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Most of the patients frequently visit doctors with a complaint of pain along with other symptoms. Almost one-third of Americans are suffering from chronic pain and are managed by painkiller prescriptions. Every 2 patients out of 100 develop painkiller addiction. Firstly, know that painkiller abuse is very common. 259 million people were prescribed pain meds in the USA, over 2 million people developed an addiction. 

Painkillers do not fight off the bacteria or reduce any symptoms. Simply, these reduce the sensation of pain by blocking the nerve endings that take the message to the Central Nervous System (CNS). Many post-operative patients have been prescribed painkillers for weeks and months to reduce pain sensitivity. However, chronic use creates a sense of euphoria. 

List of Opioids Strongest to Weakest

Painkiller use disorder activates the receptors in CNS that are related to pleasure and pain. Additionally, these create a sense of happiness, euphoria, which is quite addictive to some people. So, let us talk about the side effects of painkiller abuse, different types of frequently used painkillers, how the painkiller abuse starts and what are painkiller addiction facts? What do painkillers do to your body?

A person holding a pill in their hand.

Death due to painkiller addiction is twice as compared to cocaine and five times compared to heroin. The most common abused painkillers are usually opiates, opioids, NSAIDs, etc. These pain relief drugs are derived from opium, which is extracted from a poppy plant. The purest and natural forms are morphine and codeine. 

However, it does not mean if your doctor has prescribed you painkillers, you are on a death road. Analgesics are prescribed to millions of patients daily and not all of them get addicted to it. Hence, the blame does not fall on the shoulder of the doctors and surgeons prescribing these painkillers. Primarily, these are made for treatment purposes. 

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Unfortunately, a patient does not feel when he is in the initial stages of painkiller use disorder. Suddenly, he feels the urge to take medications before the prescribed time. Before you know it, you will be popping pills more than the doctor’s advice and labeling it the need to survive. That is the first step to opioid addiction and still many do not feel that they are addicted. 

You must be wondering how do painkillers work? How the addiction starts and what are the signs of pain pill abuse? This article is all about some crucial painkiller addiction facts. Firstly, know that the pain is a sign of inflammation. Inflammation means there is something abnormal going on inside your system which needs to be shut down. 

Primarily, inflammation causes pain along with multiple other symptoms. Treatment of other symptoms can be done with the proper diagnosis but for pain relief analgesics are prescribed suddenly. So, if a patient comes to ER with a complaint of severe headache and vomiting. Before jumping to the diagnosis, an ER specialist will inject IV analgesics before the MRI, CT, or other relevant tests. 

Painkillers like NSAIDs block the COX (cyclo-oxygenase) enzyme. COX releases certain prostaglandin which causes inflammation. Therefore, by blocking COX, painkillers directly reduce inflammation and lowering the pain. Injured cells due to inflammation cannot release prostaglandin and hence the message is not sent to CNS. 

The important fact is to know that addiction does not develop within days or weeks. Yet, there are some alarming painkiller addiction signs which you might notice in patients on analgesics. We will discuss those thoroughly so you can judge a potential abuser before it gets too late. Whenever we try to control a thing, it is a good indication that how uncontrolled it was.

Usually, painkillers are prescribed for a long term for chronic pain such as in patients with arthritis, joint pain, migraine, etc. The second category which usually gets a list of painkillers is post-operative patients. The route to use the drug is also advised by the health care professional. It depends upon the patient’s condition, the severity of the disease, and how fast the result is required. 

For example, the fastest route can be IV or spinal, so these go directly into the blood and the respected organ or to the central nervous system via the cerebrospinal fluid. Well, one question that must be circulating in your system would be what is the cause of opioid addiction? One thing is certain that painkiller abuse develops for chronic users. 

The alarming sign is when painkiller abuse effects the sleep and making a person irritative, despite being physically and symptomatically okay. Before we get into the methods of abusing painkillers, know different types of analgesics, and find out which of them is the most addictive. 

Opioids and opiates are two vast varieties of analgesics that include thousands of medications. Now, you must be wondering the difference between these two terminologies. Opiates are derived naturally from opium without any manufactured ingredient. Commonest include morphine and codeine. 

On the other hand, opioids are either fully synthetic or partially synthetic with some part derived from opium. Both result in the release of endorphins which creates a sense of calmness and peace. Ultimately, it does not matter if it is derived naturally or synthetically, misuse of any of these can lead to a rather serious opioid addiction. 

If you have a history of using analgesics, tell your doctor so he may prescribe your medications accordingly. The risk should be discussed thoroughly. Furthermore, opiates are classified into agonist and antagonist drugs. The antagonists are slightly less addictive as compared to agonists. However, the potential of misuse and abuse is still present. 

Agonists include the most misused drugs such as: 

  • Codeine
  • Darvon
  • Demerol
  • Dilaudid.
  • Fentanyl 
  • Hydrocodone
  • Methadone
  • Morphine 
  • Oxycodone

Codeine is primarily prescribed to relieve moderate pain and cough. Mostly, adults get addicted to this drug. Combining it with a soft drink and calling it “purple drank” is a very common painkiller. 

Darvon/Darvocet is currently banned due to the multiple deaths caused by it. However, some shots might still be available in the black market supplying to painkiller addicts. 

Demerol is a narcotic drug used to treat severe pain. With the same euphoric effects as morphine, it is banned by the govt. officials. It contains the highest potential to be used as an abused drug. 

Dilaudid, labeled as hospital-level heroin is one of the strongest analgesics present now. Misuse of this drug can cause breathlessness and even death within minutes.  

Fentanyl, a magical painkiller that is 100 times more addictive than morphine. Only used to treat severe pain, when it is abused with a combination of heroin, can cause severe side effects. 

Hydrocodone is another powerful painkiller. It is usually prescribed with a combination of ibuprofen or acetaminophen. Though, a clean/non-addictive version is now introduced in the market. 

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Methadone is used to treat moderate pain. It is also used by many addicts when they cannot get their hands on the first choice like heroin. 

Morphine is considered the gifted drug for those suffering from severe chronic pain. Unfortunately, it is also the most abused drug causing the greatest number of death due to opioid addiction. You can read more about Morphine Addiction and its side effects

Oxycodone, selling with different brand name as OxyContin, etc. similarly, as morphine it is highly addictive. Read more about Oxycodone Addiction

The above given is the list of pain pills that can get you high. 

The common ways to ingest the above drugs are: 

  • Compressing and crushing the pill and snorting through the nose.
  • Crushing the pills and injecting them into the intravenous line. 
  • Combination of different drugs. 

Snorting a crushed pill or injecting it makes the addict feel “high” and relaxed. When taken orally, the metabolism slows down the absorption process and the specific spark of sudden energy is gone. The side effects of painkiller abuse are uncountable. Here we have enlisted some of them. 

However, with inappropriate usage and addiction, their side effects can cause serious complications and even death. When abused with Zaleplon, alcohol painkillers can cause symptoms like delirium, disarray, and headaches. These are the earliest physical signs of painkiller addiction. The usual dosage of morphine for adults is 0.1 to 0.2 mg per kg every 4 hours. It is injected slowly via an IV line. Morphine is used worldwide to treat severe pain. 

However, painkiller abuse effects can cause severe hypotension and hypovolemia. Sometimes, patients feel extremely relax and the state of euphoria increases their craving. It can lead to hypovolemic shock and even death. Abusing painkillers also results in short-term memory loss. Hence, most of the addicts do not remember what they did after injecting the drug. 

Painkillers Addiction Luxury Treatment

Note: “drug-seeking” behavior is very common in painkiller addicts. 

Painkiller addiction side effects features a signature behaviour. Besides which, short-term side effects of taking painkillers may include: 

  1. General fatigue.
  2. Lack of concentration.
  3. Memory loss.
  4. Constipation.
  5. Respiratory depression.
  6. Delirium. 
  7. Mood swings.
  8. Slow movements. 
  9. Hypoalgesia.

The above listed are the signs someone is addicted to pain pills. 

The Long-Term Effects of Painkiller Use Disorder

Mostly, the chronic abuse of painkillers causes adverse effects including physical, social, and psychological symptoms. 

Gastrointestinal Problems

Addiction to pain meds may lead to severe digestive effects. Painkiller addicts might be dependent on laxatives for proper digestion. Sometimes, the anus is damaged too. The condition is called narcotic bowel syndrome, where there is a severe lack of intestinal movement resulting in bloating, vomiting, abdominal distention. 

Liver or Kidney Damage

Liver is involved in detoxifying every harmful substance in the body. Most of the medications are metabolized in either liver or kidney.Usually, due to acetaminophen abuse, the liver starts storing toxins and eventually releasing them into the blood. 

Immobilization/Muscle Fatigue

A condition called Rhabdomyolysis occurs where muscles fibers are torn leading to the inability to move for hours. This can lead to kidney damage hence many pain med addicts are on dialysis. 

Death Due To Toxicity

Liver and kidney failure can even lead to sudden cardiac arrest. 

Hormonal Dysfunction and Reduce Libido

Opioids affect the endocrine system resulting in hormonal imbalance. Low levels of estrogen and testosterone can also cause loss of erection, low libido, and altered sexual drive. Indeed, the short-term side effects can be reversed quickly. Although, a stoppage of pain med abuse after a chronic use results in painkiller addiction withdrawal symptoms. Which we will discuss shortly. 

Note: if a patient is trying to get some specific medicines prescribed, there is a good chance they are addicted.

Despite knowing the side effects of painkiller abuse, if you feel you cannot resist the need for a painkiller, you are probably on the road to addiction. Painkillers include a vast majority of drugs. Hence, the signs and symptoms depend upon the drug, the abuse’s age, severity, etc. 

Related: Gabapentin Abuse and Side Effects

Some of the signs are so obvious that you can judge them in a blink of an eye. Painkiller Addiction symptoms can range from mild to worse depending on the use of a particular person.

The patient thinks about medication a lot: the earliest sign is when a patient cannot stop thinking about “when will be the next dose” and a general feeling that if the dose is not enough. 

However, dependency and addiction are not the same things. A person can be dependent but not an addict. Here is how. When you are dependent, you need a higher dose physically to get the same result. On the other hand, if you feel an emotional need to get a higher dose. It is addiction. Even, it is causing a behavioral change and problems in social, family life you cannot skip it. 

Taking different amounts as compared to the prescription: if a patient is stretching out time to take more doses later, and taking more painkillers as compared to the doctor’s prescription called as prescription painkiller addiction. 

Doctor shopping: do you see someone in your loved ones visiting multiple doctors for the same problem and labeling it that they went for a “second opinion”. 

Possibly, the goal is to increase the supply of painkillers. Sometimes, they even lie about losing the prescription of medication in an unfortunate event. 

Getting painkillers from other possible sources: when a patient cannot get their hands on more painkillers. They might choose other means to satisfy their craving which may include:

  • Ordering drugs online.
  • Burrowing medications from a relative.
  • Stealing painkillers from a friend or relative.
  • Prescription painkiller abuse by making fake doctors notice.  
  • Buying other people’s prescriptions.
  • Illegally writing prescriptions of painkillers.
  • Buying painkillers/drugs i.e., heroin on the streets. 

Using painkillers for a long time: at first, a patient starts painkillers to lower the pain. But if they continue using the same medications even after the doctor’s advice, it is an alarming sign. 

Maybe, they are taking these because they like it, and not to relieve the pain. 

Feeling raged when someone talks about it: one of the physical signs of painkiller abuse is that the addict gets raged and angry even if someone mentions the overdose of drugs. 

Note: This irritating behavior is a red flag that the addict needs treatment ASAP.

So, when painkillers are abused, your body gets dependent on them. You cannot seem to do the regular daily routine task without the intake of a painkiller. Which results in your brain getting habitual of daily intake. Now, after abrupt discontinuation or induction of an antagonist, withdrawal symptoms start appearing. Physical dependence and increased tolerance are due to chronic use of opioid addiction. 

Some of the signs of pain pill withdrawal are 

  • Restlessness.
  • Rhinorrhea.
  • Lacrimation. 
  • Yawning.
  • Mydriasis.
  • Chills.
  • Perspiration.
  • Myalgia. 

Other symptoms which may develop are:

  • Anxiety.
  • Backache.
  • Joint pain.
  • Abdominal cramps.
  • Insomnia. 
  • Vomiting.
  • Diarrhea.
  • Altered BP.
  • Decrease respiratory rate. 
  • Nausea. 
  • Anorexia.

Note: Symptoms tend to be even worsened with the abrupt discontinuation. So, the patient might need strong emotional, psychological, and social support. 

Painkiller Abusing Withdrawal Time

If we talk about the commonest abused painkiller i.e. morphine. It has a half-life of 2 to 4 hours. This means our body takes about 2 to 4 hours to eliminate the half dose of morphine. Unfortunately, the withdrawal symptoms of morphine appear rapidly. It rushes your mind and body that there is no morphine left. Hence, the craving starts, and the addict gets intensely irritating and anxious. 

The good news is that all the symptoms are reversible with proper treatment. Fortunately. Now there are luxury rehab centers and centers which help addicts and abusers grow stronger and make social life. Primarily, the symptoms which occur are restlessness, anxiety, and insomnia. With time they heal, and the person can get healthy within few months. If your symptoms are adverting, it is a good idea to see a good doctor and do as he says. 

Every painkiller has a different mechanism of action. If we talk about morphine, acute overdose symptoms include respiratory distress, CNS depression.In severe abuse, it can cause cardiac arrest, arrhythmia, leading to death. Morphine abuse can cause miosis. 

A classical sign of opioid abuse is pinpoint pupil. Mydriasis is seen with hypoxia and over dosage. Pain med addiction is most likely to occur when a patient takes it along with other CNS depressants. Additionally, alcohol triggers the signs and symptoms of painkiller abuse. 

Furthermore, in severe cases, the BP of addict goes below alarming condition, and he might go into hypovolemic shock and coma. Fortunately, treatment of both acute and chronic overdose and abuse is available. The symptoms can be reversed 100%. 

Watching someone close to your heart having a pill addict behavior is heart wrenching. Finding yourself with a pill addict behavior is alarming too. Fortunately, if you have realized the disease and are willing to get better, it is never too late. Also, there are multiple ways to satisfy the craving.

Even if you are snorting or injecting but taking multiple pills every few hours, know that you are involved in painkiller abuse. Secondly, you can never take the side effects for-granted. It can cause severe complications in your physical, social, mental, sex life. Moreover, some of the symptoms are irreversible or might take a lifetime to completely heal. 

Once you take the first step of the painkiller abuse ladder. You are already above few steps before realizing what is going on. If you have made it up till the very end, you must know now what do painkillers do to your body. Watch out for people who have gone through this painkiller addiction and make sure to keep the common painkillers out of their very reach.

The list of painkillers that get you high is quite long. However it falls upon us to keep an eye on folks around us with a pain pill addict behavior. Painkiller use disorder is becoming one of the uprising problem in our society and needs to be taken care of.

If you see signs and symptoms in any of your close friends or relatives possessing painkiller dependency and happens to be a painkiller addict, reach out to them and try to control the situation. Even if the withdrawal symptoms are worsening. Always remembers, where there is a will there is a way.



The Balance RehabClinic is a leading provider of luxury addiction and mental health treatment for affluent individuals and their families, offering a blend of innovative science and holistic methods with unparalleled individualised care.


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