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Prescription Painkiller FAQ

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What are Prescription Painkillers?

Prescription painkillers are opioid medications used to manage relatively severe pain (such as pain associated with surgical procedures or more chronic issues like cancer-related pain).1, 2 They can be safe and effective when taken exactly as prescribed. Opioid analgesics are extremely beneficial medications for people with pain management needs, but misuse can increase the risk of a number of health issues, including addiction and fatal overdose.2

The primary active components of painkiller medications activate opioid receptors in the brain, resulting in a therapeutic alteration of pain perception. When taken in high doses, however, opioids may also have certain side effects, such as marked drowsiness, respiratory depression, and a reinforcing sense of euphoria.4 At high enough doses, the euphoria associated with painkiller misuse can be similar to that of an illicit drug like heroin. People who repeatedly attempt to elicit such rewarding, euphoric effects may find themselves falling quickly into a cycle of compulsive misuse. Those using the drugs to get high will often:3, 4

  • Take higher doses than directed.
  • Take doses more frequently than directed.
  • Crush the pills into a powder form for unintended routes of administration, including snorting the pills or dissolving the powder in solution to then inject into a vein, muscle, or under the skin.4

Doing any of the above can have detrimental and potentially life-threatening consequences ranging from loss of consciousness to respiratory arrest, brain damage, and coma.4

Can I Get Addicted Even if I Have a Prescription?

Yes, you can get addicted to opioids even if you have a prescription. Opioids can induce intensely pleasurable sensations and activate the reward pathways in the brain. This mechanism acts as positive reinforcement to continue taking the drug.1 This addictive potential is the reason why someone taking a painkiller should be closely monitored and re-evaluated regularly. Taking more than instructed or using them via alternate methods like snorting or injecting can further increase the risk of developing an addiction.

If you take a painkiller for a medical need, follow your doctor’s instructions very carefully, and avoid taking more than prescribed, the risk of addiction is relatively low. Over time, you may naturally develop some level of tolerance to the medication and require a higher dose in order to alleviate pain.4 This is a normal response to ongoing opioid therapy; however, you should never make the decision to increase your dosage on your own in an attempt to overcome any tolerance. Doing so could increase the risk of adverse effects, including overdose, and may increase your chances of eventually becoming addicted.

What are Common Opioid Painkillers?

Opioid painkillers are sometimes also referred to as narcotic analgesics. These medications diminish or otherwise alter our perception of pain signals throughout the body by binding to and activating opioid receptors. Narcotics are generally prescribed by a physician for severe pain for relatively short durations of time.

Some common prescription painkillers include:4

Are Painkillers Safer Than Illegal Drugs?

One common misconception is that opioid painkillers are inherently safer than illicit drugs due to their legality and medicinal properties, but that isn’t always the case.

At high enough doses, the effects of many of the prescription opioids are virtually indistinguishable from other dangerous drugs of abuse, such as heroin.4 Like heroin, painkillers can produce profound respiratory depression at high doses, so those who misuse them are at increased risk of respiratory arrest, which can result in widespread organ injury, coma, and subsequent death.4

What are the Short-Term Effects of Painkiller Abuse?

Some side effects of painkiller misuse include:2, 5

  • Drowsiness.
  • Dizziness.
  • Confusion.
  • Nausea.
  • Vomiting.
  • Constipation.
  • Itching.
  • Respiratory depression.
  • Loss of consciousness.
  • Coma.

What are the Long-Term Effects of Painkiller Abuse?

Some potential long-term effects of prescription opioid abuse include:2, 5

  • Increased tolerance.
  • Physiological dependence.
  • Acute opioid withdrawal syndrome upon cessation of use.
  • Sleep apnea.
  • Falls and fractures.
  • Sexual dysfunction.
  • Cumulatively increased risk of overdose.

Other Dangers

If you inject these drugs, you’re also at risk of dangers like:4, 6

  • Abscesses.
  • Collapsed veins.
  • Tuberculosis and other pulmonary disease.
  • Infection of the heart lining.
  • HIV, hepatitis, and other bloodborne diseases.

Can I Overdose on Prescription Opioids?

Yes, it is possible to overdose on prescription opioids. These drugs are prescribed with strict dosing parameters for a reason. When people misuse painkillers, they can easily exceed safe, recommended amounts and approach lethal doses (especially if used in combination with other opioids, sedatives, or alcohol). Again, because these drugs are respiratory depressants, overdose can result in slowed or even stopped breathing and death.4

According to the Centers for Disease Control and Prevention (CDC), more than 70% of all drug overdose deaths in 2019 were opioid related.7

How Many People Abuse Opioid Painkillers?

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that approximately 1.4 million people, ages 12 and older, struggled with a substance use disorder involving prescription opioids in 2019.8

How Similar are Prescription Opioids and Heroin?

Prescription opioids and heroin are both opioid agonist substances; they share chemical structural similarities and, at certain doses, elicit nearly identical pharmacologic effects. Its perhaps unsurprising then that research has revealed a connection between prescription painkiller abuse and heroin use.4

People who abuse opioid painkillers will sometimes transition to using heroin due to its cheaper price and accessibility. In fact, one study found that 80% of new heroin users had abused prescription opioids prior to using heroin.4

What Happens if I Suddenly Stop Using Opioids?

If you misuse opioid painkillers or have been taking them over a long period of time, then it’s likely that you will experience unpleasant withdrawal symptoms once you stop using. This is due to the physical dependence that develops as the body adapts to the presence of the drug. Once dependent on any drug, your body will act as if it needs the drug for baseline functioning.

Opioid withdrawal symptoms include:4, 9

  • Dysphoric mood.
  • Restlessness.
  • Insomnia.
  • Muscle aches.
  • Involuntary muscle movements (e.g., kicks).
  • Fever.
  • Chills.
  • Goosebumps.

  • Sweating.
  • Increased tear secretion.
  • Yawning.
  • Runny nose.
  • Nausea.
  • Vomiting.
  • Diarrhea.

The appearance of withdrawal symptoms varies among types of painkillers; many are short-acting, though some are relatively long-acting or available as extended-release formulations. Withdrawal symptoms can appear within hours after the last dose if your prescription opioid is short-acting. Conversely, if it is long-acting, the onset of withdrawal symptoms may be somewhat delayed.9

How do I Quit Abusing Prescription Painkillers Safely?

If you suffer from an addiction to prescription painkillers, help is available to you. Quitting opioids cold turkey and the resulting unmanaged withdrawal can be unnecessarily unpleasant and challenging; it can even place you at increased risk of relapse in an attempt to mitigate symptoms.4 Fortunately, you can get assistance in managing withdrawal more safely and comfortably in a supervised medical detox program.

Once you have cleared your body of opioids and successfully managed the acute opioid withdrawal period, there are different kinds of addiction treatment to continue your recovery efforts. These options include:

  • Inpatient treatment: You can live at the facility while receiving 24-7 care. An inpatient drug rehab program will typically last between 30-90 days (or longer). Inpatient care will provide a tailored treatment plan that may include an intake evaluation, supervised detox, psychiatric and medical care, individual and group therapy, and aftercare planning.
  • Outpatient treatment: You are able to live at home while attending a recovery program that works with your schedule.
  • Individual therapy: You will meet with a therapist one-on-one to address underlying factors influencing your opioid addiction and to develop coping skills to be used in stressful situations.
  • Group counseling: Your group counseling sessions will consist of building sober social skills and healthy coping strategies.
  • 12-Step programs: 12-Step programs are commonly incorporated into formal substance abuse rehabilitation programs. Both during rehab and afterwards, 12-Step groups provide members with a supportive and encouraging environment amongst their peers in recovery. Fellowships such as Pills Anonymous and Narcotics Anonymous are free to join and have helped many sustain lasting sobriety.

For help finding a program to end your addiction to opioid painkillers, call us at We can assist you in sorting through the options to find the right care for you or someone you love.

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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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