Quick summary
In 2021, about 14.3 million people aged 12 or older misused a prescription psychotherapeutic drug in the past year, according to NIDA. The three classes most often misused are opioids, central nervous system depressants, and stimulants. Treatment exists, but withdrawal from depressants needs medical supervision.
Prescription medications help millions of people manage pain, anxiety, sleep, and attention problems. They can also be misused, and misuse can develop into a substance use disorder. NIDA reports that in 2021 about 14.3 million people aged 12 or older misused a prescription psychotherapeutic drug in the past year. The good news is that treatment works, and for some classes it includes medication.
How many people are affected
NIDA's research report draws on the 2021 National Survey on Drug Use and Health. In the past 12 months:
- About 8.7 million people misused prescription pain relievers.
- About 4.9 million misused prescription tranquilizers or sedatives.
- About 3.9 million misused benzodiazepines.
- About 3.7 million misused prescription stimulants.
Use disorders are less common than misuse but still widespread. NIDA estimates that about 5.0 million people had a prescription opioid use disorder, 2.2 million had a tranquilizer or sedative use disorder, and 1.5 million had a prescription stimulant use disorder.
SAMHSA's 2023 survey found that 48.5 million people aged 12 or older had any substance use disorder in the past year. Among people who needed treatment, only about 1 in 4 received it, which means most people who could benefit are not getting care.
The three classes and their different risks
Opioids are prescribed for pain. NIDA says they can reduce pain and also produce euphoria, which is part of why misuse and use disorder are possible even when a medicine is taken as prescribed. Opioids act on the part of the brain that controls breathing; too much can slow or stop it. Naloxone can reverse an opioid overdose if it is given quickly. Call 911 first.
Central nervous system depressants include benzodiazepines such as diazepam and alprazolam, sleep medicines such as zolpidem, and barbiturates. They slow brain activity and are used for anxiety and sleep. Combining them with alcohol or opioids raises the risk of overdose and death.
Stimulants such as dextroamphetamine and methylphenidate increase alertness and raise heart rate and blood pressure. NIDA says high doses can raise body temperature to a dangerous level, cause irregular heartbeat, and in some cases lead to seizures or psychosis.
Withdrawal is not the same across classes
How you stop depends on the drug. Opioid withdrawal is intensely uncomfortable but rarely life-threatening on its own. Stimulant withdrawal can bring fatigue, depression, and disturbed sleep, and the low mood can be serious.
Depressants are different. NIDA is direct that people dependent on tranquilizers, sedatives, or hypnotics should not try to stop on their own, because withdrawal can be severe and, for certain of these medicines, potentially life-threatening. The dose should be tapered gradually under medical supervision. Benzodiazepine withdrawal, in particular, can cause seizures that require emergency care.
Do not try to "arrive clean" by stopping a sedative or heavy alcohol use alone. Call 911 for a seizure, chest pain, collapse, or breathing that slows or stops.
Treatment that has evidence behind it
Treatment is matched to the person and the substance:
- Opioid use disorder: NIDA names methadone, buprenorphine, and naltrexone, often alongside counseling. These medicines prevent withdrawal and craving rather than producing a high.
- Stimulant use disorder: There are no FDA-approved medications. Treatment relies on behavioral therapies, including contingency management and cognitive behavioral therapy.
- Depressant use disorder: There are also no FDA-approved medications for the addiction itself. Care centers on a supervised taper and behavioral support.
Because depressant misuse often happens alongside alcohol or opioids, treatment may need to address more than one substance at once.
Getting help
Use SAMHSA's FindTreatment.gov locator to search by ZIP code or service type, or call the SAMHSA National Helpline at 1-800-662-HELP (4357), which is free, confidential, and open 24/7.
To talk through options, call or text (800) 653-9376 or use the form below.
Calling is free; the referral service is paid for by treatment providers. If the danger is happening now, call 911. For a mental health crisis, call or text 988.
Last updated: Sun Oct 04 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Frequently asked questions
What counts as prescription drug misuse?
NIDA defines misuse as taking a medication in a way or dose other than prescribed, taking someone else's prescription, or taking a drug to get high. It is a description of how a medicine was used, not a diagnosis.
Which prescription drugs are most often misused?
NIDA names three classes: opioids prescribed for pain, central nervous system depressants prescribed for anxiety and sleep, and stimulants prescribed for ADHD and narcolepsy.
Can I stop a sedative or a sleep medicine on my own?
No. NIDA says people dependent on tranquilizers, sedatives, or hypnotics should not try to stop on their own, because withdrawal can be severe and, for some of these drugs, life-threatening. The dose should be tapered under medical supervision.
Are there medications to treat prescription drug addiction?
For opioid use disorder, NIDA names methadone, buprenorphine, and naltrexone. For stimulant and depressant use disorders, there are no FDA-approved medications, so treatment relies on behavioral therapy.
What should I do in an emergency?
Call 911 for an overdose, a seizure, chest pain, or breathing that slows or stops. For a mental health or substance use crisis, call or text 988.