Taking Your Prescription or Misusing It? How to Tell the Difference

Millions of people take medicine every day for pain, anxiety, sleep, seizures or depression, and the vast majority take it exactly as their doctor intended. Still, prescription medicines can be misused, and the line between needing a medication and depending on it in an unhealthy way is not always obvious from the inside.

This guide explains where that line is, what to watch for, and how to check in with yourself privately.

What counts as prescription misuse

The National Institute on Drug Abuse describes prescription misuse in three ways:

• Taking a medication in a manner or dose other than prescribed. Taking extra pills, taking them more often, or crushing or snorting them.
• Taking someone else’s prescription, even for a real problem like pain or trouble sleeping.
• Taking a medication to feel euphoria, in other words, to get high.

NIDA names three classes as the most commonly misused: opioids for pain, central nervous system depressants such as tranquilizers, sedatives and sleep medicines, and stimulants used for ADHD.

Misuse is common but not inevitable. SAMHSA’s 2024 National Survey on Drug Use and Health found that prescription opioid misuse among people 12 and older fell from 3.0% in 2021 to 2.6% in 2024.

Dependence is not the same as addiction

This is the part that worries people most, so it is worth being clear about.

If you take certain medicines for a while, your body can adjust to them. You may need a dose change over time, or feel withdrawal symptoms if you stop suddenly. That is physical dependence, and it can happen even when you follow your prescription perfectly.

Doctors do not count that alone as a substance use disorder. When a medication is taken as prescribed under medical supervision, the clinical criteria set tolerance and withdrawal aside. What matters is the pattern around the medicine: losing control over how much you take, cravings, and continuing despite harm.

Some medicines carry little risk of misuse at all. Nova’s own guide to Lexapro notes that it is not considered addictive, though dependence and withdrawal can occur if it is stopped suddenly, which is why tapering with a clinician matters.

Warning signs to take seriously

Any one of these is worth a conversation with your prescriber. Several together suggest the medicine may be causing more harm than help:

• Running out of your prescription early, or taking more than directed “just this once” more than once.
• Using it for a different reason than prescribed, such as to relax, sleep, focus or feel good.
• Getting the medicine from friends, family or more than one prescriber.
• Thinking about your next dose a lot, or feeling anxious when your supply runs low.
• Mixing it with alcohol or other drugs to strengthen the effect.
• Hiding how much you take from the people close to you or from your doctor.
• Trying to cut back and not being able to.

Do not stop suddenly on your own

If you are worried, the instinct can be to quit on the spot. With some medicines, especially opioids and sedatives such as benzodiazepines, stopping suddenly can bring on difficult or dangerous withdrawal.

Talk to your prescriber before changing how you take any medication. If withdrawal is a concern, medically supervised drug and alcohol detox exists so that it can be monitored and treated safely. If symptoms are severe, call 911.

Free, confidential self-checks

If you want a private way to look at your own use, Nova offers short self-assessments for several commonly prescribed medicines. Each takes a few minutes and is a starting point for reflection, not a diagnosis:

• Opioid painkillers
• Percocet
• Sedatives and benzodiazepines
• Gabapentin
• Lyrica
• Lexapro
• Meloxicam

There is also an alcohol self-assessment, since alcohol and prescription medicines are often part of the same picture.

When you are ready to talk

If the answers worry you, the next step is a conversation, not a decision. Nova’s admissions team answers 24 hours a day, and the first conversation is free and confidential. You can also verify your insurance online in a few minutes.

Common Questions