Prescription Opioid Addiction: Signs, Effects, and Treatment
What Are Prescription Painkillers?
Prescription painkillers are medications used to treat moderate-to-severe pain after injury or surgery and for specific medical conditions like cancer.1 Prescription opioids have become increasingly accepted as treatment for other types of chronic pain (e.g., back pain) despite potential risks.
The acceptance of opioids as treatment has led to increased opioid prescriptions written in the U.S.1 In 2019, there were nearly 10 million Americans 12 years of age and older who reported misusing prescription opioids.6 Due to the way prescription opioids act on the brain’s reward center, some people may compulsively misuse them. This can lead to withdrawal symptoms if they try to stop or reduce use or the development of an opioid use disorder.2,3
What Are Prescription Opioids Used For?
Prescription opioids are powerful medications used to treat pain. They include familiar names such as morphine and oxycodone.3,23 Some opioids are naturally derived from the opium poppy, while others are created synthetically in a lab by mimicking the chemical structure of natural opioids.4
Prescription opioids are highly effective in treating acute pain and, as a result, they are commonly overprescribed, regardless of the risk of addiction.1,3,4,5 Due to their ability to relax the body and/or produce a euphoric high, some people take pills for pain relief for non-medical uses, which can be potentially lethal as opioids have a high overdose risk.4
What Pain Medications Are Prescription Opioids?
There are several prescription opioid pain medications that include natural, synthetic, and semi-synthetic varieties. Some commonly prescribed prescription opioids include:3,4,5,9,11
- Fentanyl (Actiq).
- Hydrocodone (Vicodin).
- Hydromorphone (Dilaudid).
- Meperidine (Demerol).
- Oxycodone (OxyContin, Percocet).
What Is Prescription Painkiller Misuse?
Prescription opioid abuse can occur whenever these drugs are taken differently than intended. This can include:3,4,11
- Taking them when they haven’t been prescribed to you.
- Taking more than prescribed.
- Taking them more frequently than prescribed
- Taking them to get high rather than for pain relief.
- Taking them differently than prescribed, such as chewing the pills, crushing them up to snort the powder, or dissolving the powder to inject the substance.
Chronic use of prescription opioids can lead to the development of an opioid use disorder. It is possible for this to happen even when opioids are taken as prescribed, but the risk is increased when prescription opioids are misused.3,4,7,8
How Do Prescription Opioids Affect the Body?
Prescription opioids can affect the body in a number of ways, from mild side effects to long-term health effects. The way they affect the brain’s reward circuit is particularly significant, as it can cause a person to want to use them repeatedly, which can lead to misuse.3
Opioids bind to and activate mu receptors throughout the brain and body, which interfere with how pain signals are processed, causing an analgesic, or pain-relieving effect. Prescription opioids also increase the activity of dopamine in the brain, which can cause a reinforcing, euphoric high.2-5,7,9
Health Effects of Prescription Painkiller Misuse
Prescription painkiller abuse can produce other short- and long-term health effects on the body, including:2-5,7
- Respiratory depression.
- Itchiness or skin irritation.
- Suppressing the urge to cough.
Over time, even if you take opioids as prescribed, your brain can develop a tolerance to the effects of opioids, which means a person feels they need to keep taking the substance to produce the same effect.1,2,4,9,10 Tolerance commonly leads to taking higher doses of prescription opioids to obtain relief or achieve the high that was felt when the use of the medication began.
Are Prescription Opioids Addictive?
Opioid prescription pain medications act primarily on the mu-opioid receptor in the brain which, in addition to altering pain perception, is subsequently associated with a rewarding sense of extreme pleasure (euphoria). As a result of these reinforcing physical and psychological effects, some people may begin to compulsively misuse pain medications.
As the body and brain become increasingly dependent on prescription opioids, people want to continue using them for long periods of time or in higher doses to prevent withdrawal symptoms.2
While some degree of tolerance and dependence can develop even if you take prescription opioids as prescribed, you are at increased risk for developing these issues if you misuse them.3,4,7,11 Long-term use of opioids may also increase the risk of developing an addiction and/or lead to an overdose.3
Not everyone who uses or misuses prescription opioids will become addicted to painkillers. Various biological, developmental, and environmental risk factors can influence a person’s risk of addiction. Some risk factors include genetic factors (e.g., gender), exposure to physical or sexual abuse, or using drugs at an early age.24
Signs and Symptoms of Prescription Opioid Addiction
It can be difficult to identify when someone is misusing prescription opioids, so it can be helpful to know some of the common signs and symptoms of misuse. While knowing the signs and symptoms can be helpful in recognizing potential painkiller abuse, only a professional can diagnose an opioid use disorder.12
The following criteria from the Diagnostic and Statistical Manual of Mental Disorders (5th edition) are used by professionals to diagnose an OUD. If you or a loved one has experienced 2 or more of these criteria in the past 12 months, it may be time to seek help for opioid misuse:14
- Prescription opioids are taken in larger amounts and/or over a longer period than was intended.
- A person has a persistent desire and/or unsuccessful efforts to reduce or control prescription opioid use.
- Spending more time seeking out prescription opioids, using them, and/or recovering from the effects of use.
- Cravings, or a strong desire or urge to use prescription opioids.
- Repeated prescription opioid use that prevents a person from fulfilling work, school, or home obligations.
- Continued prescription opioid use despite ongoing interpersonal problems due to prescription opioid misuse.
- Social, professional, and/or recreational activities are given up or reduced because of prescription opioid use.
- Continued prescription opioid use even in situations that could be physically dangerous, such as while driving a car or operating a heavy piece of equipment.
- Continued prescription opioid use even when a person has a known physical or psychological problem that could have been caused or worsened by use of the substance.
- A person shows signs of tolerance to prescription opioids.
- A person is experiencing withdrawal symptoms.
If you are assessed by a clinician, they may ask about how your use of prescription opioids affects various areas of your life, including:13,14
- Your physical and mental health.
- Your social relationships.
- How you function at work, school, and home.
- Potential financial or legal troubles.
If you would like more information about addiction treatment options available in your area, contact American Addiction Center’s helpful admissions navigators at for a free, private consultation today.
Prescription Opioid Withdrawal
When you are dependent on opioids, your brain chemistry adjusts to their presence to function normally. This means that if you stop using prescription opioids or drastically reduce your use, you may experience physical withdrawal symptoms.2,4,10,15
Prescription Painkiller Withdrawal Symptoms
Opioid withdrawal, although not lethal, can be extremely uncomfortable, and people often relapse in an attempt to seek relief.3,4,10 Common signs and symptoms of opioid withdrawal include the following:3,11,14,15,16
- Alternating bouts of chills and hot flashes.
- Depressed mood.
- Dilated pupils.
- Increased blood pressure.
- Muscle and bone pain.
- Nausea and vomiting.
- Racing heart.
- Runny nose.
- Stomach cramps.
- Strong cravings for opioids.
- Tearing eyes.
Dangers of Mixing Prescription Opioids With Other Substances
Mixing prescription opioids with other substances, particularly those with similar sedating or respiratory depressant effects (e.g., alcohol, benzodiazepines) may increase the risk of experiencing adverse health effects.3,7 If you are taking prescription opioids and other medications, it’s important to tell your doctor so that you can avoid the potentially harmful effects.
Many painkiller overdose deaths involve a combination of prescription opioids and alcohol or benzodiazepines such as Valium (diazepam) or Xanax (alprazolam). This lethal combination can result in slowed breathing and heart rate which could be life-threatening.1,3,7,11
Older adults are more likely to be diagnosed with chronic medical diseases and, as a result, may have multiple daily prescription medications, which may put them at an increased risk of accidentally misusing opioids.4,11 Additionally, older adults may be taking medications prescribed by different healthcare providers who are not aware of how these medications can interact.4,7,11
As people age and their metabolisms slow down, their bodies may take longer to break down medications. This means that opioids can stay around longer in the body, increasing the likelihood of accidental overdose in certain individuals.11
Treatment for Prescription Opioid Misuse & Addiction
Treatment for prescription opioid abuse is an important part of recovery and should be tailored to meet your unique needs.7,13,17 For many people, addiction treatment may occur in more than one setting and for varying lengths of time, such as inpatient drug rehab or outpatient drug rehab.17 Follow-up care and ongoing support, such as that of family, friends, or recovery groups, can be especially helpful in maintaining long-term sobriety after completing treatment.13,15,18,19 Effective treatment addresses all issues that can contribute to substance use, including co-occurring mental health disorders, to provide you with the best chance at long-term recovery.7,13,17,19
Because cutting back on or quitting opioid use can lead to uncomfortable withdrawal symptoms, many people begin treatment with painkiller detox, which can provide care and management of withdrawal symptoms.7,19 Detox is the initial phase of recovery that allows your body to eliminate opioids under medical supervision in a comfortable, safe setting. Detox may involve medications, such as buprenorphine or methadone, to manage painkiller withdrawal symptoms, ease cravings, and reduce the risk of complications.2,15,16,20
Detox is an important step in recovery, but on its own is seldom enough to create long-term change. Instead, detox is commonly followed with a more comprehensive addiction treatment program in which people can continue their recovery efforts.17,19 Once detoxification is completed, you may enter into further treatment to continue recovery and learn healthy coping skills to help you succeed in your lifelong recovery journey.19
Medication-Assisted Treatment (MAT)
MAT, or medication-assisted treatment, is the combined use of FDA-approved medications and behavioral therapeutic techniques to treat OUD.21 It has been found to help stabilize brain chemistry, reduce cravings, improve safety, and block the effects of any opioids that are ingested. MAT may lower the likelihood of relapse and help some people maintain their recovery.7,17,19,21 Common medications used include the opioid agonists methadone and buprenorphine (both also potential medical detox drugs), as well as the opioid antagonist naltrexone.2,7,10,11,17
Many studies have shown MAT to be effective. MAT can:10,21,22
- Encourage a reduction of opioid use.
- Increase chances of staying in treatment.
- Lower the likelihood of overdose on painkillers.
- Improve your ability to function in various life areas.
Various types of behavioral therapies can help you change how you think and behave so that you can stop misusing prescription opioids and instead use healthy coping skills to overcome life’s challenges and daily stressors.4,7,17,19 This is a vital part of recovery since it helps a person develop important skills needed to live a life without misusing prescription opioids.4,7,19 Commonly used behavioral therapies include:4,11,17,19
- Cognitive behavioral therapy (CBT): helps you explore your behaviors and expectations, develop effective coping skills to manage triggers and stressors, learn better communication skills, identify cravings early on, and learn techniques to help avoid situations that are high risk for relapse.
- Contingency management: uses small rewards to reinforce desirable behaviors, such as attending treatment sessions and maintaining sobriety.
- Motivational interviewing/enhancement: works to explore mixed feelings about treatment and sobriety, allows you to resolve these emotions within your own timeline, and helps you develop effective coping skills for stressors that put you at risk for relapse.
Find Painkiller Addiction Treatment Programs
If you or someone you care about is struggling with prescription opioid use, seeking treatment is a courageous first step in the recovery process. Rehab programs are located throughout the U.S., and many offer specialized treatment that can cater to individual needs. You can use SAMHSA’s Behavioral Services Locator to search for rehab centers. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’ Once your state website is located, substance use resources shouldn’t be hard to find, and they should provide further phone contacts for your assistance.
American Addiction Centers (AAC) can help you find the right program. AAC is a leading treatment provider and has trusted rehab facilities across the country. Our caring admissions navigators are available 24/7 to provide information about painkiller addiction treatment options and help you begin the road to recovery today. You can contact us free at . Our professional and caring admissions navigators are here for you 24/7.
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