How Does A Painkiller Addiction Develop? 4 Things You Need To Know About Opioid Use Disorder

You already know that opioid painkillers like morphine, oxycodone, codeine, hydrocodone, and fentanyl can be addictive. You may be surprised to discover, however, that up to a quarter of people who are prescribed opioid painkillers struggle to get off them. Yet, they're still the most commonly prescribed medications in the United States, with over 245 million prescriptions filed in 2014 alone.

Yes, you bet that opioids are powerful pain relievers that can liberate patients with severe acute or chronic pain from living hells. Are they also, as many doctors will say, safe when used for short periods of time or only in the dose prescribed? Perhaps not.

1. How does a painkiller addiction develop? 

There are people — usually ones already experimenting with different kinds of illicit drugs — who actively go out looking to buy prescription opioids on the black market for recreational purposes without ever having needed them for medical reasons. That's not what we're looking at today, though. People who start off taking opioid painkillers because their doctors prescribed them for serious pain can fall into the clutches of addiction just as easily, and there are a few different reasons for that.

Prescription opioids alter brain chemistry — these drugs cause tolerance as well as dependence. That means that patients will need to take higher and higher doses to achieve the same pain-relieving effect with time, as well as that they go into withdrawal when they don't get the drug. Or, as one study explained very candidly:

"Repeated exposure to escalating dosages of opioids alters the brain so that it functions more or less normally when the drugs are present and abnormally when they are not."

People become addicted to opioid painkillers because they are inherently addictive, in other words, and research shows that the longer a person has been on an opioid painkiller, the higher their risk of addiction. Chronic pain patients may also, however, discover that their prescription painkillers make them feel good — inducing feelings of euphoria and relaxation, and helping them function better than they could without their painkillers. 

Combining all these factors explains why many chronic pain patients begin misusing their opioids, taking them in higher doses, exaggerating their complaints to get their doctors to prescribe higher doses, or straight-up buying them illegally. It's also important to note that an addiction to opioid painkillers poses a risk for heroin use. This drug, also an opioid, is cheaper and more readily available in some localities. 

2. Who is at risk of becoming addicted to opioid painkillers?

Certain factors — genetics, a family or personal history of addiction, anxiety, and stress, for instance — increase your risk of becoming addicted to opioid painkillers if they are ever prescribed to you. Doctors should take these factors into account when deciding whether or not to suggest an opioid to their patients.

3. What are some of the signs of an opioid use disorder?

You — or someone you know — may be in trouble if:

• You use higher doses than you intended to, more often than you planned — and you do not stick to your doctor's instructions, or continue using after your prescription has come to an end.
• You want to stop using, but your efforts to quit are fruitless. 
• You crave opioids when you are not using them, and will notice withdrawal symptoms such as muscle and bone pain, nausea, vomiting, diarrhea, chills, and restless legs when you haven't taken opioids for a while.
• You need to use higher doses more often to get the same effect as before.  
• Your opioid use continues despite the fact that itr is interfering in daily responsibilities and relationships, and you may use in circumstances where it is particularly dangerous — such as while driving. 
• You are preoccupied with opioid use. 

Overdosing is another sign of addiction. If this happens, your prescribing healthcare provider needs to reevaluate your prescription and offer assistance to safely stop using opioid painkillers. 

4. How can you stop using opioid painkillers?

Pain patients who want to or need to stop using opioid painkillers will need medical supervision to safely come off the drug and find alternative ways to manage their pain. 

• When patients are getting ready to stop using opioid painkillers, their doses should gradually be reduced — by 10 percent a month for those who have been taking the painkillers for over 12 months, and 10 percent a week for those who have not been using them for more than a few months. 
• You can be prescribed naltrexone to block the effects of your painkillers, reducing your risk of overdose. 
• Painkiller addicts will benefit from therapy to aid their recovery and will also need the support of their social circle. 
• If you still need pain management, the options available should be assessed by a specialist. Non-opioid painkillers as well as pain management techniques that aren't medication-based may both be among the possibilities.