Prescription Painkiller and Opiate Addiction

Treatment Options for Addiction to Hydrocodone, Oxycodone, Codeine, and Other Painkillers

Leave your opiate addiction in the past. Find out how you can feel good naturally by asking for professional help today.

Opiates and opioids are the most misused prescription painkillers. So you're definitely not alone in your struggle. Many people just like you have overcome their addictions with the help of caring specialists who have supported them every step of the way. Now it's your time to reach out and join them on the path to recovery.

By facing your addiction and receiving treatment, you can start feeling good about yourself again. You can wake up in the morning with a renewed joy for life and an optimistic view of your future. You can restore healthy relationships, recover your finances, and reclaim your self-esteem and confidence.

Facts About Painkiller Addiction

Painkillers play a significant role in both the practice of medicine and addiction. Many times, the two intersect since prescription painkillers are highly addictive and often misused. These substances are classified as either opiates or opioids and are commonly considered "narcotics" or "scheduled drugs" (controlled by law). Painkillers are abused more than any other prescribed drugs. Overall, in the U.S., only marijuana and alcohol are abused more than painkillers (SAMHSA, 2014).

Both opiates and opioids can trace their origins back to the poppy plant; however, opiates are directly derived from the poppy flower, and opioids are further processed, derived from an opiate and synthetic. Both classes of these drugs act upon the human brain in similar ways and are, therefore, typically grouped together when discussing painkiller addiction. They block pain, imitate an important part of the body's natural painkilling and "feel-good" chemistry (endorphins), and induce a "high" or sense of well-being (Pinsky, 2013).

The most commonly abused prescription drugs for pain relief include:

Tolerance and Withdrawal—Characteristics of Addiction

Painkillers cause an effect called tolerance, otherwise known as physical dependency, in which the user becomes able to take greater amounts over time. Also, with tolerance, a person needs greater amounts to achieve the desired effects. Additionally, having a tolerance for painkillers causes withdrawal symptoms if lesser amounts than usual are taken or if their use is stopped altogether (Hazelden, 2013).

While tolerance and withdrawal are symptoms of an addiction, they, themselves, do not constitute a Substance Use Disorder (the medical term for addiction). All patients who are prescribed painkillers cannot be considered addicts even though their bodies will develop tolerance and be vulnerable to withdrawal symptoms. It is simply the nature of the chemicals' reactions in the human body. These effects occur in all medical uses of painkillers over time (Tollison, Satterthwaite, & Tollison, 2002). They are expected and should be addressed by prescribing physicians. Developing an addiction to painkillers involves more than being a long-term patient who appropriately takes prescribed drugs for legitimate medical reasons.

What Constitutes a Painkiller Addiction?

Painkiller addiction symptoms are the same as those found in other addictions like alcohol, cocaine, and cannabis. Only the name of the specific drug (or class of drugs) that is used changes in the list of symptoms below.

The symptoms of a painkiller addiction include the following:

• Continuing to use painkillers despite negative personal consequences
• Being repeatedly unable to carry out major obligations at work, school, or home due to painkiller use
• Recurrently using painkillers in physically hazardous situations
• Continuing to use despite persistent or recurring social or interpersonal problems caused or made worse by painkillers use
• Having an opioid or opiate tolerance—a need for markedly increased amounts to achieve the desired effect, or a markedly diminished effect with continued use of the same amount
• Experiencing withdrawal, or using to avoid withdrawal
• Using greater amounts, or using over a longer time period than intended
• Having a persistent desire to use or unsuccessful efforts to cut down or control use
• Spending a lot of time obtaining, using, or recovering from use
• Stopping or reducing important social, occupational, or recreational activities due to painkillers use
• Consistently using painkillers despite awareness of persistent or recurrent physical or psychological difficulties from using painkillers
• Craving or having a strong desire to use painkillers (American Psychiatric Association, 2013)

The severity of the addiction is determined by how many of the symptoms above are present. The range is:

• Mild—two to three symptoms are present
• Moderate—four to five symptoms are present
• Severe—six or more symptoms are present (Gorski, 2014)

If an individual has at least two of the symptoms listed above, a diagnosis can be given. Sometimes, different terminology is used to describe the same condition such as, for example:

• Opiate Use Disorder—for drugs like morphine and codeine
• Opioid Use Disorder—for drugs like OxyContin
• Painkiller Use Disorder—for both opiate and opioid disorders
• (Specific name of painkiller) Use Disorder—such as OxyContin Use Disorder or Morphine Use Disorder

"Addiction" is a layman's word and is not a formal medical diagnosis; however, the term is most used to describe a Substance Use Disorder as outlined in the list of symptoms above.

Who Becomes a Painkiller Addict?

"Americans rely…heavily on chemicals to adjust their mood, enhance their daily performance, and escape the problems in their lives" (Pierce, 2011). While only 4.4 percent of the world's population lives in the U.S., over 80 percent of the world's prescription medications are consumed by Americans (MN Department of Health , 2022). Estimates have ranged from five to 12 million people in the U.S. using painkillers illegally in recent years (NABP, 2013; CDC, 2011). Prescription drug abuse statistics show that addiction crosses all boundaries of race, gender, and economic, occupational, and education status. For example, according to an article in the American Journal of Law & Medicine, some medical professionals misuse painkillers, getting colleagues to write prescriptions or steal them from work. On a website for recovering medical professionals, the following medications are listed as those typically abused by medical staff:

• Dilaudid
• Demerol
• Diprovan (Propofol)
• Fentanyl
• Morphine
• OxyContin
• Percocet
• Vicodin (Anonymous, 2014)

There is a wide range of people affected by these drugs. Opiate and opioid abuse occurs among diverse groups of people that include doctors, the elderly, and teenagers among others like chronic pain patients. For instance, high school students were surveyed in recent years about prescription painkiller use. About five percent of high school seniors reported having abused OxyContin, and approximately 10 percent of high school seniors reported having used Vicodin without a prescription (U.S. Department of Justice, 2012).

The Consequences of Painkiller Addiction

The consequences of painkiller addiction are similar to those of other addictions. Commonly, there are many losses such as jobs, relationships, and physical and mental health. Not meeting one's commitments and responsibilities is also a common outcome for addicts and can lead to family disruption and estrangement from spouses, children, and other family members. In addition, the misuse of painkillers is illegal. Obtaining them fraudulently, or without a prescription, is a crime. Many addicts have legal consequences.

The financial burden of maintaining a prescription drug addiction can be severe, particularly if one does not have prescriptions or the insurance to cover them. Buying painkillers off the street can require hundreds of dollars daily if one's addiction is severe—pills range from about $5 to $80 depending upon the type and strength of painkiller used. Additionally, few addicts take only one pill per day—multiple doses are more common, especially as the addiction progresses. This requires addicts to find a means of support for the addiction and many must engage in illegal activities in order to do so.

The danger of overdose and death is high with painkillers, particularly as one's tolerance builds for taking higher and higher doses. An addict's need for higher doses in order to feel the desired high can exceed the body's ability to withstand the use. "Deaths from prescription painkillers have reached epidemic levels in the past decade. The number of overdose deaths is now greater than those of deaths from painkillers and cocaine combined" (CDC, 2011).

Also, for some, the long-term consequences of painkiller addiction are that obtaining painkillers may be too difficult (supply and cost) causing a switch to heroin (Tyrer & Silk, 2008). There are other long-term effects of opiate or opioid addiction. These "may include depression, insomnia, HIV/AIDS…hepatitis…and decreased pain threshold" (CODA, 2011). The risks of HIV/AIDS and hepatitis are primarily related to injecting painkillers rather than taking them orally.

Signs That a Loved One May Be Addicted To Painkillers

There are many signs of painkiller addiction that you can watch for. Some of these include:

• Continued use after the medical issue is over
• Increasing dose over the one prescribed
• Having personality and mood changes
• Becoming withdrawn from family, friends, and usual activities
• Being preoccupied with getting prescriptions—traveling to do so and seeing multiple doctors
• Having a change in habits, appearance, and routine
• Neglecting responsibilities, obligations, and commitments
• Being sensitive to normal sights and sounds
• Having difficulty managing emotions
• Having blackouts or forgetfulness
• Being defensive, hostile, irritable, lashing out (Adapted from Warning Signs of Prescription Painkiller Dependency, Foundation for a Drug Free World, 2014)

Other signs of prescription drug abuse are:

• Having an analgesic effect—no pain
• Sedation
• Small pupils
• Itching
• Flushed skin
• Constipation
• Poor judgment
• Slurred speech
• Nausea
• Vomiting
• Slowed breathing (Adapted from Painkillers, Narcotic Abuse, and Addiction, WebMD, 2014)

Withdrawal

Opiate and opioid withdrawal symptoms are easily observed and indicate that a loved one has a painkiller addiction. Initially, withdrawal symptoms appear cold or flu-like with "aches, chills, sweating, a runny nose, nausea and anxiety" (Glass, 2001). Other symptoms include vomiting, diarrhea, stomach cramps, hypertension, fever, insomnia, and intense craving (Tyrer & Silk, 2008).

The opioid or opiate withdrawal timeline varies between addicts, but the first two days are usually the hardest. Withdrawal typically begins within 12 hours of taking the last dose, and it's in those first 48 hours that the symptoms tend to be the most intense. By days three to five, the muscle and body pains have commonly subsided, but other physical effects like stomach cramping and body chills can still be prevalent. By day six, most of the worst physical symptoms have subsided. However, patients may still have trouble eating, and they will likely have mental health issues to work through. In fact, the mental side effects of opiate withdrawal can last for months or years. This is why professional help is crucial to staying clean.

What to Do If a Loved One Is Addicted to Painkillers

• Learn as much about painkiller addiction as possible—including the symptoms and signs of opiate use, the effects of the drugs, how they are obtained, and what and where treatments are available.
• Consult with professionals who can provide suggestions and information about helping a loved one receive opioid or opiate addiction treatment.
• Remember that another's addiction is not your fault or your responsibility and neither is his or her recovery; however, appropriate loving support and involvement in recovery efforts can help the addict and you.
• Take care of yourself and other loved ones that are your responsibility.
• Talk openly with your loved one about his or her addiction and be prepared that this might be upsetting to him or her. Communicate with compassion, remaining firm but calm.
• Remember that painkiller addiction is a serious medical condition, not just a matter of irresponsibility, thrill-seeking, or "partying."
• Discuss the addiction calmly using facts and without shaming, arguing, or issuing ultimatums. Discuss the addiction as if you were discussing any other serious medical issue with someone you love.
• Expect anger, denial, avoidance, and relapse as part of any addiction, and decide for yourself how much of them to tolerate before you pull away from the situation.
• Offer your loved one the help to find help and get there.
• Be supportive of all recovery efforts.
• Express your support, love, and concern.
• Remember that money or valuables can be easily converted into painkillers.
• Remember that any "slack" of theirs that you take up can help them use more and postpone seeking help.
• Find a support group for yourself, and focus on your own life.
• Seek counseling for yourself to get help for the impact of your loved one's addiction upon you.
• Participate in community support groups such as 12 Step meetings for loved ones of addicts.
• Help any children involved understand the addiction as a sickness, and include them as is age and developmentally appropriate in the recovery process.

Treatment for Opiate Addiction

Treatment for prescription painkiller addiction requires medical supervision for withdrawal and detox. For some addicts, the use of medicines to manage symptoms after opioid or opiate detox may be required. This is the case for many. Some have experienced brain changes due to long-term painkiller use that make them candidates for medication. The attending addiction specialist can make recommendations based upon each individual situation. Some of the medications used in recovery are buprenorphine, methadone, and naltrexone (NIDA, 2014). Suboxone is also frequently used. These medications work in the brain receptors that painkillers have affected. So it's important to seek professional medical help in order to detox from opiates or opioids.

Additionally, many painkiller addicts have other conditions that require treatment while they are recovering. These include chronic pain, depression, anxiety, addiction to other substances, and PTSD. There may also be painkiller-induced disorders, and these also need to be treated at the same time as the addiction. Some examples of these are:

• Painkiller-Induced Psychotic Disorder (hallucinations and/or delusions)
• Painkiller-Induced Depressive Disorder
• Painkiller-Induced Anxiety Disorder
• Painkiller-Induced Sleep Disorder
• Painkiller-Induced Cognitive Disorders (for example, dementia and delirium)

Individual, group, and family counseling—as well as education and relapse prevention planning—are typically provided in opiate or opioid treatment. It can take place in a variety of settings, although due to the distress of withdrawal, detox is typically in an inpatient or residential setting where staff can monitor withdrawal symptoms and administer medication as needed. Many addicts may choose to enter "step-down" settings before returning fully to the community after treatment. Such programs include halfway houses, transitional programs, and "sober living" communities. So there are various options for opioid or opiate treatment centers. Additionally, community self-help groups such as Narcotics Anonymous provide further support and are often recommended for those in recovery and those leaving treatment settings.

Opiate Addiction Help Is Within Your Reach

Are you ready for real change? Then ask for help today. With assistance, you can make that happen.