Painkiller abuse and addiction is one of the most unfortunate and devastating forms of addiction and overdose, leading to death. Thirty eight percent of all overdose deaths in the U.S. are attributed to painkillers, causing over 17,000 deaths per year. In nearly every case, painkillers were originally prescribed for entirely valid medical reasons. Patients might have needed the medication temporarily for anything from surgery to broken limbs, but they became addicted to the drugs over the course of their recovery and increasing doses or mixture of doses with alcohol or other drugs is a typical cause for drug overdose and death.
History and Prevalence of Painkiller Addiction
While modern painkillers are much different, this type of medication has existed for centuries. The modern history of painkiller addiction, however, begins in the 1700’s when opium was made into a solution called morphine. From morphine came codeine. In the 1930’s, Methadone was synthesized and, since then, American pharmaceutical companies have released dozens of various painkillers, the majority of which carry a high risk for abuse.
If you’re the parent of a teenager or young adult, it is essential that you understand the risks of painkiller addiction. Young adults, between the ages of 18-25, are the highest abusers of prescription meds, with 12% reporting having abused prescription meds in the past year. This is pretty much the case for all addictive drugs, but in other areas, painkiller abusers are not homogenous or easily categorized. The exception seems to be that women experience chronic pain, are prescribed pain relievers in higher doses, and use them for longer periods than men. The most commonly abused painkiller is hydrocodone, followed by OxyContin, which is become more common in older Americans.
When a person’s drug-seeking behavior scales completely out of control and begins to compromise their physical and psychological health, a full-blown addiction is present. Addiction is far more serious than a strong desire to use drugs – it is a neurological disease that feels inescapable to the person suffering.
Painkillers are incredibly easy to become addicted to, even for people who otherwise exhibit no addictive tendencies. Even a person who has exhibited no previous addictive patterns can easily become addicted to painkillers after even a short time. As such, the DEA now reports that painkillers have surpassed marijuana as the most common gateway drug for first-time drug abuse.
Outward Symptoms of Painkiller Addiction
Painkiller abuse is not as obvious as other common addictions. Many painkiller addicts may have few or no outward symptoms. Painkillers do not typically produce profound impairment in verbal or motor functions (at least not until they amount taken is very high), they have no discernible smell, and the pills themselves are often very small and easy to hide. Painkillers are quite easily purchased at work or school from other students or peers who have taken them from the medicine cabinet of a family member.
The longer an addict is actively using prescription painkillers, the more likely you are to be able to pick up on symptoms. Increasing symptoms to look for over time include:
- Drowsiness, especially nodding off mid-conversation or in other inappropriate settings.
- Poor hygiene. This includes infrequent bathing, unkempt hair and facial hair, and wearing same clothes repeatedly.
- Frequent flu-like symptoms. Opioid painkillers have side effects which can mimic the flu, including nausea, fever, and headache.
- Weight loss. Painkillers suppress appetite. After a period of abuse, this will often lead to noticeable weight loss in the addict.
- Financial discrepancies. Painkillers are an expensive habit to maintain. They may rapidly run through their available funds and eventually resort to stealing money or valuables from others.
- Social withdrawal: withdrawal from family and friends.
- Neglects responsibilities: neglect of household chores and bills; calling in sick to school or work more often.
- Increased sensitivity: normal sights, sounds and emotions becoming overly stimulating to the person; hallucinations.
- Blackouts and forgetfulness: forgetting events that have taken place and experiencing blackouts.
- Defensiveness: becoming defensive and lashing out in response to simple questions in an attempt to hide a drug dependency, if users feel their secret is being discovered.
The pathological urges to use these drugs can also drive people to borrow, buy or steal the drugs from friends and family. As an act of desperation, some individuals may resort to seeking out heroin, an illegal substance that closely mimics opiate effects is commonly purchased off the streets. Despite the well-known dangers of heroin, it is often easier and cheaper to obtain heroin than opioid pills.
Typical Cost to the Addict
Painkillers can also be relatively inexpensive or easy to obtain, given the right circumstances. Most addicts begin using painkillers as part of a prescribed recovery plan under the care of a physician. During this time, the price of painkillers is often very inexpensive, especially if offset by the user’s insurance.
This is only the beginning of the issue for most painkiller addicts, however. Once their prescription runs out, addicts find themselves still physically craving the painkiller medication. This will require them to either purchase more of the drug than they are prescribed or continue buying the drugs on the street after their prescription has run out. While prescription painkillers are usually about $40-$100 for an entire bottle, that price can skyrocket on the street. Addicts seeking to buy the same drugs at street value are often looking at spending 10-13 times the market value of these prescription drugs.
Painkillers simply mask the pain for which they are taken. They don’t “cure” anything. Someone continuously trying to dull the pain may find himself taking higher and higher doses—only to discover that he cannot make it through the day without the drug.
An addiction to painkillers brings a whole host of issues with it, aside from money problems. Although many addicts are able to maintain relatively normal lives, keeping jobs, families, hobbies, etc., there often comes a time when their addiction becomes overwhelming. As their tolerance grows, most prescription addicts become unemployable or at the very least unable to hang onto quality jobs. At the same time, the cost of their addiction continues to increase. This combination of factors can often lead to theft, robbery, and other crimes, all of which carry substantial jail time. Teenagers will often resort to stealing money from their parents’ purse or wallets or committing petty theft.
Painkillers can also be a slippery slope into even more dangerous, unregulated drugs. Painkillers are a common gateway to the lethal drug known as heroin, which many addicts turn to as a less expensive, more readily available, alternative to their current addiction7.
Effect on the Addict of Painkillers in Teenagers
Painkillers, in the correct setting, are highly regulated and strictly controlled drugs. Their side effects are serious and they are only meant to be used under the direct supervision of experienced clinicians. They are also meant to be used exclusively in the short-term because the effects of the drugs can be extremely harmful over time. Physical effects of painkillers include a sensation of deep relaxation, lack of sensitivity to pain (both emotional and physical), drowsiness, constipation, and slowed respiration.
Painkillers derived from opioids can have serious effects on the brain. Opiates interact with opioid receptors in the brain and prevent the release of a chemical called GABA, which regulates the flow of dopamine in the brain. This accounts for the euphoria these drugs create and is also linked to long-term brain issues including depression.
As always, the longer a person uses painkillers, the more serious the risks become. Users who abuse painkillers in the long-term run the risk of muscle spasms, cardiovascular issues including heart attacks, and even death9. Painkillers are the most common cause of overdose in the United States, with over 20,000 people dying from painkiller overdoses in 2016 alone.
Permanence and Relapse of Painkiller Addiction in Teenagers
Painkillers are often compared with drugs like opiates and heroin, in terms of the difficulty of recovery. Over 90% of people recovering from opiate addiction will experience a relapse. The vast majority of these relapses occur within the first week of sobriety, but many others relapse within the first 30 days.
Since relapse is common, it’s important to understand the reasons and triggers which most often lead back to the drugs. When an addict is actively using painkillers, the drug affects the mesolimbic system of the brain, responsible for sensations of pleasure and reward. As an addict continues to use drugs, they begin to affect the chemistry of the brain, conditioning them to crave the drug, even needing it to feel any sensation of pleasure whatsoever. This condition becomes deep-seeded and requires a great deal of time and effort to overcome.
Most addicts will require a period of time deliberately set aside for early recovery. A controlled treatment center environment is essential, especially for teenagers. After the cravings have become less frequent, therapeutic sessions, 12-step programs, and religious programming are often effective in preventing a return to their addiction.
Detox of Painkiller Addiction in Teenagers
When an addict has used painkillers for an extended period of time, they can expect to suffer a period of withdrawal after giving up the drug. Severity and length of withdrawal depend upon the person, the length of drug abuse, and the quantities they were taking.
Early withdrawal symptoms will typically include agitation, anxiety, muscle aches, insomnia, sweating, and exhaustion. Depending on the severity of the addiction, the addict may also experience abdominal cramps, diarrhea, nausea, and vomiting. While all of these symptoms are quite uncomfortable, they usually subside within 7-10 days and are not typically lethal, barring any unforeseen complications.
There is not necessarily a profound medical contraindication for withdrawal in a home setting. However, patients who attempt withdrawal without professional support are far more likely to relapse during the process. Additionally, medical professionals can prescribe opioid detox drugs, including methadone or suboxone, which can ease the discomfort of the withdrawal to an extent.
Types of Painkillers Used by Teenagers
Opiates are prescribed for a wide range of medical needs. There are two main classifications for this type of drug: antagonists and agonists.
Antagonists such as Naltrexone and Naloxone are considered to be less addictive than agonists, though the potential for abuse still exists. They are often used to help with the detoxification process, which often takes place as the first part of addiction treatment.
Agonists mimic the effects of naturally-occurring endorphins in the body and produce an opiate effect by interacting with specific receptor sites in the brain. Agonists include drugs like morphine and fentanyl, which are most commonly used in medical settings and have the strongest effects. Many substances in this category have a very high potential for abuse and addiction. Other examples of agonists include hydrocodone, oxycodone, heroin, and buprenorphine.
The most common opiate agonists can be found in the list below.
Manufactured to relieve mild to moderate pain and coughing, codeine is less potent than other opioid painkillers. It is easily obtained with a prescription, as well as in some over-the-counter medicines. Commonly abused among young adults, codeine is often combined with sugary drinks.
Though now banned by the FDA, Darvocet and Darvon are propoxyphene-based painkillers that were responsible for thousands of hospitalizations and deaths during their prime. While these prescriptions are no longer being produced, a black market still exists for this drug.
A narcotic used to treat moderate to severe pain, Demerol is less frequently prescribed in modern times because of its high potential for addiction. Demerol is the brand name for meperidine, which has euphoric effects similar to morphine.
Sometimes referred to as “hospital grade heroin,” Dilaudid is a powerful type of painkiller. Available in extended-release tablets, Dilaudid abuse can quickly lead to breathing problems or even death.
A synthetic painkiller that is up to 100 times as potent as morphine, fentanyl is only prescribed in cases of severe pain. When used in conjunction with other painkillers such as heroin, fentanyl can quickly lead to overdose and other dangerous side effects. Fentanyl, though the most dangerous and deadly painkiller, has exploded in availability on the streets due to massive illicit shipments from China and Asia.
A main ingredient in many powerful painkillers, hydrocodone can be found in drugs such as Vicodin. It is typically combined with acetaminophen or ibuprofen, but the FDA has also approved pure hydrocodone medications.
An opioid used for moderate to severe pain, methadone is also used as a way to curb cravings for people who are addicted to other substances, including heroin. Despite its use for helping treat other addictions, methadone is still an addictive substance in its own right.
Morphine has been touted as a godsend for people suffering from severe chronic pain. It is also one of the most addictive substances known and responsible for a large amount of unintentional drug-related deaths nationwide.
Oxycodone is sold under different brand names including OxyContin and Percocet. It is a widely prescribed painkiller and has a high potential for abuse.
Physical and Mental Difficulty of Recovery
The road to permanent recovery is a long one. After the addict undergoes the initial withdrawal and detox phase, they will need to go through additional phases of recovery.
Once the initial withdrawal phase is over, addicts will continue to experience powerful cravings which wrack their entire body and psyche. As a result, some recovery plans for opiate addiction include tapering protocols. During this time, addicts will be prescribed medications like methadone, buprenorphine, naltrexone, or naloxone, which act on the opioid receptors in the brain to reduce frequency and power of cravings. Over time, these drugs will be tapered off, until the addict is no longer dependent upon anything at all.
For most addicts, recovery should also incorporate therapy. This can vary greatly depending on the person and the recovery center or group they approach to help them. Therapy can take place in an inpatient, outpatient, 12-step, religious, individual, group, or family setting, or any combination thereof. What’s important is that the addict discover the underlying causes of their addiction and make appropriate changes to their worldview and their lifestyle in order to further ensure against any chance of future relapse.
New Adventure Treatment Center (NATC) is a certified addiction and alcoholism treatment center. If your son is struggling with alcohol, he needs professional help to ensure permanent recovery. This program employs experienced and well-educated therapists and counselors to make sure that his addiction is a thing of the past. Addiction will turn your son into a shell of his former self. It’s important to understand that, as terrifying and all-consuming as addiction might be, there is a solution. There is a way out.
New Adventure Treatment Center has a complete course of treatment for addiction, including an extensive Aftercare Program to protect against relapse. Call 888-289-6818 today – swift action can prevent your teenager’s addiction from spiraling further out of control.
"NO WARRANTY" LEGAL NOTICE: While independent outcomes studies have shown very high recovery rates for indiviuals in our programs, we cannot guarantee recovery for any particular individual. Recovery and future abstinence from addicting substances and the effects that such substances may have on the individual or their life, actions, or their future are entirely dependent on the individual and how well they apply the principles we have taught them. We are an educational institution, and how the individual in our program learns from what they are taught and modeled here, is totally up to them. Individuals who stay the full term (until graduation) have much better long-term recovery from addicitons than those who do not.