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Painkillers

Drawing the line between pain relief and opioid dependency

When prescribed and managed by a doctor, opioid painkillers — including codeine, oxycodone (OxyContin), hydrocodone (Vicodin), morphine, methadone, and Percocet (a mix of oxycodone and acetaminophen) — can provide relief for people dealing with acute or chronic pain. Too often, though, their use gets out of control. Across the country, about 4.3 million people have misused opioid painkillers in the last month. If taking painkillers has become ingrained into your daily routine — even after the pain subsides — and is causing problems in your life, it may be time to address a dependency. Seek out help.

Recovery is possible. 

Naloxone can stop an overdose. With it, you can save a life.

If you or someone you know is using opioids, you should carry naloxone, a medication that can safely reverse the toxic effects of an overdose. Learn more.

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Risk factors

Opioid painkillers have a chemical makeup similar to heroin, which is why dependency can form over time. People who receive long-term opioid therapy for noncancer pain in a primary care setting are at especially high risk; up to 25 percent of these patients may struggle with addiction. According to the Centers for Disease Control and Prevention, the following risk factors can make people more vulnerable to problems with prescription painkillers:

  • Overlap of prescriptions through multiple doctors and pharmacies
  • High daily dosages
  • Mental illness or addictive personality
  • History of substance abuse

In some states, these risks are intensified by economic hardship, the overprescription of opioid painkillers, and the weak regulation of these drugs, allowing users to more easily obtain them.

Signs and symptoms

A physical dependency on opioid painkillers can form quickly because the body gets used to the dulled sense the drugs create; also, after finishing a prescription or reducing use, some patients may begin to experience symptoms of withdrawal. Without these drugs, pain can seem just as bad as it was before starting a prescription — or may feel even worse.

Patients may experience agitation, anxiety, cramping, muscle aches, nausea, and vomiting. These symptoms should be treated under a doctor’s care, but some patients instead self-medicate by continuing — and increasing — their use of opioids, even after their original prescriptions have run out.

If you notice any of the following behavioral changes in yourself or a loved one while taking prescription opioid painkillers, consider reaching out for support:

  • Taking pills in greater amounts or more frequently than prescribed
  • Increasing the daily dosage of a prescription and finishing it early
  • Using another person’s prescription drugs
  • Mixing pain pills with other substances like alcohol, illegal drugs, or other pharmaceuticals, whether prescribed or available over the counter
  • “Doctor shopping” visiting multiple doctors and pharmacies — to obtain multiple prescriptions

If you’re worried about someone you know, you can learn about how to encourage a heroin user to seek treatment. Remember that recovery is a process, but heroin treatment has been effective for many people. 

Treatment

Talk to your physician or physician anesthesiologist and consider all your options when treating pain. Non-opiate options may be as effective as prescription painkillers in relieving the pain — and may also reduce side effects and remove the risk of chemical dependency that is associated with opioid painkillers. These options include:

There are also non-opioid alternatives for anesthesia. If you’re planning on getting surgery, you can talk to a physician anesthesiologist about your options.

When dealing with opioid addictions, some doctors will suggest medication-assisted treatment, which can help alleviate the severe symptoms of withdrawal. Other approaches include various forms of detox and rehabilitation, such as counseling and behavioral therapies. Therapy isn’t one-size-fits-all; you may have to try different types to find the one that works for you. Refer to our general drug treatment page to see a full list of therapy types and descriptions.

Remember: Your doctor prescribed an opioid painkiller to you (and only you) for a specific reason. Never sell or share your pills, and store your medicine in a safe place, out of the reach of others. If you don’t finish the entire prescription, find a community drug take-back program or consult your doctor or pharmacy about safely disposing of any unused pain pills.

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