Prescription drug abuse is a serious problem in the US. With the proliferation of these pills on the black market, they are seemingly everywhere. But where do all these pills come from? The truth is that they come from a variety of sources.

Among the most commonly abused prescription pills in the US are narcotic pain relievers. They act on the brain by interfering with how a person’s body perceives pain. These drugs also affect the neurotransmitters in the brain that bring about pleasure. Generally, individuals who take these kinds of drugs report feeling euphoria, alertness, or confusion, even when used orally as prescribed.

Where Do All the Pills Come From?

Those looking for a more intense or quicker “high” will crush the pills and then either snort or inject the resulting powder. Using the medications in these ways increase the chances for addiction, and these medications are already highly addictive even when used as prescribed. That is why they are usually only prescribed on a short-term basis, as noted by MedlinePlus, a division of the National Institutes of Health.

Some examples of prescription pain relievers include the following:

  • Hydromorphone

Benzodiazepines are also commonly abused. A majority of individuals who abuse benzodiazepines were prescribed the medication to treat anxiety or another health issue. Oftentimes, these drugs are abused alongside other substances. Benzodiazepines or tranquilizers are often prescribed to patients who have anxiety disorders, experience panic attacks, or deal with sleep disorders. Examples of benzodiazepines include:

Amphetamines and methylphenidate are also popular to abuse, particularly by college-aged kids to enhance academic performance and decrease the need for sleep. Some individuals snort or inject these drugs to receive the euphoric effect and bring a heightened level of energy. These stimulants increase levels of dopamine in the brain. Examples of these drugs are:

  • Metadate
  • Concerta
  • Methylin

Where Do They All Come From?

Despite the dangers of narcotic pain relievers, doctors still regularly prescribe them to patients who have moderate to severe pain. The number of prescriptions written for opioids has increased tremendously over the past 25 years. In 1991, doctors in the US prescribed 76 million prescriptions for narcotic pain relievers. In 2013, the number of prescriptions for opioids elevated to 207 million. These statistics indicate the United States is the biggest consumer of narcotic pain relievers. Nearly 100 percent of all hydrocodone prescriptions, the generic form of Vicodin, are written in the US. The National Institute on Drug Abuse states that the US accounts for 81 percent of all the prescriptions written for oxycodone, the compound found in drugs like OxyContin and Roxicodone.

The doctor’s office is not the only location where a person receives prescriptions for opioids. People looking for drugs oftentimes go to the hospital because, in many cases, doctors in hospitals prescribe opiates a bit more freely than primary care doctors do. This is in an effort to treat the person quickly and get the optimal level of customer satisfaction. In 2014, hospitals reported an increase in emergency department visits for problems like lower back pain and throbbing headaches. The increase in pain pill prescriptions written by emergency room personnel increased several years before that though. In fact, between 2001 and 2010, there was a 49 percent increase in the number of narcotic pain relievers prescriptions. However, the study revealed there was only a small increase in the number of visits for painful conditions. Across the nation in 2010, 31 percent of hospital emergency room visits involved a doctor administering or prescribing a narcotic pain reliever. This is an increase of 10 percent since 2001.

Although some people seek out prescriptions for pain relievers and other opioids, some receive legitimate scripts for their condition to manage the pain and end up addicted. A study conducted by Johns Hopkins Bloomberg School of Public Health in Baltimore; the Geisinger Health System in Danville, PA; Temple University School of Medicine in Philadelphia; and Mount Sinai School of Medicine determined that of nearly 700 patients who took opioids on a regular basis for a year or longer, over one-quarter of them became dependent on the drug.

Even individuals who obtained a prescription legitimately may seek out the drug to prevent the symptoms of withdrawal, just as someone who abused these drugs would. Even though some take the prescription according to their doctor’s instructions and still become addicted, some take the drugs more frequently or at higher dosages than recommended.

In certain states, the number of prescriptions for opiates is much higher than the national average. In particular, southern and Midwestern states have high rates of opioid prescriptions. Statistics reveal 13 states have an opiate-prescribing rate of 96-143 prescriptions per 100 people. These states include:

  • Louisiana
  • Mississippi
  • Alabama
  • Arkansas
  • Oklahoma
  • Tennessee
  • North Carolina
  • South Carolina
  • Kentucky
  • West Virginia
  • Ohio
  • Indiana
  • Michigan

Eleven states have a high number of prescriptions, with there being 82.2-95 prescriptions per 100 residents. Washington, DC made the list, as did the following states:

  • Georgia
  • Pennsylvania
  • Missouri
  • Maine
  • Kansas
  • Arizona
  • Utah
  • Nevada
  • Idaho
  • Oregon

A person may go from one doctor to another to another to find one that will prescribe them the drugs they desire. If the physician should want to decrease the dosage, place the person on another nonnarcotic drug, or take the person off the drug, the individual will find a new doctor and often exaggerate the pain or discomfort. A dentist can prescribe pain relievers as well, so some individuals who seek out opioids complain of frequent tooth pain.

This practice of “doctor shopping” occurs when a person has multiple doctors prescribing the same or similar drugs. These doctors may prescribe different medications that are commonly abused, often in the opioid family. The patient does not make the doctor aware of the other medications prescribed by other doctors.

Where Do They All Come From?

In 2005, 22,400 people died from prescription drug overdose. Opioid painkillers were responsible for a majority of the deaths, causing 38.2 percent of all overdose deaths. With prescription drugs accounting for more deaths from drug overdoses than any other substance, government officials on a statewide level have implemented databases to avoid multiple prescriptions for the same patient. Additionally, some states have created mandatory disclosure laws, and all states have antifraud statutes.

In some instances, people may steal medications from the medicine cabinets of friends or family members. People have also stolen them from hospitals, pharmacies, and other facilities that are licensed to carry them. In some cases, the person taking them is a healthcare worker who either uses or sells them. It is also possible to buy them on the street from people who have legitimate prescriptions. Generally, a person looking for oxycodone will pay at least $1 per milligram while oxymorphone sells for at least $1.50 per milligram.