Woman with prescription painkiller addiction
Prescription painkillers, such as oxycodone, hydrocodone, and fentanyl, are opioid medications prescribed for the management of moderate to severe pain that has not been resolved with other methods of pain relief 1. Opioid painkillers are closely related to and often synthesized from opiate substances, including morphine and codeine, and are controlled substances due to their high potential for abuse. About 4.3 million people in the U.S. abused prescription painkillers in 2014 2. Chronic prescription opioid abuse can lead to a problematic pattern of use known as addiction, or opioid use disorder. Quitting using opioid medications can be challenging due to the distressing withdrawal symptoms associated with cessation or reduction of use 3.
In this article, you will learn more about the following:
- Opioid painkiller addiction.
- Is detox necessary?
- Prescription painkiller withdrawal symptoms.
- The detox process.
- Treatment after detox.
- Find help today.
Opioid Painkiller Addiction
Prescription painkillers reduce pain and anxiety, and in higher doses, can produce euphoria, a feeling which acts as positive reinforcement for the continued abuse of these medications 5. Opioid painkillers hijack the brain’s reward pathway, which, when functioning properly motivates people to engage in pro-survival behaviors, such as eating and engaging in sex. These reward pathways flood the brain with dopamine, a neurotransmitter associated with pleasure. Essentially, this artificial spike in dopamine levels communicates to the brain that the opioid drug being abused is promoting survival, and encourages repeated use 3. This cycle of behavior can lead to the development of addiction, a chronic condition characterized by intense cravings and compulsive drug-seeking behaviors despite negative consequences.
Once you’re addicted, quitting opioids can be difficult. The withdrawal symptoms can be extremely uncomfortable, which may contribute to relapse, especially when accompanied by severe cravings. Seeking the assistance of a detox program can reduce the likelihood of relapsing by alleviating unwanted withdrawal symptoms.
Detox is a term used to describe a variety of interventions aimed at clearing a person’s body of opioids while also reducing the negative physical impact of the drug while it leaves the body 4. Among the interventions that are commonly used during drug detox are:
- Evaluation and monitoring.
- Medication-assisted detox.
- Social services.
- Medical care for co-occurring physical conditions.
In some sense, detox is similar to palliative care, in that it is aimed at managing painful symptoms associated with a serious condition (in this case, addiction) while not necessarily focusing on the underlying issues 4. While detox may not be considered comprehensive and definitive treatment for prescription painkiller addiction, it is often a necessary first step toward recovery.
As with other levels of substance abuse treatment, drug detox can be provided in a variety of settings including 4:
- Detox facilities.
- Inpatient treatment programs.
- Partial Hospitalization Programs (PHP).
The level of care that an individual needs to successfully detox from painkillers will vary from person to person. Speaking to a professional who is trained to assess drug abuse and withdrawal will give you a better idea of the services that will best suit your own individual recovery.
If you’re addicted to prescription painkillers and are ready to make a positive change in your life, call our helpline at 11111 to speak to a treatment support specialist about detox and treatment.
Is Detox Necessary?
Prescription painkiller detox is not generally life-threatening. Therefore, supervised detox is not always necessary. However, a detox program can be beneficial for many people, because it can reduce cravings, ease withdrawal symptoms, and prepare you for ongoing treatment. Those who would especially benefit from a detox program include people who:
- Have attempted to quit in the past and been unsuccessful.
- Have survived an accidental overdose of painkillers in the past.
- Have been taking extremely high doses.
- Have been using painkillers for an extended period of time.
- Do not have a support system, or live in a home where drug abuse is common.
Prescription Painkiller Withdrawal Symptoms
Man experiencing prescription painkiller withdrawal symptoms
The use of opioids to relieve pain can lead to tolerance and dependence 5,6. Tolerance occurs when the current dose being taken becomes ineffective at treating pain or no longer has the same effect on the user 6. Tolerance to opioid painkillers can develop quickly, even within therapeutic doses 6. Both medical and nonmedical use of prescription opioids can lead to dependence, the body’s normal adaptation to the presence of a drug. Once a person has become dependent on opioid painkillers, they will likely experience some level of withdrawal symptoms if they attempt to reduce their dose or quit taking the medication altogether 3.
The severity and duration of withdrawal symptoms a user will experience when withdrawing from painkillers will depend upon several factors, including:
- The length of time of use.
- The average dose and frequency with which it is taken.
- The individual’s physiology.
- The presence of any underlying medical, psychiatric, or polysubstance abuse issues.
The onset and severity of opioid withdrawal symptoms are influenced by the half-life of the drug, which represents how quickly the body eliminates the drug. A person addicted to short-acting opioid painkillers may experience withdrawal symptoms within several hours of their last dose, while someone who’s addicted to a longer-acting prescription opioid may not experience withdrawal symptoms until a couple days after the most recent dose 8. Symptoms may take a few days to a couple weeks to subside, depending on the specific opioid 8.
The following is a list of the common symptoms associated with opioid painkiller withdrawal syndrome 2,5,8:
- Watery eyes.
- Runny nose.
- Excessive yawning.
- Profound sweating.
- Muscle aches and pains.
- Hot and cold flashes.
- Goose bumps.
- Abdominal cramps.
- Increased sensitivity to pain.
Withdrawal from prescription painkillers is usually not life threatening but the symptoms can be extremely uncomfortable and lead to relapse2. Accidental overdose may even occur immediately after a person has gone through a period of detox, which is why it’s so important to receive ongoing substance abuse treatment 2.
Call our helpline at 11111 to speak to a treatment representative about detox and recovery options.
The Detox Process
The prescription painkiller detox process incorporates 3 essential elements, which include 4:
- Evaluation: The evaluation process will occur within the first 24 hours of admission to a detox program. Medical evaluations will include labs and urinalysis, monitoring of vital signs, assessment of any past or present medical diagnoses, and current physical symptoms. Psychiatric evaluations will include full psychosocial assessments of past and present symptoms. This phase serves as the framework from which a treatment plan is developed.
- Stabilization: The stabilization stage consists of regular monitoring and treatment of symptoms that emerge throughout the detox process. With the patient’s consent, this phase may include the family, outside providers, and sometimes employers in the short-and long-term plan for recovery.
- Transition to lower levels of treatment: The transition process usually consists of planning and preparing for the next stage of recovery, by stressing the importance of a longer-term treatment program, such as inpatient or outpatient, and providing education and guidance.
Treatment After Detox
Someone who continues on with appropriate treatment once they have completed detox will increase the likelihood that they will sustain long-term recovery.
There are various treatment options available to someone who is coming out of a detox program. These options include:
- Inpatient: Inpatient, or residential treatment, can last anywhere from 30 to 90 days, or even longer if needed. These programs provide medication as well as individual and group therapy on a regular basis. Inpatient programs provide a safe environment to begin your new life of sobriety.
- Partial Hospitalization(PHP)/Intensive Outpatient(IOP): PHP will provide group counseling and medication management 5 days a week. IOP will provide group counseling a few times a week but expects that you have a provider for any medications you require. Both programs may utilize family therapy or individual therapy, depending on the program.
- Standard Outpatient: Standard outpatient programs are less intensive than PHP or IOP and may consist of individual and group therapy. Individual therapy can assist you in dealing with some of the deeper issues related to substance abuse. Group counseling will help you to get the support and mentoring that is often helpful when recovering from substance abuse.
Each program will have its own philosophy and approach to treating substance abuse, and will offer its own unique set of amenities and services. While finding a program that fits your individualized needs may take time, it can make a difference in terms of improving your treatment experience and increasing your chances of long-term recovery.
Find Help Today
If you or a loved one suffers from a prescription painkiller addiction, reach out to a member of our dedicated recovery support team at 11111 today. They can help you understand the treatment options out there and get you started on your path to recovery.
1. U.S. National Library of Medicine. (2015). Medline Plus, Pain medications-narcotics.
2. U.S. National Library of Medicine. (2013). Medline Plus, Opiate and opioid withdrawal.
3. National Institute on Drug Abuse. (2007). The Neurobiology of Drug Addiction.
4. Knowledge Application Program. (2013). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol TIP. Rockville, MD: U.S Department of Health and Human Services.
5. Harvard Medical School. (2009). Treating opiate addiction, part I: Detoxification and maintenance.
6. Eddy, N. B., Halbach, H., Isbell, H., & Seevers, M. H. (1965). Drug Dependence: its Significance and Characteristics. Bulletin of the World Health Organization, 32(5), 721–733.
7. Janssen Pharmaceutica Products L.P. (2003). Duragesic Label.
8. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.