Prescription Drugs with the Highest Addiction Potential

The terms “drug addict” and “drug addiction” often elicit derogatory images of individuals snorting cocaine in the back room of a club or shooting up heroin in a dark alley somewhere. However, the real picture is much more comprehensive.  In many cases it doesn’t involve street drugs, clandestine meetings, or young adults with questionable morals and too much time on their hands. Quite the opposite, actually.

With more and more people desperately seeking quick relief from common ailments like anxiety, pain, and exhaustion, prescription drug addiction is reaching epidemic proportions.  Granted, some who are addicted to these drugs abuse them for recreational purposes. But many started out taking them for legitimate reasons, only to find themselves becoming completely dependent on them. They’re not partiers, delinquents, or felons. They’re not hanging out in clubs and dark alleys. Rather, they’re often just regular, nice, respectable folks – your next door neighbor, the head of the PTA, the deacon at your church, or the CEO of a company.

While most prescription medications are not potentially addictive, far too many are.  It’s important to know which ones have a particularly high potential, especially if you are already taking them or are considering doing so.  It’s easy to assume, “I would never become addicted.”  But it happens more often and more readily than many realize – and sadly, that realization usually comes too late.

Three Main Categories

Following is a brief overview of some of the most highly addictive prescription drugs currently available in the U.S.  They typically fall into one of three categories:

  • Opioid Painkillers
  • Stimulants
  • Benzodiazepines

Opioid Painkillers

Physical pain is challenging, and in some cases, debilitating.  When it’s particularly intense or severe, or if it becomes chronic, powerful prescription pain medications can provide considerable relief.  In fact, pain relief is one of the top reasons people frequent doctors’ offices.

Unfortunately, many of these medications have a very high potential for addiction.  Legitimate users risk dependency for a variety of reasons, but particularly if they use the drug more frequently, in higher doses, or for longer periods of time than prescribed – all of which are easy to do when judgment is clouded by severe or chronic pain.

Recreational abuse of prescription painkillers is popular due to the euphoria these drugs can produce.  Some of the greatest offenders (and a new potential offender*) include:

Oxycodone (OxyContin, Percocet)

OxyContin is one of the most well-known and widely prescribed oxycodone medications.  Often called “Hillbilly Heroin,” the medication is widely abused for the euphoria it can elicit. Percocet, another frequently prescribed painkiller, is a combination of oxycodone and acetaminophen.  Both have a very high potential for addiction and can be very dangerous – and even lethal – if taken in high doses, combined with certain other medications, or combined with alcohol.

Hydrocodone (Vicodin, Zohydro*)

Prescription Drugs with the Highest Addiction PotentialHydrocodone is an opiate analgesic.  Up until very recently, hydrocodone has been available only when combined with other substances.  Vicodin, which is a powerful painkiller comprised of hydrocodone and acetaminophen, is probably one of the most well-known and highly addictive forms of this drug.  However, Vicodin’s top status is likely about to be bumped.

The FDA recently approved a new drug called Zohydro, which is pure hydrocodone and up to 10 times as potent as Vicodin.  A recent Huff Post article by Andrew Kolodny, M.D., aptly titled “Zohydro: The FDA-Approved Prescription for Addiction,” eloquently expresses the h2 concerns of many physicians and addiction specialists across the country.  Dr. Kolodny is the president of Physicians for Responsible Opioid Prescribing.  Not only will the potential for addiction be extremely high with this off-the-charts painkiller, the high potential for death via overdose is also frightening.  According to his article, a single Zohydro capsule is h2 enough to kill a child, and just two pills would be lethal for an adult who hasn’t developed a tolerance to opioids.

Meperidine (Demerol)

Designated only for the treatment of acute pain episodes, meperidine is another highly addictive opioid drug. Its potential for abuse is similar to morphine. The brand name for meperidine is Demerol. One of the potential dangers of this drug, when used for prolong periods, is seizures. Like other drugs in this category, Demerol can be especially dangerous if taken in high amounts or combined with alcohol, other street drugs, and certain other medications (particularly CNS depressants).

Opioid Pain Medication Withdrawal

As a general rule, it’s never wise to suddenly stop taking prescription painkillers. If you’ve developed a drug addiction to opioid medications, you may experience some or all of the following symptoms if you abruptly discontinue using them:

  • Yawning
  • Nausea and vomiting
  • Chills
  • Anxiety
  • Restlessness
  • Weakness
  • Sweating
  • Irritability
  • Nasal congestion
  • Abdominal cramps
  • Diarrhea
  • Confusion
  • Aching joints and muscles
  • Decreased appetite
  • Increased respiration
  • Insomnia
  • Tremors


Prescription stimulants are most frequently prescribed for two things: ADD / ADHD (attention deficit disorder / attention deficit hyperactivity disorder) and narcolepsy. ADD and ADHD affects millions of children and adults, and medication can be very beneficial in terms of helping to control and alleviate symptoms. Narcolepsy is a sleep disorder in which sleep-wake cycles are significantly disturbed. Approximately 1 out of every 2000 Americans suffer from it.

Stimulants are especially ripe for abuse and addiction. They stimulate the central nervous system, increasing energy levels, the ability to focus, and alertness. These properties make them especially appealing to individuals such as exhausted parents, shift workers, and college students during exam time. Some people also take them due to their belief that they’ll enhance their ability to learn.

Methylphenidate (Ritalin, Concerta)

This drug is widely prescribed for ADHD and ADD. In some cases, doctors also prescribe it “off-label” for other problems, including symptoms of depression, fatigue, and obesity.  Unfortunately, even at normal doses methylphenidate and similar stimulant medications can be very dangerous – and even lethal – for individuals with certain types of heart conditions.  It can have serious side effects. For example, it can trigger mania, psychotic symptoms, suicidal thoughts, and aggression in some who take it. It can also be dangerous when taken in high doses, combined with certain medications, or combine with alcohol.

Amphetamine / Dextroamphetamine (Adderall, Dexedrine)

Medications in this category are very similar to methylphenidate.  They are most commonly prescribed for ADD, ADHD, and narcolepsy. Adderall is comprised of amphetamine and mixed dextroamphetamine salts, while Dexedrine is the brand name for dextroamphetamine sulfate. Like Ritalin and Concerta, these two medications help increase wakefulness, energy, and alertness.  Side effects, even at recommended levels, can include psychotic symptoms, mania, and aggressive behavior.  They can also exacerbate agitation and feelings of anxiety.   Stimulant medications can produce euphoria when used recreationally.

These medications should not be combined with other drugs, alcohol, certain medications, or taken in higher doses than prescribed.

Stimulant Withdrawal

Withdrawal symptoms can occur if prescription stimulants are discontinued suddenly after long-term use and / or dependence. These may include:

  • Extreme fatigue
  • Depressed mood
  • Shakiness
  • Poor concentration
  • Altered heart rhythm
  • Irritability
  • Hostile or violent behavior
  • Mood swings
  • Paranoia


The third group of highly addictive prescription medications is comprised of benzodiazepines. Benzodiazepines are also known as “minor tranquilizers” due to their sedating effect.  Unlike the stimulant medications discussed above, benzodiazepines work in the body as CNS depressants.

Benzodiazepines are most commonly prescribed for the short-term treatment of anxiety and insomnia, although they are often prescribed for other conditions as well. Three of the most addictive – and most widely prescribed and abused – benzodiazepines are:

  • Diazepam (Valium)
  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)

These drugs are popular because they have a very calming, relaxing effect. For someone feeling highly anxious or having a panic attack, there is a desperate desire for fast relief.  Benzodiazepines can provide that.  They are also very beneficial for individuals struggling with insomnia, especially those who find it hard to relax or “shut off” their busy brain when they try to fall asleep.

Because of these effects, it is very easy to become psychologically dependent upon them. Unfortunately, it’s also very easy to build up a tolerance to them. If taken for prolonged periods, many people find that they need increasing amounts of the drugs in order to get the same benefit. This easily leads to the vicious cycle of addiction.

Because these medications suppress the central nervous system, they can be especially dangerous if taken in high doses or combined with alcohol or other CNS depressants.

Benzodiazepine Withdrawal

Benzodiazepines can have serious and even deadly withdrawal effects if stopped abruptly rather than tapered gradually after prolonged use or dependence.  Withdrawal symptoms may include:

  • Depressed mood
  • Hallucinations
  • Anxiety and / or panic
  • Confusion
  • Seizures
  • Light sensitivity
  • Nausea and vomiting
  • Rapid or irregular heartbeat
  • Memory problems
  • Insomnia
  • Sweating
  • Elevated blood pressure
  • Heart attack
  • Stroke

Always Use Caution

If you’ve been taking or are thinking about taking any of these prescription medications, it’s absolutely essential to use considerable caution. The potential for dependence and drug addiction is especially high with each of these drugs.  While they all serve an important purpose, and can provide significant benefits for those who truly need them, developing an addiction is something you definitely want to avoid.

If you have any history of substance abuse or addiction, or suspect that you might be vulnerable to addiction for any reason, talk to your doctor about alternative medications, alternative therapies, and lifestyle changes that may help provide many of the same benefits.  Granted, medication is often the easiest and fastest ways to alleviate things like intense physical pain or intense feelings of anxiety, while other approaches may take more time.

However, relying on a pill to fix a problem – especially on an ongoing basis – is rarely the best long-term solution.  Learning other ways to manage chronic pain, anxiety, sleep problems, or ADHD symptoms will not only give you a greater sense of control over your life, but may also be far more effective in the long run – and without unpleasant side effects or the risk of drug addiction.

That being said, if you’ve become dependent on your medication or are using it in ways not prescribed (e.g. taking higher doses or taking it more frequently than instructed), you may need addiction treatment.  If you continue on your current path, the problem will only escalate as time goes on.  Contact a drug addiction treatment center or specialist today to discuss whether or not you need treatment and the best options if you do.


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