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How Painkiller Addiction or Overuse Happens

Ten Reasons Why People Abuse Prescription Painkillers

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Updated February 20, 2011

No one swallowing doctor-prescribed painkillers does so with the intention of getting addicted. We take them, for example, to ease post-surgery pain or deal with pain related to diseases, such as cancer. Still, for some people with particular natures and certain risk factors -- who use these medications for good initial reasons -- the risk of addiction exists.

Not all prescription painkillers are potentially habit-forming. For example, SSRIs are not, while opioids are. For those that are, here are some factors that can play into the fueling of an actual addiction or overuse behavior.

Painkillers Numb Physical Pain Very Effectively

No special training, skill, effort or techniques are required for pain management when using narcotic painkillers. You simply take a pill and soon afterward, the pain you were feeling is substantially reduced or eliminated.

The fact that these painkillers work well with little effort makes them the first choice for pain management for many people. Rather than exploring other ways of managing pain, which take effort and may not eliminate pain to the same extent as the painkillers, people reach for the pill bottle each time pain relief is required. The ease of use and effectiveness it brings may lead some to reach for the drugs more often than is safe or necessary.

Non-Drug Pain Management Services Are Inaccessible

Although there are many other effective forms of pain management, our medication-oriented culture promotes the use of medications as the first approach used for pain management. Physicians prescribe these painkillers rather than refer to pain clinics. Even when people are desperate to try non-drug alternatives for pain relief, they often have a much harder time accessing these alternatives than they do getting a prescription for painkillers -- typically only after dependence has developed.

This leaves people with few alternatives for managing their pain, other than the drugs, further fueling the addiction that has developed.

Painkillers Distance You From Emotional Pain

While it may not be the first reason that people take such painkillers, most notice that while they are under the influence of these drugs, they are distanced from their emotional pain.

Painful emotions are a part of everyday life for all of us, but often we can manage these feelings on our own or with professional help, such as counseling. However, people in physical pain have often suffered emotional trauma (from an accident or illness, for example) and are more vulnerable to the attractions of a pill that just “makes it all go away.” Over time, people come to depend on their prescription painkillers to manage their negative emotions.

Painkillers Can Be Pleasurable

Opiods, in particular, have a side effect of euphoria. This is similar to the pleasure felt when you have been successful or after intense physical excitement, but it requires no such effort to attain. As people who are in pain have typically suffered an unpleasant experience that caused the pain -- be it an accident or over-exertion -- the pleasurable effects of these painkillers can seem like a delightful surprise. Seeking repeated experiences of pleasure through the addictive behavior or substance is one of the hallmarks of addiction.

Painkillers Induce Relaxation

People with physical pain are often very tense. Unless you are experienced in non-drug pain management techniques, or practice another approach to relaxation (such as yoga or meditation), you are likely to clench your muscles and tense up when you feel pain. These are natural reactions. Because many painkillers, such as Demerol, induce physical relaxation, they can provide welcome relief from tension while under the influence.

After a while, people can come to rely on painkillers that have this effect to provide relief from tension and the added pain that tension causes.

Tolerance Builds Up Quickly

Opiods can quickly cause tolerance to occur. As a result, people who regularly take these painkillers find that they need to take higher and higher dosages of the drug they are on in order to get the same effect. In addition to physical tolerance, people develop psychological tolerance as they become desensitized to the effects of the drug. Tolerance is one of the key signs that addiction is developing.

Physical Neglect Intensifies Pain

Often, people who are becoming addicted to narcotic painkillers believe they need more of the drug because their pain is getting worse. But the worsening is often a result of the painkiller use itself. The ups and downs of a developing addiction cause physical behaviors such as overuse of an injured part of the body, poor posture resulting from a lack of sensation when in positions that would otherwise be uncomfortable, and a lack of moderate exercise that would otherwise strengthen the weakened area.

Instead of correcting these bad habits, the person will often just take more painkillers, creating a vicious cycle of physical neglect being concealed by the effects of the drugs.

Withdrawal Is Very Unpleasant

As people become addicted to painkillers, they experience withdrawal when the drug wears off. Withdrawal is very unpleasant, and it often feels like an intensifying of the very symptoms the person was trying to escape through taking the painkillers.

Pain, digestive problems and feelings of being generally unwell are common. As soon as the drug is taken, the unpleasant withdrawal symptoms disappear, and the person feels relieved of pain, relaxed, and free of tension and emotional distress. Over time, the person will choose to manage withdrawal symptoms through regularly taking more painkillers, sometimes without even realizing the withdrawal symptoms are caused by the drug itself.

Painkillers Are Legally Available

Physicians are quick to offer pain medications for most types of pain, particularly if the individual in pain has no apparent prior history of addiction or drug abuse. Advertising also encourages use of over-the-counter painkillers, which are being designed to produce quicker and more intense effects.

Although painkillers are legal when purchased as over-the-counter drugs, or prescribed by a physician, they are chemically similar to illicit drugs such as heroin. The implicit encouragement by an authority figure such as a medical professional, and the explicit encouragement by advertising, can lead people to inaccurately believe that painkillers are safe. People who would normally avoid addictive substances can easily become dependent.

Addiction Leads to Stigma, Which Leads to Illicit Drug Use

Over time, it can become a goal for someone who has an opiate painkiller addiction to maintain a constant level of the drug in their bloodstream, so that withdrawal never needs to be experienced. When people get to this stage, they are often labeled “drug-seeking,” and they may find that their physician suddenly becomes less sympathetic or even judgmental, or their insurance provider becomes unwilling to continue to cover the drug cost. Feeling betrayed and stigmatized, many feel forced into a life of illicit drug use, giving up on finding a better way to cope. This can make painkillers a "gateway drug" to illicit drugs.
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