Painkiller Addiction vs. Dependence
The terms addiction and dependence are sometimes used interchangeably, however they are distinctly different. Pain medication dependence is a physical response by your body, while painkiller addiction is a psychological response. While one can potentially lead to the other, they do not always go together.
When you become dependent on pain medication, your body basically becomes “used to” the medication. It may no longer be as effective, and you may gradually develop a physical tolerance to the drug. When you are physically dependent on a prescription medication, sudden withdrawal can cause symptoms such as cold sweats, restlessness, insomnia, diarrhea or even muscle and bone pain.
Painkiller addiction is different. Many people who become addicted to prescription drugs take them compulsively and are unable to control their use. They may no longer feel pain relief, however may enjoy the feeling of euphoria that can come with inappropriate use of the medication. Studies show that painkiller addiction is not common for people whose opioid use is well-managed by their physicians.
If you have any concerns about painkiller addiction, check out the signs and symptoms of addiction, written by our Guide to Addictions.
Will I Become Addicted to My Pain Medication?
In all likelihood, no. Chances are if you have concerns about this, you are not the typical pain pill abuser. People with a high risk for painkiller addiction include those who have previous addiction history, including alcoholism or other types of drug misuse and abuse. People with a history of psychiatric problems such as mood disorders or severe anxiety have a greater risk for developing painkiller addiction. Also, those with a family history of addiction or who experience an initial euphoric response after taking painkillers may be at increased risk of addiction.
Should people who have a greater risk of addiction not be allowed to use opioids to manage their chronic pain? Not necessarily. Studies show that people who take their medications as directed and are regularly monitored by their physician are at the lowest risk for developing painkiller addiction, or having other associated complications.
Avoiding Painkiller Addiction
In general, opioids may be used in long-term chronic pain management safely, as long as their use is monitored by a physician. Carefully managed cases rarely turn into cases of addiction. Still, there are a few things you can do to reduce your chance of painkiller addiction.
- Take pain medication only as directed. Do not crush or chew your pain pills unless you have been instructed to do so by your physician. This can deliver a time-release medication all at once, increasing the risk of complications. It can also cause a feeling of euphoria, which for some people can lead to misuse. It can also cause a potentially deadly drug overdose.
- Talk to your doctor immediately if you notice any changes with your pain medications. If you find the same dose no longer seems effective, do not take an extra dose. Instead, make an appointment with your doctor to discuss the next step. Taking more than your prescribed amount of pain medication at once can cause breathing problems, or even lead to a drug overdose.
- Do not combine your pain medication with other depressants. This can lead to respiratory distress, addiction or even a drug overdose. Opioids should not be combined with alcohol, sleep aids, anti-anxiety medications, antihistamines or barbiturates.
If you take the appropriate precautions, take your medication as directed and meet with your doctor regularly, you have a much lower risk for developing painkiller addiction. If opioids help keep your chronic pain under control, don’t let a few news stories scare you into changing your medication regime.
American Pain Society. Advocacy: The Use of Opioids in the Treatment of Chronic Pain. Accessed 6/30/09. http://www.ampainsoc.org/advocacy/opioids.htm
National Institute on Drug Abuse. Research Report Series – Prescription Drugs: Abuse and Addiction. Accessed 6/30/09. http://www.nida.nih.gov/Researchreports/Prescription/prescription2.html
National Institute on Drug Abuse. Treating Prescription Drug Addiction. Accessed 6/30/09. http://www.nida.nih.gov/ResearchReports/Prescription/prescription7.html
Wilson, Jennifer Fisher. Strategies to Stop Abuse of Prescribed Opioid Drugs. Annals of Internal Medicine. 19 June 2007, (146) 12, p 897-900.