Prescription Drug Addictions

Just because pills are prescribed by a doctor and administered by a pharmacy, that doesn’t mean they are safe for everyone. As prescription numbers continue to rise, the chance for prescription drug abuse rises as well

The most widely abused pharmaceuticals fall into three categories:

•Opioids: These produce a sought-after euphoric effect due to their pain killing abilities for short-term or chronic pain.

•Central nervous system depressants: Also called tranquillizers and depressants, these include barbituates and benzodiazepines, some of the most abused drugs. They have a calming, relaxing effect, like a warm blanket on the brain.

•Stimulants: This class increases brain activity, thereby increasing alertness and energy

Xanax

Xanax (alprazolam) is a benzodiazepine prescribed to treat panic disorder and serious anxiety. It calms a person by depressing his or her abnormal central nervous system. Those without a prescription may abuse the drug for its fast-acting sedating and relaxing effects. The Drug Abuse Warning Network says Xanax is the most abused drug for these reasons.

Klonopin & Valium

 Much like Xanax, Klonopin and Valium are often misused for their sedative effects. These “highs” can feel similar to the effects of alcohol, including feelings of drunkenness, talkativeness, and relaxation.

Due to these favorable traits, Klonopin, Valium, and other benzodiazepines can be extremely habit-forming, cause blackouts, and even death by overdose. It is not uncommon for Xanax, Klonopin, and Valium to be taken in conjunction with other drugs.

Oxycodone

Oxycodone, sold commonly as OxyContin and Percocet, is an opioid that changes the way the brain and central nervous system respond to pain. It creates a euphoric, sedative effect.

Often likened to heroin, Oxycodone is prescribed by doctors about six million times a year. Because these pills can cost hundreds of dollars a pill, addicts often have to steal to afford the habit.

Demerol & Darvocet

Like Oxycodone, Demerol and Darvocet are commonly abused painkillers. The danger in these, besides the immediate side effects, is that users often develop a tolerance to the drugs’ effects and will increase their dosage. Often, this leads to painful and possibly even violent withdrawal symptoms.

In 2010, Darvocet was pulled off the market in the United States because it was found to lead to heart complications in patients.

Codeine (Purple Drank)

Codeine is often combined with other medications to reduce coughing and pain. This opiate is commonly found in prescription-strength cough syrup. When consumed in high quantities, Codeine-based cough syrup has a sedative effect and can cause altered levels of consciousness.

Codeine cough syrup is the base for “purple drank” or “sizzurp,” a concoction made with soda and candy that was popularized in some early 2000s hip-hop music.

Amphetamines (Speed)

Simply known as speed, amphetamines are prescribed for conditions such as attention-deficit hyperactivity disorder (ADHD) and narcolepsy where focus and wakefulness are needed to combat symptoms. However, they have been historically misused for their energizing capabilities.

It’s most commonly misused today under the brand name Adderall by those who need to skip on sleep, such as truck drivers, college students working on deadlines, and shift workers.

Ritalin

Similar to Adderall, Ritalin is a stimulant that affects the central nervous system by increasing levels of dopamine—a hormone that heightens attention—in the brain. As with other stimulants, it can be habit forming.

One reason Ritalin and other ADHD drugs are so commonly abused is their availability. In 2005, doctors prescribed Ritalin and similar drugs more than 29 million times, and that number continues to rise.

How to Help a Recovering Addict

If you know someone who is struggling with recovering from an addiction, you probably have questions about how you can help through this troublesome time. Of course, the addict is the only one who can ensure a successful or failed recovery, but fortunately, there are things that you can do to make the recovery process a bit more comfortable.

 

Anticipate Stress

 

Delving into and supporting an addict in their choice to get clean is a rewarding, yet difficult and emotional experience. For example, you may come across times where you have to talk them out of doing the wrong thing or they may open up to you about their emotional trauma. Be prepared for that because it is quite common.

 

Get Help for Said Stress

 

Because supporting a loved one with an addiction is taxing emotionally, it’s a good idea to seek out treatment for yourself as well. There are many facilities and programs that offer counseling and treatment for those who are affected emotionally by a loved one’s addiction. These treatments are generally offered through family centers and other types of facilities.

 

Establish a Trustworthy Relationship with the Addict

 

There are definitely some do’s and don’ts when it comes to helping a recovering addict. For example, if you want to build trust between yourself and the addict you might want to avoid doing things such as:

 Putting your two cents in about what they’re going through

 Prodding at the addict

 Enabling

 And so on

 

Do not try to establish trust so significantly in your relationship to the addict that you end up keeping secrets and blowing off their relapses, should there be any. The purpose of developing trust with the addict is to help them move up and away from their disease. Don’t protect them from reality, either. If they’ve relapsed and are in danger of getting in trouble with the law, do not try to fight the consequences. Let things happen as they normally would.

 

Know How to Handle Treatment of the Addict

 

It depends on how you’re related to the addict that will really dictate the role you play in their recovery. For example, if you are romantically involved with the addict, expect a complex dissection of your relationship and what parts might contribute to the addiction.

 

If your loved one is going through treatment alone, give them space and allow them to heal by themselves during the appropriate times. Respect privacy, and don’t pry for information that the addict might not feel comfortable sharing. Overall, allow the recovery process ample time to run its course. It is an emotionally and physically difficult time, and it will most likely be a lifelong journey.

How Alcohol Affects Your Brain During Sleep

If you want to get a restful night’s sleep, an alcoholic nightcap isn’t the best way to go. In a new journal article in Alcoholism: Clinical and Experimental Research, scientists reviewed all known studies of how boozing affects snoozing in healthy individuals.

Led by Dr. Irshaad Ebrahim, medical director of the London Sleep Centre, the authors found that drinking alcohol can have a big impact on your sleeping brain. And that, in turn, can affect how refreshed and alert you feel the following day.

Here’s a glance at what happens inside your brain when you doze off with alcohol in your system.

At Bedtime

Alcohol is a sedative, so it makes falling asleep easier. Dr. Ebrahim and his colleagues found that this holds true whether people drink a little or a lot.

First Half of the Night: Deep Sleep

Slow-wave sleep—deep sleep associated with slow brain waves—is crucial for overall health. The body repairs and regenerates tissue, builds bone and muscle, and may strengthen the immune system during this sleep stage. Slow-wave sleep is also necessary for feeling rested and energetic the next day.

Dr. Ebrahim and his team found that alcohol increases slow-wave sleep during the first half of the night. That might sound like a good thing. However, according to Dr. Ebrahim, deeper sleep may worsen sleep apnea and sleepwalking in vulnerable individuals. Plus, any gains made during the first half of the night may be offset by fitful sleep later.

First Half of the Night: REM Sleep

Rapid eye movement (REM) sleep—named for the way the eyes dart around rapidly behind closed lids—is the type of sleep in which dreaming typically occurs. REM sleep stimulates regions of the brain used to learn and form memories. Scientists believe that the brain may use this time to sort and selectively store new information acquired during waking hours.

Normally, periods of REM sleep alternate with non-REM sleep, starting about 90 minutes after dozing off and continuing throughout the night. Studies show that heavy drinking (more than four drinks) decreases REM sleep in the first half of the night. According to Dr. Ebrahim, lack of enough REM sleep may have a negative effect on concentration, motor skills, and memory during the day.

Second Half of the Night

As the night goes on, sleeping under the influence causes more problems. The quality of sleep is disrupted, and people often wake up in the middle of the night as the effects of alcohol wear off. Having two to four (or more) drinks before bedtime also reduces the total amount of REM sleep.

The Next Day

People who drink close to bedtime may wake up tired and cranky—and not only those who stayed out until 3 a.m. Especially if you had more than one or two drinks, you may have symptoms of sleep deprivation the next day, including drowsiness, moodiness, and trouble focusing. You may take longer to finish tasks, make more errors at work or school, and be more prone to careless accidents.

DrugFacts: Anabolic Steroids

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DrugFacts: Anabolic Steroids

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“Anabolic steroids” is the familiar name for synthetic variants of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids (abbreviated AAS)—“anabolic” referring to muscle-building and “androgenic” referring to increased male sexual characteristics.


Anabolic steroids can be legally prescribed to treat conditions resulting from steroid hormone deficiency, such as delayed puberty, as well as diseases that result in loss of lean muscle mass, such as cancer and AIDS. But some athletes, bodybuilders, and others abuse these drugs in an attempt to enhance performance and/or improve their physical appearance.


How Are Anabolic Steroids Abused?


Anabolic steroids are usually either taken orally or injected into the muscles, although some are applied to the skin as a cream or gel. Doses taken by abusers may be 10 to 100 times higher than doses prescribed to treat medical conditions.


Steroids are typically taken intermittently rather than continuously, both to avert unwanted side effects and to give the body’s hormonal system a periodic chance to recuperate. Continuous use of steroids can decrease the body’s responsiveness to the drugs (tolerance) as well as cause the body to stop producing its own testosterone; breaks in steroid use are believed to redress these issues. “Cycling” thus refers to a pattern of use in which steroids are taken for periods of weeks or months, after which use is stopped for a period of time and then restarted.


In addition, users often combine several different types of steroids and/or incorporate other steroidal or non-steroidal supplements in an attempt to maximize their effectiveness, a practice referred to as “stacking.”


How Do Anabolic Steroids Affect the Brain?


Anabolic steroids work very differently from other drugs of abuse, and they do not have the same acute effects on the brain. The most important difference is that steroids do not trigger rapid increases in the neurotransmitter dopamine, which is responsible for the rewarding “high” that drives the abuse of other substances.


However, long-term steroid use can affect some of the same brain pathways and chemicals—including dopamine, serotonin, and opioid systems—that are affected by other drugs, and thereby may have a significant impact on mood and behavior.


Abuse of anabolic steroids may lead to aggression and other psychiatric problems, for example. Although many users report feeling good about themselves while on steroids, extreme mood swings can also occur, including manic-like symptoms and anger (“roid rage”) that may lead to violence. Researchers have also observed that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.

 

Are Steroids Addictive?

Even though anabolic steroids do not cause the same high as other drugs, steroids are reinforcing and can lead to addiction. Studies have shown that animals will self-administer steroids when given the opportunity, just as they do with other addictive drugs. People may persist in abusing steroids despite physical problems and nega-tive effects on social relationships, re-flecting these drugs’ addictive poten-tial. Also, steroid abusers typically spend large amounts of time and money obtaining the drug—another indication of addiction.

Individuals who abuse steroids can experience withdrawal symptoms when they stop taking them—including mood swings, fatigue, rest-lessness, loss of appetite, insomnia, reduced sex drive, and steroid crav-ings, all of which may contribute to continued abuse. One of the most dangerous withdrawal symptoms is depression—when persistent, it can sometimes lead to suicide attempts. Research has found that some steroid abusers turn to other drugs such as opioids to counteract the negative ef-fects of steroids.


What Are the Other Health Effects of Anabolic Steroids?


Steroid abuse may lead to serious, even irreversible, health problems. Some of the most dangerous consequences that have been linked to steroid abuse include kidney impairment or failure; damage to the liver; and cardiovascular problems including enlargement of the heart, high blood pressure, and changes in blood cholesterol leading to an increased risk of stroke and heart attack (even in young people).


Steroid use commonly causes severe acne and fluid retention, as well as several effects that are gender- and age-specific:

For men—shrinkage of the testicles (testicular atrophy), reduced sperm count or infertility, baldness, development of breasts (gynecomastia), increased risk for prostate cancer

For women—growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice

For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes, and risk of not reaching expected height if steroid use precedes the typical adolescent growth spurt


In addition, people who inject steroids run the added risk of contracting or transmitting HIV/AIDS or hepatitis.

 

The current study included people from Greater Cincinnati and Northern Kentucky who'd had a stroke before they hit 55.

Dr. Brett Kissela from the University of Cincinnati and his colleagues reviewed medical charts for blood or urine test results or other records of substance abuse for close to 1,200 stroke patients.

In   just over half of younger adults who suffered a stroke were smokers at the time, and one in five used illicit drugs, including marijuana and cocaine. Thirteen percent of people had used drugs or alcohol within 24 hours of their stroke, according to findings published in the American Heart Association journal Stroke.

"The rate of substance abuse, particularly illicit drug abuse, is almost certainly an underestimate because toxicology screens were not obtained on all patients," said Dr. Steven Kittner, a professor of neurology at the University of Maryland School of Medicine in Baltimore who also wasn't part of the research team.

"It's certainly underreported," The rate of smoking, drug use and alcohol abuse - defined as three or more drinks per day - seemed to increase among stroke patients  But Kissela and his team said they can't be sure whether more people were actually using those substances or doctors were just getting better at testing for and recording drug abuse.

The study also can't prove that patients' drug or alcohol use directly contributed to their strokes. It's possible, for example, that people who abuse drugs also see their doctors less often or engage in other risky behaviors that increase their chance of stroke, Josephson explained.

He said the study emphasizes the importance of learning and quickly recognizing the signs of a stroke - such as weakness on one side of the body and dizziness - even for young people. Some treatments can only be used during a short "window of opportunity" after the stroke.

"We see patients all the time who have symptoms that are classic for a stroke... and those symptoms are not recognized as being stroke symptoms because of the idea that, 'Well, that's something that happens only to older people,'" he said.

Drug Abuse First Aid

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.Drug abuse is the misuse or overuse of any medication or drug, including alcohol. This article discusses first aid for drug overdose and withdrawal.

 

Overdose from drugs

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Many street drugs have no therapeutic benefits. Any use of these drugs is a form of drug abuse.

Legitimate medications can be abused by people who take more than the recommended dose or who intentionally take them with alcohol or other drugs.

Drug interactions may also produce adverse effects. Therefore, it is important to let your doctor know about all the drugs you are taking, including vitamins and other over-the-counter medications.

Many drugs are addictive. Sometimes the addiction is gradual. However, some drugs (such as cocaine) can cause addiction after only a few doses.

Someone who has become addicted to a drug usually will have withdrawal symptoms when the drug is suddenly stopped. Withdrawal is greatly assisted by professional help.

A drug dose that is large enough to be toxic is called an overdose. This may occur suddenly, when a large amount of the drug is taken at one time, or gradually, as a drug builds up in the body over a longer period of time. Prompt medical attention may save the life of someone who accidentally or deliberately takes an overdose.

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Causes


An overdose of narcotics can cause sleepiness, slowed breathing, and even unconsciousness.

Uppers (stimulants) produce excitement, increased heart rate, and rapid breathing. Downers (depressants) do just the opposite.

Mind-altering drugs are called hallucinogens. They include LSD, PCP (angel dust), and other street drugs. Using such drugs may cause paranoia, hallucinations, aggressive behavior, or extreme social withdrawal.

Cannabis-containing drugs such as marijuana may cause relaxation, impaired motor skills, and increased appetite.

Legal prescription drugs are sometimes taken in higher than recommended amounts to achieve a feeling other than the therapeutic effects for which they were intended. This may lead to serious side effects.

The use of any of the above mentioned drugs may result in impaired judgment and decision-making skills.

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Symptoms


Drug overdose symptoms vary widely depending on the specific drug used, but may include:

Abnormal pupil size

Agitation

Convulsions

Death

Delusional or paranoid behavior

Difficulty breathing

Drowsiness

Hallucinations

Nausea and vomiting

Nonreactive pupils (pupils that do not change size when exposed to light)

Staggering or unsteady gait (ataxia)

Sweating or extremely dry, hot skin

Tremors

Unconsciousness (coma)

Violent or aggressive behavior

Drug withdrawal symptoms also vary widely depending on the specific drug used, but may include:

Abdominal cramping

Agitation

Cold sweat

Convulsions

Delusions

Depression

Diarrhea

Hallucinations

Nausea and vomiting

Restlessness

Shaking

Death

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Toxicology Screen



A toxicology screen refers to various tests to determine the type and approximate amount of legal and illegal drugs a person has taken.

How the Test Is Performed

Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after swallowing the medication, using stomach contents that are obtained through gastric lavage or after vomiting.

For information on giving a blood sample from a vein, see venipuncture.

For information providing a urine sample, see clean catch urine sample. In some circumstances, you may need to provide the urine sample in the presence of the nurse or technician to verify that the urine sample came from you and was not tampered with.

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How to Prepare for the Test

No special preparation is needed. If able, tell your health care provider what drugs (including over-the-counter medications) you have taken, including when and how much.

This test is sometimes part of an investigation for drug use or abuse. Special consents, handling and labeling of specimens, or other special procedures may be required.

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How the Test Will Feel

Blood test:

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Urine test:

A urine test involves normal urination. There is no discomfort.

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Why the Test Is Performed


This test is often done in emergency medical situations. It can be used to evaluate possible accidental or intentional overdose or poisoning. It may help determine the cause of acute drug toxicity, to monitor drug dependency, and to determine the presence of substances in the body for medical or legal purposes.

Additional reasons the test may be performed:

Alcoholism

Alcohol withdrawal state

Altered mental state

Analgesic nephropathy (kidney poisoning)

Complicated alcohol abstinence (delirium tremens)

Delirium

Dementia

Drug abuse monitoring

Fetal alcohol syndrome

Intentional overdose

Seizures

Stroke secondary to cocaine

Suspected sexual assault

Unconsciousness

If the test is used as a drug screen, it must be done during a certain time period after the drug has been taken or while forms of the drug can still be detected in the body. Examples are below:

Alcohol: 3 to 10 hours

Amphetamines: 24 to 48 hours

Barbiturates: up to 6 weeks

Benzodiazepines: up to 6 weeks with high level use

Cocaine: 2 to 4 days; up to 10 to 22 days with heavy use

Codeine: 1 to 2 days

Heroin: 1 to 2 days

Hydromorphone: 1 to 2 days

Methadone: 2 to 3 days

Morphine: 1 to 2 days

Phencyclidine (PCP): 1 to 8 days

Propoxyphene: 6 to 48 hours

Tetrahydrocannabinol (THC): 6 to 11 weeks with heavy use

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Normal Results

Normal value ranges for over-the-counter or prescription medications may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

A negative value usually means that alcohol, prescription medications that have not been prescribed, and illegal drugs have not been detected.

A blood toxicology screen can determine the presence and level (amount) of a drug in your body.

Urine sample results are usually reported as positive (substance is found) or negative (no substance is found).

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What Abnormal Results Mean

Elevated levels of alcohol or prescription drugs can be a sign of intentional or accidental intoxication or overdose.

The presence of illegal drugs or drugs not prescribed for the person indicates illicit drug use.

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Exams and Tests


Your health care provider will perform a physical exam. This may reveal:

Abnormal eye movements

Abnormal heart rhythms

Not enough fluids in the body (dehydration)

Fever

Rapid breathing

Rapid heart rate

Shaky hands

Blood and urine tests, including a toxicology screen, may be done.

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Treatment


The goal of treatment includes:

Reducing withdrawal symptoms

Prevent complications,

Therapy to get you to stop drinking (abstinence)

INPATIENT TREATMENT

People with moderate-to-severe symptoms of alcohol withdrawal may need inpatient treatment at a hospital or other facility that treats alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens.

Treatment may include:

Monitoring of blood pressure, body temperature, heart rate, and blood levels of different chemicals in the body

Fluids or medications through a vein (by IV)

Sedation using medication called benzodiazepines until withdrawal is complete

OUTPATIENT TREATMENT

If you have mild-to-moderate alcohol withdrawal symptoms, you can often be treated in an outpatient setting. You will need someone to commit to staying with you during this process,k and who can keep an eye on you. Daily visits to your health care provider are needed until you are stable.

Treatment usually includes:

Sedative drugs to help ease withdrawal symptoms

Routine blood tests

Patient and family counseling to discuss the long-term issue of alcoholism. See: Alcoholism

Testing and treatment for other medical problems linked to alcohol use

It is important that the patient goes to a living situation that helps support them in staying sober. Some areas have housing options that provide a supportive environment for those trying to stay sober.

Permanent and life-long abstinence from alcohol is the best treatment for those who have gone through withdrawal.

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Outlook (Prognosis)


How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver and heart disease.

Most people who go through alcohol withdrawal make a full recovery. However, death is possible, especially if delirium tremens occurs.

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When to Contact a Medical Professional


Alcohol withdrawal is a serious condition that may rapidly become life threatening.

Call your health care provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your health care provider if symptoms persist after treatment.

Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.

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Prevention


Reduce or avoid alcohol. If you have alcoholism, you should stop drinking completely.


 

Exams and Tests »


The health care provider will perform a physical exam and ask questions about your medical and family history, including use of alcohol.

The following questions are used by the National Institute on Alcohol Abuse and Alcoholism to screen for alcohol abuse or dependence:

Do you ever drive when you have been drinking?

Do you have to drink more than before to get drunk or feel the desired effect?

Have you felt that you should cut down on your drinking?

Have you ever had any blackouts after drinking?

Have you ever missed work or lost a job because of drinking?

Is someone in your family worried about your drinking?

Tests that may be done include:

Blood alcohol level (this can tell whether someone has recently been drinking alcohol, but it does not necessarily confirm alcoholism)

Complete blood count (CBC)

Liver function tests

Magnesium blood test

 

Treatment


Completely stopping the use of alcohol is the ideal goal of treatment. This is called abstinence. A strong social network and family support are important in achieving this.

Completely stopping and avoiding alcohol is difficult for many people with alcoholism. There will be times when it is difficult. You should aim to avoid drinking for as long as possible.

Some people who abuse alcohol may be able to simply reduce the amount they drink. This is called drinking in moderation. If this method does not work, you should try to quit drinking completely.

DECIDING TO QUIT

Many people with alcohol problems do not recognize when their drinking gets out of hand.

The ideal approach to treatment is to help the person realize how much their alcohol use is harming their life and those around them.

Studies find that more people with alcohol problems opt for treatment when their family members or employers are honest with them about their concerns, and try to help them see that drinking is preventing them from reaching their goals.

Withdrawal from alcohol is best done in a controlled, supervised setting. Complications from withdrawal can be life threatening. For more information, see: Alcohol withdrawal

Your health care provider should order blood and urine tests to check for health problems that are common in people who abuse alcohol.

LONG-TERM SUPPORT

Alcohol recovery or support programs can help you stop drinking completely. These programs usually offer:

Counseling and therapy to discuss alcoholism and its effects and how to control your thoughts and behaviors

Mental health support

Medical care

You may be treated in a special recovery center (inpatient), or you may attend a program while you live at home (outpatient).

Medications are sometimes prescribed to prevent you from drinking again.

Acamprosate is a drug that has been shown to lower relapse rates in those who are alcohol dependent.

Disulfiram (Antabuse) produces very unpleasant side effects if you drink even a small amount of alcohol within 2 weeks after taking the drug.

Naltrexone (Vivitrol) decreases alcohol cravings. It is available in an injectable form.

You cannot take these medications if you are pregnant or have certain medical conditions. The medications are often used with long-term treatment with counseling or support groups.

Depression or other mood or anxiety disorders may be noticed after you stop drinking. These should be promptly treated.

It is important that the patient has a living situation that supports their need to avoid alcohol. Some programs offer housing options for people with alcoholism or alcohol abuse.

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When to Contact a Medical Professional


Seek immediate medical care or call your local emergency number (such as 911) if:

You or someone you know has alcohol dependence and develops severe confusion, seizures, or bleeding

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Prevention


The National Institute on Alcohol Abuse and Alcoholism recommends:

Women should not drink more than 1 drink per day

Men should not drink more than 2 drinks per day

One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.




Analgesic Nephropathy

Analgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medications, especially over-the-counter pain remedies (analgesics).

Causes


Analgesic nephropathy involves damage within the internal structures of the kidney. It is caused by long-term use of analgesics, especially over-the-counter (OTC) medications that contain phenacetin or acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen.

About 6 or more pills per day for 3 years increases the risk some for this problem. This frequently occurs as a result of self-medicating, often for some type of chronic pain.

Analgesic nephropathy occurs in about 4 out of 100,000 people, mostly women over 30. The rate has decreased significantly since phenacetin is no longer widely available in OTC preparations.

Risk factors include:

Use of OTC analgesics containing more than one active ingredient

Chronic headaches, painful menstrual periods, backache, or musculoskeletal pain

Emotional or behavioral changes

History of dependent behaviors including smoking, alcoholism, and excessive use of tranquilizers

Possible Complications

Acute renal failure

Chronic renal failure

Interstitial nephritis

Renal papillary necrosis (tissue death)

Urinary tract infections, chronic or recurrent

Hypertension

Transitional cell carcinoma of the kidney or ureter

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When to Contact a Medical Professional

Call your health care provider if you have signs of this condition, especially if there has been a history of use of painkillers.

Call your health care provider if blood or solid material is present in the urine, or if your urine output decreases.

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Prevention

Follow the directions of the health care provider when using medications, including OTC medications. Do not exceed the recommended dose of medications without the supervision of the health care provider.