous system (CNS) depressants. Stimulants increase activity in the central nervous system, so they commonly increase energy and focus rather than relaxation. This makes prescription stimulants an effective treatment option for attention-deficit hyperactivity disorder (ADHD).

When compared to benzos and opioids, prescription stimulants are not as closely related to overdose death statistics, although they can cause deadly results when mixed with other drugs. With that said, prescription stimulants can cause addiction and dependence, and many people who abuse these drugs can experience poor sleep habits and a decline in nutritional habits. Long-term Adderall use can bring about detrimental health consequences, including an increased risk for stroke or heart attack.


Sedative drugs or “Z-drugs” are a class of drugs used almost exclusively as sleep aids. The reason these are referred to as “Z-drugs” is not that they help people sleep but because they include names like zolpidem, eszopiclone, and zaleplon. By far, the most popular of these drugs is zolpidem, which we know by the generic name Ambien. While these drugs are not the same as benzos, they work similarly to benzos and have a moderate-to-high addiction liability. As mentioned earlier about the alcohol-like effects of benzo use, sedative drugs are known for their intoxication effects. “Sleep driving” has been used to refer to someone who drives while “drunk” on sedative drugs like Ambien.

A Mixed Bag

A host of factors come into play with each drug, which can increase or decrease the likelihood of abuse. Because these drugs are so common (and legal with a prescription), one of the most important things to remember is the increased risk of mixing these drugs. The FDA always releases updated warnings for new dangers that come to light with various drugs over the years, and many of these warnings concern the deadly risk of mixing these drugs together.

Just because something comes in a pill bottle with a label and clear directions doesn’t mean it is harmless. If you or someone you love is prescribed any of the drugs mentioned above, remember that abuse is not limited to illegal drug use or failing to follow dosage directions. It can happen to anyone who uses these highly addictive medications as directed.


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