Is Lisinopril a Drug of Abuse?

Lisinopril is the generic name for an angiotensin-converting enzyme (ACE) inhibitor prescription medication, first approved as the brand name Prinivil by the Food and Drug Administration (FDA) in 1986. The current popular brand name for lisinopril is Zestril, but there are several other brand names associated with this medication, which was originally developed by Merck. The FDA approved generic lisinopril for prescription use in 2002.

ACE inhibitors like lisinopril lower blood pressure, reducing heart damage and the risk of heart disease associated with damage to the blood vessels. It is specifically prescribed after a heart attack to improve survival and reduce the risk of future heart attacks. When not treated, high blood pressure can cause damage to the heart, blood vessels, kidneys, brain, and many other organs in the body. Lisinopril, combined with lifestyle changes like eating a healthier diet and exercising regularly, will reduce the risk of heart disease.

Lisinopril Side Effects

Like any prescription drug, lisinopril can cause some side effects. If these are not monitored by a physician, they can become serious health risks, but typically, medications like lisinopril can be adjusted so side effects dissipate.

Common

Common side effects associated with lisinopril include:

• Dizziness
• Coughing
• Headaches
• Diarrhea
• Weakness
• Sneezing
• Runny nose
• Rash
• Fatigue or extreme tiredness
• Nausea, vomiting, or digestive issues

Long-Term

Long term side effects of lisinopril can occur, especially if someone takes too much for too long.
These include:

• Swelling in the face, throat, hands, feet, ankles, or lower legs
• Difficulty breathing or swallowing, which can indicate a serious allergic reaction
• Hoarseness
• Jaundice (yellowing of the skin and eyes due to liver damage)
• Fainting or lightheadedness
• Chest pain

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Health Risks from Lisinopril

People who already have diabetes are at risk for worsening symptoms due to rapid blood sugar changes, usually sudden drops in blood sugar, especially within the first month of use.

In rare cases, lisinopril is associated with liver damage. This may be more likely among people who have previously abused alcohol or drugs that damage the liver and kidneys, so taking a higher dose of lisinopril exacerbates existing problems.

Sometimes, a person who has struggled with addiction or substance abuse in the past will begin abusing their current prescriptions. Anyone with a history of drug abuse or addiction should report this condition to their physician when they get a new prescription medication. This will help the doctor monitor for signs of compulsive drug misuse or abuse.

Signs of prescription drug abuse include:

• Stealing drugs
• Forging prescriptions
• Taking higher doses than prescribed or taking doses more often than prescribed
• Mood swings, changes in sleeping and eating patterns, or appearing intoxicated
• Becoming defensive or aggressive when questioned about substance abuse
• Lying about how much of the drug is being consumed
• Poor decision-making
• Losing prescriptions frequently
• Needing refills more often than necessary
• Doctor shopping to get multiple prescriptions

Serious Health Issues Associated with Lisinopril Abuse

One report found that out of 179,015 people who experienced side effects from taking lisinopril, 195 people reported abusing this drug or experiencing compulsive behaviors. Most often, abuse of the drug was reported within the first month after receiving the prescription; however, 14.81% of people abused the drug after the first year, and the same percent abused the drug at 2–5 years after receiving a prescription for it. Of the people who abused the drug, 43.01% were women and 56.99% were men; 35.26% were 50–59 years old, 21.79% were 60 or older, and 28.85% were 40–49 years old. These age groups are more likely to develop heart disease and experience a heart attack, so they are more likely to receive a prescription for lisinopril.

Several conditions that are associated with an increased risk of drug abuse, including abusing prescription drugs, were reported in the 195 people who abused lisinopril: 38 people reported depression; 18 people reported insomnia or sleeplessness; 15 people reported stress and anxiety; 14 people reported drug dependence on previous substances; and 14 people reported chronic pain.

Although lisinopril does not cause a high like typically addictive drugs, including prescription painkillers, sedative-hypnotics, benzodiazepines, and prescription stimulants, some people do abuse this medication. Prescription misuse includes drug abuse, but it also includes failure to follow the prescribing physician’s instructions, failing to take doses at appropriate times, adjusting the dose without consulting the physician, stealing the drug from loved ones, accidentally ingesting too much, or taking harmful, intoxicating drugs alongside lisinopril.

Abuse of a drug like lisinopril can indicate relapse in people who have struggled with addiction in the past. Anyone who has struggled with any kind of addiction has a chance of relapse. The National Institute on Drug Abuse (NIDA) reports that addiction is a chronic illness, and like other chronic illnesses such as hypertension, asthma, and diabetes, a relapse of symptoms will occur at some point for most people. About 40­–60% of people who struggle with addiction will relapse at some point, which simply means they should return to rehabilitation to manage their symptoms.

Abusing a prescription like lisinopril, which will not cause intoxication, can indicate that one is at risk of relapse back into substance abuse for more dangerous drugs.

The Danger of Mixing Lisinopril and Other Drugs

Because lisinopril treats blood pressure and heart disease, the medication can interact with several drugs that may change its effectiveness, prevent the medication from working, or lead to further heart damage. Stimulants like Adderall, Ritalin, cocaine, and bath salts can all spike blood pressure, making lisinopril less effective and cause further heart disease. Some sedative medications may lower blood pressure which, when combined with an ACE inhibitor, can lead to fainting, passing out, or changes in blood flow that can be dangerous.

Alcohol is one of the most common substances mixed with lisinopril, leading to harmful results. Although it is legal for adults in the United States to drink alcohol, it is a sedative substance, and it can rapidly lower blood pressure, which can increase the risk of lisinopril side effects.

Other drugs that interact with lisinopril include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and acetaminophen
• Diuretics
• Potassium supplements
• Diabetes medications, including insulin
• Lithium
• Other ACE inhibitors

Long-Term Harm from Abusing Lisinopril

Although lisinopril is a safe medication for people who need help lowering their blood pressure, it can cause side effects, which can lead to long-term harm when they are not addressed.

• Low blood sugar:Lisinopril can change blood sugar levels and make hypoglycemia or diabetes symptoms worse.
• Hypotension:This medication is designed to lower blood pressure, but taking too high a dose can dangerously lower blood pressure, leading to dizziness or fainting. This effect becomes worse when lisinopril is taken with a sedative like alcohol, opioids, or benzodiazepines.
• Renal function impairment or kidney damage:Too much lisinopril can damage the kidneys.
• Angioedema:Swelling of extremities like the hands, feet, or ankles, or swelling in the face, can be a side effect of lisinopril. When swelling occurs in sensitive areas like the throat, it can be dangerous.

When one takes lisinopril as prescribed with a doctor’s supervision, these side effects are less likely to occur, and they will be addressed if they do appear. Abusing lisinopril increases the risk of serious side effects, issues that lead to long-lasting harm, and even overdose.

Allergic reactions to lisinopril can lead to hospitalization. Taking too high a dose may lower blood pressure too much, leading to fainting and difficulty breathing. It is extremely important to call 911 if someone has passed out and appears to struggle to breathe.

Withdrawing from Lisinopril

For the most part, people who take lisinopril will continue to take this medication to maintain low blood pressure for the rest of their lives. In some cases, the person may switch to a different ACE inhibitor, which may require stopping lisinopril. In the best case, one can reduce their dose of lisinopril over time while making lifestyle changes because adjusting their diet and exercise is enough to manage blood pressure. It is rare, in these cases, to experience any withdrawal symptoms because the underlying blood pressure condition is being managed.

Some studies of ACE inhibitors, as a general group of medications, show that a very small group of people experience an increase in blood pressure to levels higher than before they took lisinopril when they attempt to quit “cold turkey.” However, this outcome is not well documented. While rebound hypertension or high blood pressure should be considered, it is a rare effect, and tapering off the medication, rather than simply stopping, is not likely to change this outcome.

Help to Overcome Prescription Drug Abuse, Including Misuse of Lisinopril

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in a 2014 survey of drug abuse in the United States, about 15 million people (ages 12 and older) abused prescription medications for nonmedical reasons in the prior year. While lisinopril is not a widely abused drug since it has no intoxicating effects, there are people who have misused or abused it.

Orange County substance abuse programs offer medical drug detox programs, evidence-based treatment programs, peer-based support groups can also help to augment recovery. There are also several support groups that can help people stay sober, including SMART Recovery and Pills Anonymous.