Learn / Recognizing the Signs of Addiction to Prescription Pain Relievers

Recognizing the Signs of Addiction to Prescription Pain Relievers

Hannah Friedman
 March 1st, 2022

It can be hard to recognize the signs of a substance use disorder. That’s especially true for patients who overuse prescription medications. Even if you started taking a drug for medical reasons, it’s still possible to misuse it. Because of this, many patients struggle to admit that they need to go to rehab for an addiction to prescription pain relievers.

If you regularly use any type of pain medication, especially a narcotic, you should learn about the symptoms of addiction. By paying attention to these signs, you can stay in touch with your own relationship with your prescriptions. That way, you’ll be ready to get help if and when you need it.

Defining Addiction

Experts at the American Society of Addiction Medicine define addiction as “treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

In layman’s terms: people with substance use disorders continue to take drugs even when those drugs have a negative impact on their lives. However, there is a difference between having physical dependence on a medication, vs having a substance use disorder.1

Physical Dependence

Many people depend on medications for their health. For example, a person with severe diabetes may depend on insulin in order to regulate their blood sugar. If a medication clearly and consistently improves your quality of life, its use does not qualify as addiction.

However, the line between physical dependence and substance abuse is blurry at best. You don’t misuse a substance because it makes your life worse. At first, you’ll probably have reason to believe it helps. And even in the throes of substance abuse, dangerous drugs may still provide some positive effects. For example, a prescribed narcotic may continue to relieve your back pain, even while it wreaks havoc on your relationships.

Substance Use Disorders

People who struggle with substance misuse often display signs of “compulsive drug use despite harmful consequences.” These consequences of addiction2 may include mental health issues, such as depression and anxiety, and physical ailments, such as cardiac arrest, dental problems, and cancer. Drug use can also damage interpersonal relationships and interfere with your career.

This condition may or may not include chemical dependence. If it does, then it’s often essential for patients to undergo supervised medical detox, rather than attempting to stop using a drug by themselves. The physical side effects of detox can be especially dangerous for people with an addiction to opioids, including prescription pain relievers.

Signs and Symptoms of Addiction to Prescription Painkillers

Opioids are widely prescribed to treat chronic pain.3 These medications “play a unique role in society. They are widely feared compounds, which are associated with abuse, addiction and the dire consequences of diversion; they are also essential medications, the most effective drugs for the relief of pain and suffering.”

It’s difficult for many people, including patients and medical professionals, to immediately recognize the difference between addictive behavior and the appropriate use of pain medications. If you’re concerned about potentially misusing opiates, you can look out for the following signs and symptoms:

Using Prescription Painkillers When You’re Not in Physical Pain

Opiates should be prescribed to treat physical pain. If you find yourself compelled to continue taking them even when you have no physical symptoms, you may be at risk for a substance use disorder.

It’s also possible to treat some types of pain with non-addictive medications. For example, a minor headache might be better treated with an over-the-counter anti-inflammatory, like aspirin or ibuprofen. If you find yourself medicating minor ailments with powerful drugs, this can also be a warning sign.

Using Painkillers for Emotional Reasons

There are significant similarities between physical and emotional pain.4 Because of this, it may be hard to differentiate between your own physical and psychological reasons for using a drug. However, you may notice the urge to use medication when you’re experiencing overwhelming emotions. If you find yourself taking prescription painkillers to deal with your mental state, you may have a problem with drug abuse.

Obsessive Thinking

Patients with substance use disorders may spend a disproportionate amount of time thinking about using drugs. This may include thinking about when you’ll next take a pain pill, how you’ll refill your prescription, or whether anyone else has noticed how often you take opioid medications.

There’s a difference between planning around your medication and obsessing over your access to drugs. For example, it can be perfectly healthy to plan to take a pain pill before bed so that you won’t have to drive while intoxicated. On the other hand, if you spend all day, every day, looking forward to your nightly dose, you may have reason to be concerned.

Changing Sleep Patterns

Most mental health conditions, including substance use disorders, can disrupt sleep patterns.5 Opioids, in particular, “can produce profound sleepiness, but they also can disrupt sleep.” Exhaustion, insomnia, and disrupted sleep may all be signs of opiate misuse.

Because so many different stimuli can affect sleep, pay attention to what’s going on in your life when your sleep patterns change. If you’re going through a particularly stressful time, or you just got a new mattress, you may not have a cause for concern. However, if your sleep patterns change in tandem with your narcotic use, then substance abuse may be the cause.

Negative Physical Effects

Prescription drugs are intended to improve your quality of life and your physical well-being. If any prescription has more negative effects on your body than positive ones, you should talk to your doctor about discontinuing its use. However, if you have a substance use disorder, you may be tempted to ignore side effects in order to keep using the drug.

The side effects of prescription opioids include,6 but are not limited to, drowsiness, constipation, itching, sweating, and a decreased libido. Drug use may also change your behaviors in a way that causes negative physical health effects. For example, you might spend less time exercising, or put less effort into personal hygiene.

Negative Psychological Effects

Although painkillers may relieve emotional symptoms in the very short term (e.g., while you’re high), data suggests that prolonged opioid use may increase the risk of depression.7

If you find that your baseline emotional state has changed since you started taking a certain drug, it’s important to talk to your doctor. Whether or not you have a substance disorder, this is a serious side effect that requires medical attention.

Negative Interpersonal Consequences

Substance use disorders can undermine your ability to keep commitments. If you find yourself arriving late for plans, or skipping social functions entirely in order to use a drug instead, it may be an early warning sign of a serious addiction.

Addiction can also impact the quality of your relationships. The people around you may comment that your personality has changed, or you may lose interest in doing things you used to enjoy. Pay special attention to any activities you stop or avoid doing because you can only do them while you’re sober. If you’re prioritizing drug use over meaningful social interactions, it might be time to get help.

Risk-Taking Behaviors

Unusual risk-taking behavior is another symptom of addiction.8 For example, you may start habitually driving while intoxicated, missing work because of drug use, or showing up to important family functions while you’re high.

If you have trouble accessing a particular drug, you may also take risks in order to obtain it. Specifically, patients may trade sex or steal “for illicit drugs, drug money, or the drugs themselves.”

Increased Tolerance

As you develop a substance use disorder, your tolerance to the effects of a particular drug may increase. Patients often find themselves taking higher doses of a drug in order to achieve the same effect.

With any drug, but especially with opiates, this pattern can be extremely dangerous. Because opiates inhibit breathing, overdose can be fatal. Pay close attention to how much of a drug you use on a daily basis. Contact your doctor before changing your dosage, especially if you feel the need to increase it.

Treating Addiction to Prescription Pain Relievers

There’s one silver lining to the opiate epidemic: because it’s so widespread and well-documented, many rehab facilities offer treatment for this substance use disorder. Depending on your specific symptoms, and your other underlying health conditions, you may be a candidate for a number of different programs.


Detox from opiate use disorder should take place under strict medical supervision. Withdrawal symptoms can be very serious, or even fatal. However, they tend to resolve within a matter of days. Many patients benefit from residential treatment during this transitional period. While you’re in a detox program, you can work with your team of providers to decide on next steps.

Inpatient Treatment

Some patients choose to attend residential rehab after detoxing from prescription pain relievers. These programs offer a variety of treatments, including talk therapy, cognitive behavior therapy, medication-assisted therapy, behavioral therapy, and life skills coaching.

Inpatient treatment programs may last anywhere from several weeks to several months. There are residential rehabs all over the world, with a wide variety of approaches to treatment. No matter how unique your needs are, you’ll likely be able to find a program that can accommodate them.

Outpatient Treatment

Once you achieve a certain level of stability, your providers may recommend that you return home while undergoing outpatient treatment. Some programs still provide daily outpatient therapy or group sessions, while others will ask you to come in once or twice a week to receive treatment.

In an outpatient program, you may continue to engage in a number of different therapies. For example, you may see a talk therapist, take non-addictive medications, and/or attend support groups for people with substance use disorders.

Support Groups

There are numerous support groups for people with a history of addiction. You can choose between them based on your personal goals and values. For example, patients with a strong sense of faith may find meaning in 12-Step groups like Narcotics Anonymous. Others may prefer a non-12-Step program, like SMART recovery.

Long-Term Recovery From Opiate Use Disorder

Healing from any substance use disorder, including the misuse of prescription painkillers, can be a lifelong process. If you began taking a drug in order to manage another health issue, you may need to explore alternative treatments with your primary care physician. If you continue to have chronic physical pain, you may benefit from ongoing cognitive behavioral therapy, or a prescription for non-addictive pain medication.

Remember that this is an extremely personal process, and the road to recovery often involves ups and downs. Be patient with yourself. As challenging as recovery can be, it’s absolutely possible. With the right support, you can live a healthy and meaningful life without the need for opioids.

If you think you may be misusing prescription pain relievers and want to find support, you can learn more about rehabs for opioid addiction treatment here.

  1. Abuse, N. I. on D. (–). Is there a difference between physical dependence and addiction? National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence-addiction []
  2. Abuse, N. I. on D. (–). Addiction and health. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health []
  3. Rosenblum, A., Marsch, L. A., Joseph, H., & Portenoy, R. K. (2008). Opioids and the treatment of chronic pain: controversies, current status, and future directions. Experimental and clinical psychopharmacology, 16(5), 405–416. https://doi.org/10.1037/a0013628 []
  4. Sturgeon, J. A., & Zautra, A. J. (2016). Social pain and physical pain: Shared paths to resilience. Pain Management, 6(1), 63–74. https://doi.org/10.2217/pmt.15.56 []
  5. Abuse, N. I. on D. (2020, March 9). Connections between sleep and substance use disorders. National Institute on Drug Abuse. https://nida.nih.gov/about-nida/noras-/resources/2020/03/connections-between-sleep-substance-use-disorders []
  6. Prescription opioids | cdc’s response to the opioid overdose epidemic | cdc. (2021, October 2). https://www.cdc.gov/opioids/basics/prescribed.html []
  7. Scherrer, J. F., Salas, J., Copeland, L. A., Stock, E. M., Ahmedani, B. K., Sullivan, M. D., Burroughs, T., Schneider, F. D., Bucholz, K. K., & Lustman, P. J. (2016). Prescription opioid duration, dose, and increased risk of depression in 3 large patient populations. The Annals of Family Medicine, 14(1), 54–62. https://doi.org/10.1370/afm.1885 []
  8. Addiction: Symptoms, effects, and what to look for. (2018, October 26). https://www.medicalnewstoday.com/articles/323459 []

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