Painkiller Addiction, Symptoms & Rehab Treatment

4 min read · 7 sections

Based on a 2012 survey published by the American Pain Society, around 50 million Americans suffered from severe pain or significant chronic pain. Also in 2012, over 250 million prescriptions were dispensed for opioid pain relievers – enough for every single adult in the United States to have a bottle of pills, the Centers for Disease Control and Prevention (CDC) reports.

How Pain Pills Work

Prescription opioids interact with opioid receptors in the brain, intercepting and warding off pain sensations. They also slow down heart rate, blood pressure, and breathing rates, inducing a sense of relaxation. Most prescription opioid drugs (including Vicodin, Dilaudid, OxyContin, fentanyl, and methadone) are classified as Schedule II controlled substances by the Drug Enforcement Administration (DEA). Even though they do have accepted medical use, they also have a high potential for diversion, misuse, and dependence.

The National Institute on Drug Abuse (NIDA) reports that about 54 million Americans have misused a prescription drug at least once in their lives. At the time of the 2014 National Survey on Drug Use and Health (NSDUH), approximately 4.3 million American adults were considered to be currently abusing prescription painkillers.

Taking these drugs, even as directed, can lead to physical and psychological dependence, as the brain gets used to the chemical changes incurred by their interference. When an opioid drug enters the brain, fills an opioid receptor, and depresses the central nervous system, it also increases the presence of dopamine and endorphins. Dopamine is one of the brain’s chemical messengers, or neurotransmitters, that signals feelings of pleasure. With repeated chemical interference, the brain may stop making and absorbing dopamine naturally, and brain chemistry may be negatively impacted. This is called drug dependence. When an opioid drug wears off, dopamine levels dip and both physical and emotional discomfort can occur.

Opioid withdrawal can be difficult, and individuals may struggle to stop taking prescription painkillers as a result. A loss of control over dosage and the frequency of taking these drugs, and overall compulsive drug use, may result; these are the hallmarks of addiction. According to the American Society of Addiction Medicine (ASAM), 2 million Americans battled prescription opioid addiction in 2015.

Replacement Medications and Detox

Physically, opioid withdrawal is typically similar to a particularly bad case of the flu, including symptoms like stomach pain, nausea, vomiting, diarrhea, sweating, chills, muscle aches, runny nose, tearing of the eyes, and insomnia. Emotionally, individuals are likely to feel anxious, depressed, irritable, and agitated in addition to suffering from strong cravings for the drugs. The National Library of Medicine (NLM) publishes that withdrawal symptoms likely begin within about 12 hours after the last dose of an opioid drug. Autonomic functions of the central nervous system that have been regularly suppressed by the opioid drug can become hyperactive during withdrawal, and things like body temperature, respiration, heart rate, and blood pressure can be irregular.

Admission to a medical detox program is ideal to stop taking pain pills safely. Withdrawal symptoms that result from stopping a prescription opioid pain reliever once a dependence has formed can be extremely uncomfortable, and for this reason, it is not recommended to stop taking these drugs “cold turkey,” or suddenly. Instead, they are often tapered off slowly over a set period of time to allow the brain a chance to recover and re-stabilize itself.

Medications designed for treating opioid dependence can be helpful for someone who has been taking pain pills for a long time. When dependence on opioids is significant, other drugs are also used, or there is a co-occurring disorder, medical detox is without a doubt the safest way to approach withdrawal.

Opioid withdrawal typically peaks in the first 2-3 days, and the majority of cravings and side effects start to lessen after about 7-10 days, SAMHSA publishes. A medical detox program generally runs about 5-7 days on average, and the person is then transferred to a comprehensive addiction treatment program at that point.

Other Addiction Treatments for Pain Pills

Detox and medications are only part of the answer for stopping pain pills and staying off them. They can be great tools to help process these drugs out of the body and reach a safe physical balance; however, the emotional aspects of drug dependence and addiction need to be handled too.

Relapse is common and can be particularly dangerous after detox and a period of abstinence. For this reason, counseling and therapies are essential in helping to prevent and minimize relapse. Behavioral therapies help individuals learn how to control cravings, recognize and manage potential triggers for relapse, and form healthy coping mechanisms for handling stress. Therapy and counseling sessions typically include both individual and group formats.

A residential opioid addiction treatment program is often recommended in cases of severe or long-term painkiller abuse. These programs can promote overall healing and wellness by attending to both physical and emotional needs. For example, therapy and counseling improve self-reliance and emotional balance while physical health is improved with nutritious and balanced meals, regular physical activity, and structured sleep schedules. Malnutrition is often a side effect of chronic drug use, and healthy sleep, exercise, and eating habits can promote healing. The brain will need time to restore its balance without drugs, and a comprehensive addiction treatment program can provide the time and space for this to take place.

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Sustaining Long-Term Recovery

Opioid treatment programs provide a strong foundation for preventing relapse and maintaining long-term abstinence. It is important to remain in a treatment program for long enough to allow the brain time to heal and for healthy habits to become more natural. NIDA recommends that a person remain in an addiction treatment program for at least 90 days.

Support groups can help. Twelve-Step programs, like Narcotics Anonymous (NA) or Pills Anonymous, provide people with a healthy social outlet of peers who can empathize and relate to each other. Alumni programs can also be helpful, as they keep people connected to their treatment program and others in similar circumstances. Surrounding oneself with others who are striving toward the same goals, and supportive and encouraging, is highly beneficial in recovery.

It is important not to get complacent and to keep working the program. Don’t be afraid to reach out to a trained professional, mentor, family member, or friend when cravings appear. Talking about it and keeping an open line of communication is vital to resisting temptation.

Tips to Avoid Painkiller Addiction

  1. Follow orders your Doctor’s orders: One of the best ways to avoid becoming addicted to prescription painkillers is to follow a doctor’s orders. People should only be taking these pills as their doctors or pharmacists recommend, and should not exceed the dosage they are told to stick to.
  2. Don’t avoid painkillers: Individuals who are concerned about becoming addicted to these medications may try and wait to take them until their pain gets very bad. However, this could lead to them eventually breaking down and taking more pills than they should, which is why it is a better idea to simply take these pills as recommended.
  3. Know the signs of painkiller addiction: Everyday Health suggested that people who may be worried that they could be developing an addiction to their painkillers should look for the signs of this type of addiction. For example, running out of a prescription early, using multiple doctors to get pain medications, taking pain medications from others and lying to doctors about a need for painkillers are all strong signs of an addiction.
  4. Ask yourself if you still need your painkiller: Everyday Health spoke to James Zacny, Ph.D., professor of anesthesia and critical care at the University of Chicago and a drug-dependence researcher, who explained that people who are addicted to painkillers use them even when they are no longer in pain. However, it can be tough for some people to know whether pain or a painkiller addiction is causing them to ask for more.
  5. Look for alternatives: People who have had problems with drugs and alcohol in the past may want to avoid painkillers altogether. These individuals should talk to their doctor and see if they have any other options available to them that can help ease the discomfort they are experiencing, or ask their doctor to closely monitor their use of these drugs.

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