Side Effects of Prescription Painkiller Abuse

If you use or misuse prescription painkillers, you should understand the potential for painkiller side effects that may occur with use, misuse, and addiction. Learning more about the short- and long-term side effects of painkiller medications, prescription painkiller safety, and the addictive potential of painkillers may help you make an informed decision about your health and well-being.

Prescription painkillers include prescription opioid medications that you may receive from a doctor if you suffer from moderate to severe pain, such as pain after surgery or severe pain due to trauma or disease such as cancer.^1,2

There are many types of prescription opioids, also known as narcotics.³ Some of the more common opioid painkillers include:

• Hydrocodone.¹
• Oxycodone (Oxycontin, Percocet).¹
• Oxymorphone (Opana).¹
• Morphine (Kadian, Avinza).¹
• Codeine (Tylenol with codeine).³
• Fentanyl (Actiq, Duragesic).³
• Methadone (Dolophine HCL, Methadose^™).³
• Tramadol (Ultram).³
• Buprenorphine (Butrans).³

In general, people can safely use prescription painkillers under the guidance of a physician.¹ However, they are highly misused, which means that people may take painkillers in ways or doses other than originally prescribed, use someone else’s medication, or take painkillers just to get high.^1,2,4 Feelings of relaxation and euphoria are potential painkiller side effects, which can drive people to use prescription opioids for non-medical reasons, making these medications especially risky.¹

Prescription pill addiction can cause a variety of consequences to the lives of those who misuse these medications, but treatment can help.¹ Treatment may include a variety of interventions, including medications for opioid use disorders and behavioral therapies.¹ If you or a loved one are struggling, you should know that help is available, and people do recover from addiction.¹

What Are the Side Effects of Prescription Painkiller Abuse?

Side effects of painkiller medications can vary depending on several factors, such as whether it’s the first time you’re using opioids, whether you take medications that interact with opioids, and whether you have other medical conditions, such as liver conditions, sleep apnea, or breathing problems.^2,3

Severe side effects can occur with painkiller use, even when you take the medication as directed by your doctor.⁵ Some of the more negative side effects of painkillers can include a risk of addiction, difficulties breathing, and even potential overdose.⁵

Polysubstance use, which is combining prescription opioid painkillers with other drugs, alcohol, or medications like benzodiazepines, may intensify painkiller tablet side effects and increase the risk of serious adverse health issues, which makes them even more dangerous.^3,6

Short-term, medically managed use of prescription opioids does not often lead to addiction, and these medications can be safe and effective when used under a doctor’s guidance for their intended purpose.³ Still, as mentioned above, the potential for pain reduction, relaxation, and euphoria can contribute to dependence, misuse, and addiction.^1,4

Short- and Long-Term Effects of Prescription Opioid Misuse

When prescription opioid painkillers are taken as directed, they can be beneficial for pain management in people who are suffering from pain due to illnesses, injuries, or surgical procedures.^2,4 However, they also come with a risk of potential short-term side effects.³

Side effects may include:^3,5

• Slowed breathing.
• Constipation.
• Sleepiness.
• Sweating.
• Nausea and vomiting.
• Itching.
• Dry mouth.

Over time and with chronic use, people may also have a risk of long-term effects on the body and brain, such as:

• Worsening pain, which can indicate that a change in your treatment plan is necessary.³
• Decreased sex hormones, which can cause symptoms such as lower sex drive, night sweats, menstrual changes in women, or loss of erection in men.³
• Tooth decay due to dry mouth, which can lead to tooth loss.³
• Bone loss, which can lead to osteoporosis (brittle bones).³
• Addiction, or opioid use disorder, which can occur even when painkillers are taken as directed.³
• Tolerance, meaning you need more of the medication to achieve previous results.¹
• Physiological dependence, meaning your body has adapted to the presence of the drug and you need to take it to function and feel normal and you experience withdrawal symptoms when you stop taking it.¹
• Withdrawal, or unpleasant symptoms such as muscle and bone pain or severe cravings, that occur when you cut down or stop the medication.¹
• Respiratory depression (slowed or shallow breathing) and overdose which can be fatal if left untreated.³

Prescription painkiller/opioid overdose is a serious concern for people who use these medications.⁷ Opioids can cause overdose because they interact with the part of the brain stem that is responsible for controlling breathing.⁷

When someone takes too much of an opioid, they can suffer from suppressed breathing and suffocation and potentially die.^2,7 However, even people who take low doses of opioids may be at risk of overdose, especially if they have sleep apnea, breathing problems, liver problems, or kidney problems, or combine opioids with alcohol or other medications, like benzodiazepines.³

Non-medical use of opioids (misuse) and long-term use are also significant risk factors for overdose.⁸ In addition, people who are tolerant on their medication can require higher and/or more frequent doses, which can also increase the risk of overdose.²

Overdose can be reversed with naloxone, providing that it is promptly administered.⁷

Addiction Potential of Prescription Painkillers

Addiction to prescription painkiller opioid medications is diagnosed as opioid use disorder (OUD).² Opioid addiction is a potential risk of long-term painkiller use that can occur even when these medications are taken as directed by a medical professional.² People who misuse prescription painkillers are at an increased risk for OUD.²

Prescription opioid painkillers produce their effects because of the way they act on the brain and body.⁴ Opioids work by attaching to opioid receptors on nerve cells found throughout the body, including the brain, spinal cord, gastrointestinal tract, and other organs.⁴ Activation of these receptors causes the release of large amounts of dopamine, a neurotransmitter that is known to play a role in the reinforcement of pleasurable activities.¹

This process results in an altered perception of pain in the body due to an inhibition of pain signals and can also lead to feelings of euphoria and relaxation.^2,4 Not everyone experiences euphoria, but people who do may have an increased risk of misuse, and people who misuse opioid painkillers to experience this effect can have an increased risk of addiction (OUD).²

In addition, the regular use of painkillers, even when used therapeutically as prescribed by a doctor, can lead to tolerance and dependence, which, while not the same as OUD, are often features of the disorder.^1,4

Healthcare professionals use criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose an addiction to prescription painkillers.⁹ They will evaluate a person to determine whether they meet the necessary criteria for a diagnosis. In order to receive a diagnosis, a person needs to have experienced a problematic pattern of opioid use that results in significant distress and impairment, evidenced by meeting at least 2 of the 11 diagnostic criteria over a 12-month period.⁹

Some, but not all, of the diagnostic criteria include:⁹

• Using opioids in larger amounts or over a longer period than originally intended.
• A persistent desire or unsuccessful efforts to cut down or control opioid use.
• Spending a lot of time in activities necessary to obtain, use, or recover from the effects of the opioid.
• Cravings, or strong desires or urges to use opioids.
• Failing to fulfill major role obligations at work, school, or home due to opioid use.
• Ongoing opioid use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
• Tolerance.
• Withdrawal.

Can Prescription Painkillers Be Used Safely?

If prescription opioid painkillers are taken as directed under a doctor’s guidance, they can generally be used safely and effectively to help with pain management.⁴

When using prescription painkillers, it is important to communicate with your doctors and/or pharmacists regarding the proper dosage for your needs, medication safety (especially if you use other medications), the concurrent use of other substances like alcohol, overdose potential, opioid withdrawal symptoms that can occur upon abrupt cessation or rapid dose reduction, and other considerations, such as whether there might be a different option to treat your pain.³

As mentioned earlier, side effects will vary depending on several factors, including your level of pain, age, how long you’ve used the medication, and whether you use other medications or substances.^2,3 Everyone responds to medications differently. If you are concerned about painkiller safety and side effects, it’s important to talk to your doctor.³

Finding Treatment for Prescription Painkiller Addiction 

If you or a loved one are struggling with painkiller misuse or addiction, you should know that treatment can help. Treatment usually involves a combination of medication and behavioral therapies.¹

The first step in getting help might be to speak with your doctor or healthcare professional to discuss your condition and treatment options. Treatment should be individualized for your unique needs; some treatment types or settings may work better for different people depending on their specific situation.¹⁰

There are different levels of addiction treatment that typically advance as:

• Medical detox, which provides medical supervision, medication, and support as you undergo withdrawal.¹⁰
• Treatment (also known as rehabilitation), which may involve inpatient drug rehab or outpatient addiction treatment.¹⁰
• Aftercare, also known as continuing care, which can help solidify the skills learned during the initial phase of treatment and mitigate the risk of relapse.¹¹

If you’re interested in treatment, you can learn more by calling our admissions navigators at , who can guide you through the admissions process and help you learn more about your rehab options. You can also search the drugabuse.com treatment directory to find rehab facilities across the country.

No matter how things might seem right now, there is always hope. Research shows that treatment can help people with OUD stop using opioids, maintain a drug-free lifestyle, and achieve a healthier and more productive life.^1,10 When you’re ready to take back control of your life, call us to get started with the recovery process.