Painkiller Addiction

When someone experiences a headache or pain from a minor injury, many individuals immediately turn to their medicine cabinet for painkillers. If the pain is more severe, such as that experienced after surgery, doctors may prescribe stronger painkillers to alleviate discomfort. However, did you know that these types of painkillers can potentially lead to a devastating addiction? This page explores the most addictive types of painkillers and offers advice on how to seek help for a painkiller addiction.

What are painkillers?

Painkillers are medications designed to relieve pain. They can range from over-the-counter (OTC) options for minor ailments to stronger prescription medications for more severe pain. The choice between OTC and prescription painkillers often depends on the nature and severity of the pain, as well as the individual’s medical history.

OTC painkillers

OTC painkillers are available without a prescription and are typically used for mild to moderate pain. Common examples include:

• Paracetamol: Effective for relieving pain and reducing fever. It’s not anti-inflammatory, so it doesn’t reduce swelling.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): An example would be ibuprofen. These types of medications reduce pain and decrease inflammation.

OTC painkillers are often used for headaches, menstrual cramps, minor injuries, muscle aches and mild arthritis. Although they are available without a prescription, they can still have side effects, especially when taken in large doses or for a prolonged period.

Prescription painkillers

Prescription painkillers are stronger medications that are used for moderate to severe pain, often under conditions where OTC medications are not effective. These include:

• Opioids: Such as oxycodone, hydrocodone, morphine and fentanyl. They are very effective for pain relief but can be addictive and are associated with a risk of overdose.
• Non-opioid prescription painkillers: Such as tramadol or certain types of antidepressants and anticonvulsants, can also be used for pain management.

Prescription painkillers are usually prescribed for acute pain following surgery or injury, cancer pain and, in some cases, chronic conditions like severe arthritis. Due to their potential for addiction and side effects, their use is closely monitored by healthcare providers.

Are all painkillers addictive?

Over-the-counter (OTC) painkillers

OTC painkillers typically do not carry addiction warnings. While not addictive in the traditional sense, their misuse or abuse can lead to serious health issues, including liver damage and gastrointestinal problems. Consumers often overlook the potential risks, assuming that OTC availability equates to safety. However, exceeding recommended doses or prolonged use without medical supervision can have detrimental effects on health.

Prescription painkillers

Prescription painkillers, especially opioids, have a higher potential for addiction:

• Codeine: Often prescribed for mild to moderate pain relief. It has a lower potency among opioids but can still lead to dependence and addiction.
• Hydrocodone: Used for moderate to severe pain. It’s more potent than codeine and highly addictive.
• Oxycodone: Prescribed for moderate to severe pain and has a high risk of addiction.
• Morphine: Used for severe pain, including pain from cancer and serious injuries. It has a high potential for addiction.
• Fentanyl: Extremely potent and prescribed for severe pain, typically in cancer patients. It has a very high potential for addiction and is also linked to a significant number of overdose deaths.
• Tramadol: Used for moderate to moderately severe pain. It’s considered to have a lower risk of addiction than other opioids, but the risk is still present.
• Methadone: Used for pain relief and as part of drug addiction detox programs. It can be addictive.

Analgesics Addiction

Analgesic addiction involves the compulsive use of pain-relieving medications, such as opioids or over-the-counter painkillers, leading to tolerance, physical dependence, and withdrawal symptoms upon cessation, posing significant health risks and challenges for individuals seeking to overcome their addiction.

Why are these painkillers so addictive?

Painkillers, especially opioid types, have the potential to be addictive if misused or poorly managed. Below, we take a look at some of the main reasons that these types of painkillers can be so addictive:

Activation of the brain’s reward system

Opioids have a way of latching onto the brain’s receptors, not just easing pain but also ramping up feelings of joy and well-being. This can make taking opioids more than just pain relief, as it becomes a deeply enjoyable experience. For some, the rush of happiness becomes something they seek, leading them down the path of using opioids for nonmedical reasons. This hijacks the brain’s reward system, making opioids seem like the ultimate source of pleasure and making other enjoyable activities pale in comparison.

Tolerance development

As people use opioids over time, their bodies get used to the drug and they find themselves needing more of it to get the same effect, whether that’s pain relief or a high. This tolerance happens because the brain’s receptors get less sensitive to opioids. Taking higher doses increases the risk of an overdose and sinks the user deeper into addiction, creating a vicious cycle of increased use.

Physical dependence

Physical dependence on opioids means the body starts to react badly when the drug isn’t present, leading to withdrawal symptoms that can range from uncomfortable to downright painful and hard to endure. This makes the thought of quitting seem daunting, as the fear of withdrawal keeps people locked into using opioids, even when they desperately want to stop.

Psychological dependency

There’s also a psychological side to opioid addiction. It’s not just about the body craving the drug; it’s about using opioids to numb emotional pain, deal with anxiety, or feel normal. This mental dependency makes overcoming addiction more complex, as it involves tackling both the physical withdrawal and the emotional and psychological challenges.

Variability in individual response

Why some people get addicted to opioids while others don’t can vary widely, involving a mix of genetics, environmental factors, psychological health and social surroundings. Some are more genetically prone to addiction, while things like stress, access to drugs and mental health issues like anxiety can increase a person’s risk. On the flip side, a supportive social network can offer a buffer against falling into addiction.

Prescribing practices

The role of prescribing opioids has also come under scrutiny, as it’s contributed significantly to the opioid crisis. Many became addicted after being prescribed opioids for valid medical reasons, not realising the addictive potential. Despite tighter controls and guidelines now in place, the effects of past prescribing habits continue to ripple through the ongoing battle with opioid addiction.

What are the signs of painkiller addiction?

Painkiller addiction is a complex condition that affects individuals physically, psychologically and behaviorally. Recognising the signs of addiction can be crucial for early intervention and treatment. Here’s a breakdown of the symptoms across these three categories:

Physical symptoms

• Tolerance: Needing more of the painkiller to achieve the same effect.
• Withdrawal symptoms: Experiencing physical symptoms like sweating, shaking, nausea and vomiting when not taking the drug.
• Changes in sleep patterns: This could include insomnia or sleeping more than usual.
• Weight loss or gain: Significant changes in weight without a clear reason.
• Neglect of personal hygiene: Showing less interest in bathing, grooming or dressing appropriately.
• Unusual energy levels: This could be periods of hyperactivity or, conversely, excessive sleepiness.

Psychological symptoms

• Cravings: Experiencing intense urges to use the drug.
• Inability to stop using: Unsuccessful efforts to cut down or control painkiller use.
• Preoccupation with the drug: Spending a lot of time thinking about the drug, how to get more of it and when you’ll use it again.
• Mood swings: Experiencing significant fluctuations in mood, from euphoria to depression.
• Increased sensitivity to pain: Feeling pain more acutely, a condition known as hyperalgesia, which can occur with long-term opioid use.
• Anxiety or depression: Feeling more anxious or depressed than usual, which may be a consequence of the drug’s effects on the brain.

Behavioural symptoms

• Doctor shopping: Visiting multiple doctors to obtain more prescriptions (occurs in countries with privatised healthcare systems)
• Isolation from friends and family: Withdrawing from social activities and relationships.
• Neglecting responsibilities: Failing to fulfil obligations at work, school or home due to drug use.
• Engaging in risky behaviours: Taking dangerous risks to obtain the drug, such as stealing or driving under the influence.
• Legal issues: Encountering legal problems related to drug use, such as arrests for possession.
• Financial problems: Spending significant amounts of money on drugs, leading to financial difficulties.

How do I know if I have a painkiller addiction?

Self-assessing your use of painkillers is vital as it helps spot early warning signs of misuse or addiction. This is important whether the painkillers come from a prescription or are acquired by other means. Catching any issues early on enables prompt action, which can stop addiction from worsening and avoid the related health, social and legal problems that come with it.

Below, we’ve designed seven questions to ask yourself:

1. Have you found yourself needing to take more of the painkiller to achieve the same effect or experienced withdrawal symptoms (like nausea, sweating, shaking) when you try to stop or reduce your use?
2. Have you tried to cut down or stop taking painkillers but found that you couldn’t?
3. Do you spend a lot of time thinking about painkillers, including how to get more and when you’ll take them next?
4. Have you continued to use painkillers even though it’s causing problems in your life, such as issues with relationships, work or health?
5. Have you neglected your family, work or educational responsibilities because of your use of painkillers?
6. Have you engaged in risky behaviours, such as driving under the influence of painkillers or using painkillers obtained from nonmedical sources?
7. Have you given up or reduced social, occupational or recreational activities due to your painkiller use?

How can I get help for painkiller addiction?

Seeking help for painkiller addiction is vital, and in-patient rehab offers the best chance for thorough recovery. These centres provide a secure environment for medically supervised detox, the initial step to eliminating the drug from the body, reducing withdrawal symptoms and ensuring safety.

Beyond detox, in-patient rehabs delve into the root causes of addiction through individual and group therapy, helping patients understand their dependency and develop healthier coping strategies. They also equip individuals with skills to avoid triggers and build supportive networks, which are essential for preventing relapse. The immersive experience of in-patient care, with its intensive therapy and support, is highly effective for overcoming painkiller addiction.