Last Updated on September 24, 2025
Battling Prescription Drug Abuse in Texas
At a Glance: Battling Prescription Drug Abuse in Texas
- Texas is experiencing a growing crisis with prescription drug misuse, particularly opioids.
- Prescription drugs become addictive due to their euphoric effects, leading many to misuse them in higher doses or in combination with other substances.
- The most abused prescription drugs include opioid pain relievers, stimulants for ADHD, and CNS depressants such as Xanax.
- Contributing factors to rising abuse include overprescribing, social acceptance of medication use, and aggressive pharmaceutical marketing.
- Effective solutions require awareness, prevention, and access to professional treatment programs.
Table of Contents
Like most states in the U.S., Texas is facing a severe problem with abuse of and addiction to prescription opioids.
What is Prescription Drug Abuse?
Prescription drugs are carefully controlled substances that are prescribed by a doctor to an individual patient for a specific condition. Taking a drug that was prescribed to someone else, in a higher dose than prescribed, or with the specific intent to get high is abuse.
Some individuals are abusing prescription drugs by altering them; for example, crushing tablets to snort or inject the powder thus amplifying the drug’s effects.
What Makes Prescription Drugs Addictive?
Many prescription drugs produce feelings of euphoria and calmness when they are taken in large doses. Although they are not intended to be taken this way, people may develop a tolerance over time and start taking larger doses to feel the effects. Additionally, when prescription drugs are taken with other addictive substances like alcohol, heroin, or methamphetamine, the pleasurable side effects are often enhanced. Due to the extreme addictive qualities of prescription opioid drugs, scientists and researchers are working to develop alternative drug options, such as meloxicam, to treat chronic pain.
Most Abused Prescription Drugs
Some prescription drugs are more likely to be abused than others. This often depends on their pleasurable effects and how easy they are to get.
According to the National Institute on Drug Abuse (NIDA), prescription drugs remain among the most commonly misused substances in the United States, following marijuana and alcohol. In 2021, an estimated 14.3 million people (about 5.1 % of the population) reported misusing prescription psychotherapeutic medications, including pain relievers, stimulants, and tranquilizers. Of these, approximately 8.7 million people misused prescription pain relievers. The 2023 National Survey on Drug Use and Health (NSDUH) further reported that nearly a third of those who misused pain relievers favored oxycodone products, while almost a quarter misused codeine products. Most individuals cited relieving physical pain as the primary reason for misuse. The public health toll remains severe—according to the CDC, more than 105,000 people died from drug overdoses in 2023, and nearly 80,000 of those deaths involved opioids, underscoring the ongoing and urgent nature of the prescription drug abuse crisis.
According to the NIDA, the classes of prescription drugs most commonly abused are opioid pain relievers, stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), and central nervous system (CNS) depressants. These categories include drugs like:
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What is the Cause of Prescription Drug Abuse?
Opioid medications are typically prescribed for painful conditions, including dental work and injury-related pain.2 Morphine is often used before and after surgical procedures to alleviate severe pain. Prescriptions for codeine are more commonly used for mild pain but are also given to relieve symptoms like coughing and diarrhea.
These drugs all have legitimate medical uses, but they are also being used in unintended ways and for durations longer than necessary, and they are often diverted or sold to those who do not have legal prescriptions or genuine conditions requiring these medicines.
During her testimony to the Senate Caucus on International Narcotics Control, NIDA Director Nora Volkow emphasized that several factors contributed to the rise of prescription drug abuse in the U.S. These included a dramatic increase in the number of prescriptions written and dispensed, greater social acceptance of medication use for a wide range of conditions, and aggressive pharmaceutical marketing. These forces created widespread environmental availability of prescription medications, especially opioid pain relievers.
Since that time, these dynamics have continued to influence the crisis. Although prescribing rates for opioids have declined since their peak in 2012, the U.S. still writes far more opioid prescriptions than most other nations. According to the CDC, more than 105,000 people died from drug overdoses in 2023, and nearly 80,000 of those deaths involved opioids, including both prescription and illicit forms. At the same time, research shows that many individuals who misuse opioids initially obtain them through leftover prescriptions from family or friends, highlighting the ongoing risk created by broad medication availability.
What are the Risks of Prescription Drug Abuse?
Many individuals assume that prescription drugs are safer than illegal substances, but this assumption is false. There are many risks of prescription drug abuse.
- Harmful side effects or overdose: Prescription drugs are given for a specific purpose. Nearly all drugs have side effects, and when prescribing a drug, doctors are aware of any possible effects and have considered them with regards to the overall treatment plan. When prescription drugs are taken outside of their intended purpose, the user is at risk for adverse health effects including the possibility of overdose or a reaction to another drug or alcohol.
- Addiction: Nearly all of the most commonly abused prescription drugs have the potential for addiction. The risk of addiction becomes further amplified when the drugs are taken improperly and abused.
- Abuse of other illegal substances: Additionally, abuse of prescription drugs can be a dangerous gateway to the use of illegal substances. The NIDA reports that nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin.
Prescription drug abuse is serious and is on the rise in the United States. Taking drugs prescribed to someone else or taking drugs beyond their intended use is abuse and the individuals doing so face dangerous side effects and addiction.
Prescription Drug Addiction in Texas
According to the report “Substance Abuse Trends in Texas,” hydrocodone is the most prevalent prescription opioid used for nonmedical purposes in Texas. The report also indicates an increasing problem with abuse of codeine cough syrup and attributes the rise, in part, to music promoting “sippin’ syrup” and several cases of popular singers getting in trouble because of their use of “syrup.”
n 2017, Texas recorded about 1,458 opioid-related deaths, representing a rate of 5.1 per 100,000 residents. Of those deaths, 646 involved prescription opioids, showing that painkillers like oxycodone and hydrocodone continued to drive much of the crisis. That same year, providers in Texas dispensed opioid prescriptions at a rate of 53.1 per 100 people, which was slightly lower than the national average but still contributed to widespread access.
Since then, the problem has only intensified. By 2021, the state’s drug poisoning death rate rose to 15.8 deaths per 100,000 residents, a sharp increase from the 2017 rate of 9.4. Prescription opioids remain a significant factor, with recent data showing that nearly four out of ten opioid-related deaths in Texas involve prescription painkillers rather than heroin or fentanyl alone.
Trends in Texas center around illicit pain clinics, pharmacies, and physicians. The most desired pharmaceuticals continued to be the three that constitute what is known as the Houston Cocktail: hydrocodone, carisoprodol (Soma), and alprazolam (Xanax). The DEA reported prescriptions from Houston pain management clinics were filled in pharmacies as far north as Oklahoma, as far east as Alabama and as far west as El Paso.
Large numbers of patients from Louisiana and other states travel to the Houston area for the purpose of prescription fraud. Pill crews recruit “patients” to fraudulently obtain multiple prescriptions from pain clinics, which are filled at local pharmacies and then given to the pill crew leader for illicit distribution. Houston area physicians were also found to be mailing prescriptions to patients in other states—primarily Louisiana and Mississippi.
Monitoring Prescription Drug Abuse and Controlling Diversion
Texas House and Senate committees continue to examine ways to limit prescription drug abuse and agree that Texas should interactively share its drug monitoring database with other states. State lawmakers also propose that doctors should be encouraged to use online databases identifying patients who “doctor shop” for medications.
Since diversion of prescription drugs is a significant abuse problem, The Texas Prescription Monitoring Program was created to monitor controlled substance prescriptions. This program provides an efficient, cost-effective tool for investigating and preventing drug diversion.7
Medical practitioners and pharmacists use the Texas Prescription Monitoring Program to do the following things:
- Verify records and inquire about patients
- Help detect possible illicit use
- Generate and disseminate information regarding prescription trends
Naloxone Available Without A Prescription for Texans
Another recent effort to combat the increase of deaths from opioid overdose involves the drug naloxone. Naloxone can be administered to someone actively overdosing on opioids and can reverse the effects of opiates almost immediately.
In 2016, Texas lawmakers approved legislation to expand access to naloxone across the state, allowing qualified pharmacists to dispense it under a standing order without requiring an individual prescription. Since then, additional measures have been introduced to make naloxone more widely available, including programs that allow organizations and community groups to distribute it legally under state law.
Nationally, Walgreens and other major pharmacy chains expanded access by making naloxone nasal spray available over the counter at all U.S. locations. This change followed the FDA’s approval of over-the-counter naloxone in 2023, making it possible for people to purchase the life-saving medication without a prescription.
Despite these advances, challenges remain in Texas. Many pharmacies still do not consistently stock naloxone, and supply chain issues or uneven implementation can make it difficult for some communities to access the medication when it is urgently needed.
Addicted to Prescription Drugs? Find Prescription Drug Addiction Treatment
If you are addicted to prescription drugs, you’re not alone. There is plenty of help available for people who are suffering from the misuse of prescriptions. If you are curious about where to get help for prescription drug abuse, an addiction treatment program like Nova Recovery Center can help you achieve sustained sobriety. To learn more about our inpatient and outpatient treatment for prescription drug abuse, call us today to speak with a member of our admissions team.
Frequently Asked Questions About Prescription Drug Abuse and the Opioid Crisis in Texas
Is naloxone (Narcan) available over the counter in Texas?
Yes. In March 2023 the FDA approved naloxone nasal spray for over‑the‑counter sale nationwide, so Texans can buy it without a prescription. It continues to be recommended for community use to reverse suspected opioid overdoses.
Where can I get free Narcan in Texas?
Use the Texas Department of State Health Services’ Naloxone Distribution Interactive Map to find free naloxone near you (community clinics, recovery organizations, campus programs, dispensers). Availability varies by site, so check the map before you go.
Do I still need a prescription or standing order to get naloxone in Texas?
For OTC naloxone nasal sprays, no prescription is required. Separately, Texas maintains standing‑order pathways that allow pharmacies and organizations to distribute naloxone to the public under a delegated physician order—useful for bulk or community distribution.
What are the signs of an opioid overdose, and what should I do?
Common signs include slowed or stopped breathing, pinpoint pupils, extreme sleepiness/unresponsiveness, and blue or gray lips/skin. Call 911, administer naloxone if available, and stay with the person until help arrives. Naloxone is safe to give and won’t harm someone if opioids aren’t present.
Does Texas have a 911 Good Samaritan overdose law?
Yes. Texas’ HB 1694 (Jessica Sosa Act) provides a defense to prosecution for certain low‑level possession offenses when someone calls 911 in good faith for an overdose, with notable limitations (e.g., prior use of the defense or certain prior convictions can disqualify).
Are fentanyl test strips legal in Texas?
Not statewide as of 2025. Efforts to decriminalize drug‑checking equipment have stalled in recent sessions, and Texas remains among the jurisdictions where possession of testing equipment can still be treated as paraphernalia.
How bad is the opioid overdose situation in Texas right now?
State data show drug‑poisoning deaths in Texas rose more than 75% from 2017 to 2021 (from 9.4 to 15.8 deaths per 100,000). Texas now publishes ongoing overdose surveillance and a statewide naloxone site locator to curb fatalities.
What is the Texas Prescription Monitoring Program (PMP) and how does it help?
The Texas PMP is the statewide database of Schedule II–V controlled‑substance dispensations. It helps prescribers and pharmacists spot risky patterns, reduce diversion, and guide safer pain‑management decisions.
Are prescription opioids still a problem in Texas, or is fentanyl the main issue now?
Both are concerns. Illegally made fentanyl drives many recent deaths, but prescription drug misuse (opioids, stimulants, benzodiazepines/CNS depressants) remains widespread nationally and contributes to risk and progression to illicit opioid use.
Can naloxone reverse overdoses from non‑opioid drugs?
Naloxone only works on opioids; it won’t reverse overdoses from stimulants or benzodiazepines. However, because many substances are contaminated with fentanyl, experts advise giving naloxone when in doubt and then calling 911.
How do I safely dispose of unused prescription painkillers in Texas?
Use DEA National Prescription Drug Take Back Day events (held each April and October) or year‑round drop‑off/disposal options recommended by FDA (mail‑back envelopes, take‑back locations). Avoid flushing unless specifically directed.
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Medical Disclaimer
The information on this page is intended for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Prescription medications, including opioids and other controlled substances, should only be taken under the guidance of a licensed healthcare provider. Do not start, stop, or adjust any medication without first consulting your doctor. If you are experiencing severe side effects, withdrawal symptoms, or thoughts of harming yourself, call 911 in the United States or seek immediate medical care. For confidential mental health support, you can dial 988 to connect with the Suicide & Crisis Lifeline, available 24/7.
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- Centers for Disease Control and Prevention. (2025). Provisional drug overdose death counts. National Center for Health Statistics. Retrieved September 24, 2025, from https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
- Food and Drug Administration. (2023, March 29). FDA approves first over-the-counter naloxone nasal spray. Retrieved September 24, 2025, from https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray
- Food and Drug Administration. (2023, July 28). FDA approves second over-the-counter naloxone nasal spray (RiVive). Retrieved September 24, 2025, from https://www.fda.gov/news-events/press-announcements/fda-approves-second-over-counter-naloxone-nasal-spray-product
- Texas Department of State Health Services. (n.d.). Texas Overdose Data to Action (TODA). Retrieved September 24, 2025, from https://www.dshs.texas.gov/injury-prevention/texas-overdose-data-action
- Travis County, Texas. (n.d.). Learn the dangers about opioids. Retrieved September 24, 2025, from https://www.traviscountytx.gov/topics/opioids/learn-the-dangers
- Walgreens. (n.d.). Naloxone — OTC Narcan nasal spray. Retrieved September 24, 2025, from https://www.walgreens.com/topic/pharmacy/naloxone.jsp
- Walgreens Boots Alliance. (2023, August 30). Walgreens announces over-the-counter NARCAN® nasal spray will become available. Retrieved September 24, 2025, from https://www.walgreensbootsalliance.com/news-media/press-releases/2023/walgreens-announces-over-the-counter-otc-narcanr-nasal-spray-will-become
