Causes and Risk Factors of Prescription Drug Abuse

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Prescription drug abuse is the fastest-growing drug problem in the United States. The most commonly abused drugs are central nervous system depressants, stimulants, and opioids.

Several causes and risk factors are associated with prescription drug abuse, including those at the individual level, such as mental health issues and a history of substance abuse, and those at the environmental level, such as peers who misuse prescription drugs. 

This article provides an overview of the common causes of prescription drug abuse, including risk factors driving the problem.

An assortment of scattered prescription pills and partially used blister packs

Yulia-Images / Getty Images

Common Causes

No single cause increases the risk of prescription drug abuse. Causes and risk factors for prescription drug abuse vary across individuals not only due to people's physical and mental health differences but also what’s in their environment. Some causes come from within a person while others result from factors outside the person—like one’s relationships and surroundings. 

Individual-level factors include:

  • Mental health issues, such as depression, post-traumatic stress disorder (PTSD), and anxiety
  • Physical health issues, including pain and fatigue
  • Greater susceptibility to having a euphoric reaction
  • History of substance abuse

Environmental factors include:

  • Family history of substance use problems, such as witnessing family members overdose
  • Access to prescription medications, such as having them at home in the medicine cabinet
  • Exposure to social environments with drug use, including peers

While these causes and risk factors apply to prescription drug abuse in general, some prescription drugs are more problematic than others. Those that are most commonly abused are opioids, stimulants, and central nervous system depressants, including sedatives (slow brain activity and reduce pain and nervousness), tranquilizers (slow brain activity, relax muscles, calm nerves, and induce sleepiness), and hypnotics (aid in sleep).

Misuse of prescribed opioids is the main driver of prescription drug abuse in the United States. The problem isn’t only with opioids, however. Access to certain prescribed drugs increases the risk that they are abused. For example, having a prescription for anxiety or depression can lead to the misuse of prescription sedatives, tranquilizers, and opioids. Similarly, having a prescription for pain relievers may lead to misuse of those pain relievers as well as misuse of prescribed stimulants, tranquilizers, and sedatives.


Genetics may also play a role in prescription drug abuse. Misuse of drugs, including prescription drugs, affects the brain’s reward system, which is governed by genetics. According to the National Institute on Drug Abuse, family studies suggest that up to half of a person’s risk of becoming addicted to drugs is determined by their genetic makeup. Addiction is a complex disease, which makes determining genetic causes also complex. Research is ongoing. 

However, there is some evidence of certain genes playing a role in addiction. For example, a study found that an infectious agent called HERV-K HML-2, or HK2, has been shown to affect genes involved in dopamine activity (i.e., the brain's reward system).

Lifestyle Risk Factors

Lifestyle also plays a role in prescription drug abuse. Such risk factors include:

  • Long-term medical use of opioids
  • Nonmedical use of opioids

Behavioral risk factors for prescription drug abuse include:

  • Having another substance use disorder
  • Not adhering to medications as prescribed
  • Seeking medical care from multiple healthcare providers who prescribe high doses of opioids
  • Having in the house in an unsecured location the types of prescription drugs that are commonly abused

Prescription drug abuse is not uncommon among teenagers—in 2017, a survey showed that 1 in 7 teens reported taking a prescription drug without a prescription. These could have been obtained from home or from peers. 

Having more peers who abuse substances increases the risk of prescription drug misuse, and prescription drugs in the home may increase the risk of misuse. For example, research has shown that initial misuse of a stimulant in the home can lead to the start of stimulant abuse. Such environmental risk factors show that preventing prescription drug misuse requires measures beyond the individual.


Prescription drug abuse is a growing problem in the United States. Its causes may stem from within the individual, such as mental and physical health issues. Causes may also be environmental, such as unrestricted access to prescribed drugs of one’s own or another’s.

A Word From Verywell

Prescription drug abuse is a growing problem in the United States. It can affect anyone, and it doesn’t happen just to people with a history of substance abuse. Access to commonly abused prescription drugs of one’s own or another’s is a risk factor that can be difficult to control, as the drugs most commonly abused are commonly prescribed by healthcare providers.

This can feel scary, but prevention and education can help. Prevention must take into account what makes an individual more at risk, including factors within their environment. Healthcare providers are key people in preventing prescription drug abuse. Knowing what risk factors to watch out for also empowers you to help reduce the potential of prescription drug abuse for yourself and your community.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Emily Brown, MPH
Emily is a health communication consultant, writer, and editor at EVR Creative, specializing in public health research and health promotion. With a scientific background and a passion for creative writing, her work illustrates the value of evidence-based information and creativity in advancing public health.