While painkiller use is widespread, there is a vast amount of false information surrounding them. Unfortunately, many people begin using opioid painkillers knowing little about them. Given few details about these drugs – how they work, when to take them and, even, viable alternatives to them – people are unable to weigh the risks and benefits prior to their decision to take them. Even people prescribed them may not understand their potential for dependence, abuse, and addiction.
Misinformation about painkillers can lead to significant consequences and irreversible harm, especially with the Centers for Disease Control (CDC) reporting that 250 million painkiller prescriptions were written in 2013. Below are five of the most notable myths about painkillers and their realities.
Prescription Painkillers Aren’t Addictive
REALITY: Prescription painkillers carry great risk of abuse and addiction. Even those who use them as prescribed are at risk of becoming dependent and eventually addicted.
When people refer to painkillers, they are speaking about opioid or opiate pain medications. These substances derive from opioid alkaloids found in the opium poppy, and their mechanism of action is similar to that of heroin.
Examples of opioid pain medications include:
The substances work to change the perception of pain in the user by activating opioid receptors in the brain and throughout the body. Opioid receptor activation is accompanied by a temporary surge of dopamine, a neurotransmitter associated with rewarding feelings of pleasure. This feeling of intense pleasure may reinforce opioid abuse behavior, which is marked by taking more of the substance than prescribed or taking it in ways other than prescribed. Persistently abusing painkillers significantly increases the chances of developing an addiction, which is marked by continued and compulsive use in spite of negative consequences.
According to the CDC, in 2014, more than 2 million people in the US abused opiates. Many of these individuals exhibit behaviors or have mental health issues that are risk factors for opioid abuse and overdose, including:
- Receiving multiple prescriptions from different prescribers.
- Using painkillers at high doses.
- Having a mental illness or history of substance use like alcohol or other drugs.
Addiction is only one part of the problem, though. The other issue is physical dependence, which is the body’s adaptation to continued use. Those who develop a physical dependence will feel as if they require painkillers to function normally throughout the day.
Dependence can happen even when taking medications as prescribed, especially when more painkillers are consumed over time to combat increasing tolerance to the drug’s effects.
They Can’t Be Dangerous if a Doctor Prescribed Them
REALITY: Use and abuse of prescription opioids can lead to a slew of negative physical and mental health effects and can be fatal when misused.
Opioids have a profound impact on your body. While this impact can be positive (e.g., in cases of pain reduction), it can also be uncomfortable and potentially dangerous, especially when the drugs are abused.
Opioids are depressant medications that effectively slow various processes of the brain and body. They can reduce the speed of your breathing and heartbeat and produce other unwanted physical effects like:
- Reduce motor coordination.
- Drowsiness with lowered energy.
- Increased reports of pain.
- Decreased sex drive.
These effects may occur even at recommended dosing. As dosing increases with abuse, the results will become more pronounced. Adding to the physical health risk is a lack of oxygen to the brain due to slowed breathing or respiratory arrest. This condition, called hypoxia, can lead to permanent brain damage in some cases.
The physical health risks are only the beginning, as prolonged abuse of opioid pain medication can contribute to mental health issues as well. Use of painkillers (especially at high doses) triggers an abnormally high release of dopamine – a “feel good” chemical in the brain essential to feeling pleasure. As painkiller abuse continues over time, the brain may begin to release less dopamine on its own or scale down the number of receptors that would otherwise receive its positive signaling, leading to anhedonia (inability to feel happy) and sometimes depression.
Another very serious concern associated with painkiller dependency is the risk of eventually transitioning to heroin. According to the National Institute on Drug Abuse, about half of young injection heroin users abused painkiller medications prior to using heroin.
Taking More of Them Will Cure the Pain More Effectively
REALITY: Painkillers do not cure the source of the pain, and ongoing use typically results in tolerance.
This myth includes two separate issues: pain perception and tolerance. It is important to remember that opioid pain medications do not cure pain. Rather, they modify the way your brain perceives it. If your bad back is the source, painkillers do nothing to improve your condition. They only reduce your discomfort temporarily. When the previous dose wears off, you must take more to maintain your relief.
The continued use of opioid medications often leads to tolerance. This is the need to increase the dose or frequency of the medication over time to experience the same effects. Continually increasing your dose to counteract tolerance is a significant factor in the development of addiction as well as overdose.
Opioid overdose can result in respiratory depression, coma, and death. According to the CDC, 165,000 people died from overdose of prescription opioid medication between 1999 and 2014. The risk of overdose increases when medication is mixed with alcohol, benzodiazepines, or other depressant substances.
Borrowing/ Trading Painkillers is Safe and Legal
REALITY: Opioid medications are controlled substances that carry legal penalties for misuse, buying, and selling. Overdose is also possible for those exchanging medications of varying strengths.
Not all painkillers are equal with regard to strength and dosing. You may be used to taking one opioid analgesic and your friend may be used to taking another, but that does not make exchanging medication a safe idea.
No matter the level of pain, one should never use medication that was specifically prescribed for someone else. What is safe and effective for one person can lead to an accidental overdose for another.
Prescription opioids are a heterogeneous group of medications, with many formulation differences between them, including:
- Varying potencies.
- Extended release mechanisms.
- Additional, non-benign substances like acetaminophen and aspirin that may lead to additional health issues, especially when taken in excess.
Even if you manage to escape the physical dangers of trading medications, negative repercussions in the form of significant legal penalties are possible for misuse of prescription narcotics. The Drug Enforcement Administration (DEA) lists opiate pain medication as a schedule II substance, which indicates a high potential for abuse and addiction. Merely being in possession of a medication that is not prescribed to you can lead to fines and possible jail time.
They Don’t Cause Withdrawal
REALITY: Painkiller dependency can result in opioid withdrawal symptoms similar to those of heroin.
Opioid use can create dependency in both prescription and recreational users, and withdrawal symptoms will emerge when an opioid-dependent person stops using the drug. Withdrawal symptoms will commonly present between 12 and 30 hours after the last dose if one abruptly quits painkiller use.
Depending on the dose and frequency of the medication, withdrawal symptoms may include:
- Sleep issues.
- Stomach cramping.
Certain psychological symptoms like ahhedonia and drug cravings may be more persistent.
The painkiller withdrawal process is rarely dangerous but the discomfort of the symptoms associated with the detoxification process is often intense enough to trigger relapse. For this reason, there are a multitude of detox centers and solutions for recovery that will help to alleviate symptoms of withdrawal and usher recovering users safely into recovery.
Finding Information and Treatment
If myths are the problem, more accurate, detailed information is the solution. If you are interested in more information regarding potential treatment for opiate painkiller addiction, consider calling 1-888-744-0069 to learn what options are available for you.
- National Institute on Drug Abuse. (2014). Prescription Drug Abuse.
- Centers for Disease Control. (2016). Prescription Opioids.
- National Institute on Drug Abuse. (2014). Drugs and the Brain.
- National Institutes of Health. (2016). Opiate and opioid withdrawal.
- Congressional Research Service. (2015).Drug Offenses: Maximum Fines and Terms of Imprisonment for Violation of the Federal Controlled Substances Act and Related Laws.
- Drug Enforcement Administration. (n.d.). Controlled Substance Schedules.
- Drug Enforcement Administration. (n.d.). Drug Fact Sheet: Hydrocodone.
- Department of Veterans Affairs. (2010). Management of Opioid Therapy for Chronic Pain.
- Substance Abuse and Mental Health Services Administration. (n.d.). Physical Detoxification Services for Withdrawal From Specific Substances.
- National Institute on Drug Abuse. Heroin.