“It’s Not Addiction, It’s Just Medication”
The New Drug Abuse Myth In South Africa
Drug abuse in South Africa is changing shape. The old picture people hold in their heads is still the same, a person on the street, obviously intoxicated, visibly falling apart. That picture is real in many cases, but it has become a convenient distraction because it lets middle class homes pretend they’re safe. Meanwhile, one of the fastest growing forms of drug abuse is happening through medicine cupboards, repeat prescriptions, and “just something to help me cope” habits that families keep defending because it looks respectable.
The reason this topic hits a nerve is because it forces people to admit a painful truth. You can become addicted with a doctor involved. You can become dependent while still going to work. You can be abusing medication and still look like a responsible adult. In fact, the cleanest looking addictions are often the ones that last the longest, because nobody wants to call them what they are.
This article is about prescription drug abuse that hides behind the language of mental health and pain relief, and why families need to stop treating medication as automatically safe just because it came in a box with instructions.
The trap starts with a real problem
Most prescription drug abuse starts with something legitimate. Panic attacks. Insomnia. Chronic stress. A back injury. Surgery. Depression. A breakup that tipped someone into anxiety they can’t manage. The person goes to a doctor and gets something that works quickly. A sleeping tablet. A benzodiazepine. A painkiller. A muscle relaxant. A stimulant. Sometimes more than one.
At first it feels like relief. The person sleeps. The person calms down. The person can work. The person can function. Families see improvement and breathe again, because it looks like the crisis is being managed.
Then the body adapts. The dose doesn’t work the same way. The person takes a little more. They take it earlier. They take it for different reasons. They start taking it not only for the original problem, but for life itself. They take it before social events. They take it before stressful meetings. They take it when they feel low. They take it because boredom feels unbearable.
This is the moment medication stops being a treatment and starts being emotional control, and that is where abuse quietly becomes dependence.
The warning signs are subtle
Prescription drug abuse rarely comes with the obvious chaos people associate with drugs. Families don’t see needles or smell alcohol. They see a person who is tired, withdrawn, moody, or foggy. They see someone who sleeps oddly, forgets things, and reacts badly to stress. They see someone who seems flat, like they’ve lost their spark.
The person may become irritable when questioned, not because the family is wrong, but because dependence creates a deep fear of losing supply. They may become secretive with medication. They may keep tablets hidden. They may panic when they travel. They may complain about pharmacies or doctors as if the world is against them, when the reality is that their body now needs the substance to feel normal.
Families also see strange routines. The person disappears into the bathroom. The person falls asleep early then wakes up wired. The person is emotionally unpredictable, calm one moment and snapping the next. The person stops being fully present, and the home starts feeling like it’s living around a chemical schedule.
“At least it’s not street drugs”
This is one of the most dangerous sentences in family life. It sounds rational, but it keeps people stuck. Prescription drug abuse can destroy a life just as thoroughly as street drugs, especially when it becomes long term.
Benzodiazepines can create deep dependence and brutal withdrawal if stopped wrongly. Sleeping tablets can become a nightly requirement. Opioid painkillers can lead to tolerance and escalation. Stimulants can become a performance crutch. Mixing any of these with alcohol can increase risk and destabilise mental health fast.
Families defend it because it feels cleaner than street drugs. They tell themselves it’s controlled. They tell themselves the person is treating something real. Meanwhile, the person’s coping system is shrinking. Instead of learning how to handle stress, they are medicating it. Instead of building emotional tolerance, they are sedating it. That makes them less resilient over time, not more.
The psychiatric overlap
Prescription drug abuse sits right on the border of mental health and addiction. Many people who abuse medication genuinely have anxiety disorders, depression, trauma, ADHD, or insomnia. That doesn’t mean the medication abuse is justified. It means the situation needs real treatment, not endless sedation.
A person can be both anxious and addicted. A person can be both depressed and dependent. Families get stuck because they believe they have to choose one explanation. They don’t. The substance can be driving symptoms while also being used to escape symptoms. That loop is common, and it is why treatment needs to address both sides together.
What a grounded intervention looks like
Families often swing between silence and explosion. They ignore it until they can’t, then they confront with anger, threats, and panic. That rarely works, because the person feels attacked and the conversation becomes a war about whether they are being judged.
A grounded approach focuses on patterns and impact. Not on labels. If the person is increasing dose, mixing substances, lying about use, showing withdrawal symptoms, becoming unsafe, or losing function, those are concrete reasons for assessment. The family can insist on one prescribing doctor, proper monitoring, and a plan that includes therapy and tapering where needed. The goal is not to shame the person for taking medication. The goal is to stop the medication becoming the only way they can live.
Medication can save lives, but it can also become a quiet addiction that ruins them. If someone cannot cope without tablets, if their life revolves around supply, if they become unstable when doses are missed, then this is no longer simple treatment. It is drug abuse with a respectable story.
That is why this topic will spark debate online. People will defend their prescriptions and call it stigma. Others will recognise their own home in the pattern and finally have language for what they’ve been living with. That conversation is worth having, because denial keeps drug abuse alive, and reality is where change starts.