The abuse of prescription painkillers (Opioid Use Disorder) is a serious medical and social problem affecting millions of Americans. In this article I discuss the nature of opioid addiction. I look at its risks, signs and symptoms, withdrawal and treatment.
When Do Painkillers Become a Problem?
Prescription painkillers (opioids) are a major form of drug abuse with serious risks and consequences. Opioid drug overdose deaths in the US declined by 2019 from their 2017 peak [1]. And misusers of prescription painkiller drugs declined as well. [2].
With this downwards trend, commercially prescribed opioids are no longer driving the opioid overdose crisis. Instead it is now from the rapid increase in illicit synthetic fentanyl use and the tragic overdose deaths associated with it. Nonetheless, the abuse of prescription painkillers is still a widespread and serious problem.
Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly. Others are made synthetically in labs. Opioids are used as effective pain management medicines for moderate to severe pain. They may often be prescribed following an operation, though some can be used to treat coughing and diarrhea.
Opioids can make people feel very relaxed and “high” (euphoric). They can be very addictive. This is why they are abused for non-medical reasons. But their misuse can lead to overdose and deaths. Heroin is the most widely known opioid, and among the most dangerous.
Opioid painkillers provide a high similar to heroin. Now in the US, states are clamping down legally making it difficult to obtain prescription drugs for illicit use. So, many people have turned to heroin, spiking the number of its overdose deaths and the demand for heroin treatment [3].
Causes and Risks of Painkillers Addiction
The primary cause of addiction to painkillers is the relatively easy pathway from prescribed use for a legitimate medical issue to abuse and addiction. This is made possible by using illicit sources of prescription painkillers. The main secondary cause, for those who begin using painkillers recreationally, is simply the availability of illegal sources.
There are many prescription pain relieving drugs, among them:
- Hydrocodone, often combined with acetaminophen (Vicodin or Lortab)
- Oxycodone (OxyContin Endocet, Percocet, Percodan, Roxicet)
- Morphine
- Codeine, often used for severe coughs
- Propoxyphene (Darvon)
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
Opioid addiction is a chronic mental condition. It’s caused in part by changes to the brain that can result from regular use of painkillers such as those listed above. It is considered a chronic brain disease by the American Society for Addiction Medicine and the National Institute on Drug Abuse.
There is a range of risk factors which may lead to the use of painkillers and addiction, including:
- Physical pain: With developed dependency on painkillers for chronic pain
- Genetics: Some people may be more predisposed to addiction
- Mental health: Some people self-medicate with painkillers, especially if they have anxiety, depression or trauma
- Age: Adolescents may be tempted to experiment seeking the high that painkillers can have, especially if they had sports injuries
- History of drug abuse: Those who have already developed addictions with other substances may try painkillers, seeking the high
- Social Factors: People with a history of trauma or other stressors may seek painkillers in an attempt to self-medicate
Signs and Symptoms
Being aware of the signs of addiction to painkillers is important for loved ones and friends, so they can identify if a person may be in need of help. These include:
- Using a painkiller to feel euphoric, rather than for its intended purposes as a painkiller
- Taking more frequent or higher than normal doses of prescribed painkillers
- Using a painkiller even after becoming aware of its negative consequences i.e. relationship issues, legal problems, or financial challenges
- Putting a lot of energy and time obtaining the drugs and recovering from using them
- Hiding painkillers from others
- Noticeable change in behavior
Common symptoms of addiction to painkillers vary with many factors but may include:
Physical Symptoms:
- Dilated pupils
- Itchiness
- Sweating heavily
- Lowered blood pressure
- “Crack Lung Syndrome”: Chronic cough, shortness of breath, chest pain
- Lack of coordination
- Constipation
- Disrupted sleep
Behavioral Symptoms:
- Continuing to use painkillers when harmful to do so
- Seeing multiple doctors to get painkiller prescriptions
- Spending a lot of time getting, using and recovering from painkiller abuse
- Stealing someone else’s prescribed medication
- Lack of participation in activities previously enjoyed
- Withdrawal from friends and social activities
- Slurred speech
- Lying about their whereabouts and activities
- Trying but unable to stop using painkillers
Cognitive Symptoms
- Poor decision making
- Confusion
- Disorientation
Mental Health
- Irritability
- Drastic mood changes
- Depressed mood
Effects of Painkillers Withdrawal
Withdrawal effects also vary with the type of prescription painkiller used. These can be quite distressing and include:
- Nausea
- Fatigue
- Muscle weakness
- Confusion
- Restlessness and irritability
- Heavy sweating
- Tremors
- Abdominal crampsFeeling anxious or depressed
Treatment for Painkillers Addiction
Treatment for Opioid Use Disorder (OUD) also varies with which specific drug is being used. It consists of the physical and psychological aspects of addiction.
Medically-assisted treatment may involve detoxification (detox) with two main medications including:
- Buprenorphine (Buprenex, Butrans, Probuphone, Suboxone)
- Methadone (Dolophine, Methadose)
- Lofexidine hydrochloride (Lucemyra)
- Clonidine
Naltrexone (Revia) can also be used in certain situations in detox. More commonly it’s used to treat OUD chronically by blocking the body’s response to opioids and reducing cravings. Methadone and Buprenorphine are also used long term to help prevent relapse.
When someone has completed detox, they may still be psychologically dependent. This requires some form of longer-term treatment, typically in a residential treatment center which offers a mix of:
- Talk therapy (CBT), DBT or other type
- Psychotherapy
- Group therapy
- Family therapy
- Exposure therapy
- Mindfulness meditation
- Nutritional programme
- Experiential therapy (visual art or music or other forms)
- Ongoing group support (Narconon etc)
Restorations Is Here For You
Restorations Health Care can help you or a loved one overcome their addictions issues. Our mission is all about saving lives. We offer detox and inpatient treatment programs that help people get back on their feet. Our dedicated team of trained addiction professionals and counselors provides individualized addiction treatment programs for recovery.
Sources
[1] Drug Overdose Death Rates. 2024. National Institute on Drug Abuse.
[2] Substance Abuse and Mental Health Services Administration. 2020. Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55).
[3] Signs and Symptoms of Prescription Pain Reliever Abuse. Narconon.
Lacey graduated from Brand University with a MA in Psychology, Marriage & Family Therapy. Lacey is a skilled clinician, supervisor, and administrator with extensive therapy experience. She is responsible for providing clinical leadership and policy direction for our program and maintains accepted standards of medical practice throughout the facility.
