Painkillers are among the most prescribed drugs in the U.S., and they’re also some of the most addictive. Prescription painkillers tend to lead to a feeling of euphoria for the person taking them, and that, in turn, leads to the rapid development of dependency in many cases. With prescription painkillers, addiction is both physical and psychological, and when physical dependence occurs, it can lead to a higher level of tolerance as well as withdrawal symptoms if the addicted person attempts to stop taking these drugs. The psychological component of painkiller addiction leads to the mental and emotional need of someone to continue taking these drugs, regardless of adverse outcomes or repercussions.

What Are Painkillers?

Painkillers are often opioids, and they may be divided into two primary categories, which are strong and weak. Opioids can be used to treat severe or acute pain, as well as chronic, long-term, pain. Opioids are also called opiates, and there are many different types of opioid painkillers. Some of the weaker options include codeine and dihydrocodeine.

Types of Painkillers and Intended Use

Often people will wonder what drugs are painkillers, or how are they different from over the counter painkillers. The following is a prescription painkiller list of some of the most commonly used and also abused drugs, as well as a listing of their street/brand/generic names.

  • Codeine: Codeine can create what’s seen as a high, but the strength and effects can vary. Some of the street names for it include Cody and Captain Cody. When codeine syrup is mixed with alcohol, it’s often called Lean, Sizzurp and Purple Drank. The generic name is codeine, and there is no brand name. It’s often combined with acetaminophen or aspirin.
  • Darvocet/Darvon (this is now banned by the FDA, although it may still be in circulation)
  • Demerol: The generic name of Demerol HCl is meperidine, and this drug is used in the treatment of moderate to severe pain. The street name for Demerol is Demmies.
  • Dilaudid: The generic name of Dilaudid is hydromorphone, and other brand names can include Exalgo and Hydrostat IR. This prescription pain medication is used for moderate to severe pain treatment, and street names may include D, Dillies, and Dust.
  • Fentanyl: Fentanyl is a synthetic opioid that is 50 to 100 times more powerful than morphine. This Schedule II painkiller is used to treat severe pain or sometimes chronic pain. Other prescription names include Actiq, Duragesic, and Sublimaze. Street names include Apache, China Girl, China White, and Dance Fever. When sold on the streets, Fentanyl is often combined with heroin.
  • Hydrocodone: Hydrocodone can include Norco, Vicodin, Lorcet and Lortab. This opioid pain medication is used for severe pain, and it’s also available as Zohydro ER and Hysingla ER, which are extended-release versions of the drug. Street names may include Hydro, Narco, and Vickies.
  • Methadone: Methadone, which also has the brand names Dolophine, Methadose, Methadose Sugar-Free and Diskets, is a drug that’s often used to treat the withdrawal symptoms associated with stopping the use of heroin, but it can become addictive on its own as well. Street names may include wafer, amidone, and fizzies.
  • Morphine: Morphine is the generic name of a powerful painkiller also known as AVINza, Kadian, and MS Contin. It’s usually prescribed for moderate to severe pain, and there is an extended release version that is used for constant pain treatment. Morphine isn’t meant to be used for as-needed pain treatment, and it’s not for short-term pain following Morphine has many street names, some of which may include dreamer, emsel, first fine and God’s drug.
  • Oxycodone: Oxycodone is the generic name of OxyCONTIN, Oxyfast, Roxicodone, and Xtampza It’s used to treat moderate to severe pain, and the extended release version can be used for constant pain treatment. Street names include hillbilly heroin, kicker, Oxy, Percs, and Roxy.
  • Tramadol: Tramadol is a prescription painkiller that some caregivers see as a safer alternative to other painkillers, although it’s becoming increasingly problematic regarding Tramadol, sold under the brand name Ultram, is known by street names of Ultras, chill pills and OxyContin Lite.

What Are Painkillers Used For?

Answering the question of what are painkillers used for can have broad responses. Prescription painkillers classified as “strong” tend to vary significantly in strength even from one another, and the strongest opioids are meant to be prescribed only in instances of severe pain, for example after a car accident.

In some cases, strong prescription painkillers may be prescribed to people with chronic pain for whom other painkillers aren’t working, and they may be given to people with diseases such as cancer.

Painkillers can be taken in liquid or tablet form. They’re more commonly taken as tablets, but many of the strongest painkillers are taken as liquids or syrups. Painkillers may be available as fast-acting tablets or capsules, or slow-release tablets and capsules.

Tablets that are held in the mouth are called buccal tablets, and there are patches that are placed directly on the skin, as well as injections.

How Do Painkillers Work?

There are nerve endings in our bodies that send messages to our brain when an injury occurs. Painkillers work to alter these messages, which can take place in the brain, the spinal cord or the site of the injury. In general, painkillers can be made from either aspirin or opiates, and painkillers derived from opiates work in a way that’s similar to opium.

What is the History of Painkillers?

The history of painkillers started with the use of opium poppy, which has been used medicinally and recreationally for thousands of years. The use of opium as a painkiller began in the 16th century when it was mixed with alcohol. Morphine was first extracted from opium in its pure form at the start of the 19th century, and it was often used to treat soldiers wounded during the U.S. Civil War. This led to many soldiers becoming addicted to morphine.

Codeine is something that’s also found in opium, but it can be synthesized, which first happened in 1830.

Problems related to morphine addiction had already taken hold by the mid-18th century, and by 1905 U.S. lawmakers banned opium. In 1937 Methadone was first synthesized during the quest to find a less addictive painkiller to use during surgery. In 1984 the FDA approved Vicodin, in 1995 OxyContin was approved and Percocet was approved in 1999. All of these drugs are human-made opiates, which are designed to replicate the body’s natural painkillers.

Are Painkillers Addictive?

Painkillers are considered incredibly addictive, and the number of people who abuse and become addicted to these opioids is on the rise. There is also an increasingly apparent link between the abuse of prescription opioids and heroin in the U.S. Prescription opioids are one of the broad categories of drugs that present the possibility of abuse and addiction. The other two types are central nervous system depressants and stimulants.

Some of the contributing factors to the painkiller addiction epidemic include the increasing number of prescriptions being written and dispensed, as well as a growing sense of social acceptability to use these medications. There has also been intense marketing by pharmaceutical companies which is seen as a contributing factor for widespread abuse.

Many people wonder, why are painkillers addictive in addition to wondering just how addictive are painkillers?

Prescription opioids impact the same brain systems as heroin and morphine, and they are most addictive when they’re taken in ways that increase the euphoric effect. This can include crushing and snorting pills or combining pills with other drugs or alcohol. Another risk factor for addiction includes people who are prescribed them, but who don’t take them exactly as they’re prescribed. This could include, for example, taking more pills in one dose than what’s prescribed by a doctor.

Estimates show that more than 100 million people in the U.S. suffer from some sort of chronic pain, which is another reason the use of opioids is so prevalent, so even if a small fraction of this number of people develops a dependency on prescription painkillers, it represents a significant problem.

The potency/addiction potential is incredibly high with prescription opioids. Some of the risk factors that contribute to the addiction potential include a history of dependency, including addiction to tobacco or alcohol, a family history of addiction, or a history of mood, though or personality disorders such as depression, anxiety or borderline personality disorder.

Why Are Painkillers Addictive?

Opioid painkillers create a euphoric high when they’re injected, taken in ways other than what’s directed, or taken in high doses. Opioids have the inherent ability to calm anxiety as well, which is why painkillers can be so addictive.

There is no definitive answer as to how long does it take to get addicted. It varies by person, and some people may take painkillers without ever becoming addicted, while others may become addicted very quickly.

Specific factors that can play a role in whether or not someone becomes addicted to painkillers, as well as how long it would take to develop that addiction include your biological makeup, how sensitive you are to a particular drug, and also the chemical composition of the drug itself.

Signs of Painkiller Addiction

Some of the earliest signs of painkiller addiction or abuse of painkillers can include:

  • Not taking a drug as its prescribed (for example, taking larger doses)
  • Not taking the drug for the reasons it was initially prescribed
  • Missing work, social or family obligations because of the use of the drug.
  • Dishonesty about drug use.

Other behavioral signs of painkiller addiction include:

  • Stealing or selling prescriptions
  • Mood swings
  • Hostility
  • Bad decision-making
  • The appearance of being high, sedated or unusually energetic
  • Always losing prescriptions, requiring they be rewritten
  • Doctor shopping to get prescriptions from multiple doctors

As well as impacting outward behavior, addiction to prescription painkillers can lead to a variety of psychological symptoms. These include anxiety, depression, worsening moods and even psychosis.

Physical symptoms of painkiller abuse and addiction can include:

  • Constipation
  • Euphoria
  • Nausea
  • Slowed breathing rate
  • Drowsiness
  • Confusion
  • Poor coordination
  • Increased pain levels
  • Slurred speech
  • Seizures
  • Flushed skin
  • Pinpoint pupils

In a general sense, addiction to prescription painkillers goes beyond simply craving them. Addiction leads to disruption in the user’s life, and the person has ultimately lost control over the use of the painkillers. It’s used compulsively in spite of the potential for adverse consequences.

It’s important to note the distinction between tolerance and dependence, as well as addiction. With tolerance, people’s bodies become used to a drug, so they experience less of an effect with its use. Even if you aren’t addicted to a drug, you can still build up a tolerance. With dependence, you would experience physical symptoms if you were to stop using the painkiller. You can also develop dependence without being addicted.

If you’re someone who takes prescription painkillers, it’s important that you remain vigilant in looking at your own behavior to ensure there aren’t signs you’re misusing your medication, and the same applies to having loved ones who are prescribed prescription painkillers or who use them.

Painkiller Addiction Statistics

Below are some of the most relevant painkiller addiction statistics and painkiller addiction facts, many of which can be very eye-opening.

  • There were 20.5 million Americans, age 12 and over in 2015 that had a substance use disorder, and of those 2 million had a problem with prescription pain relievers.
  • Every day in the U.S. 2,500 young people between the ages of 12 and 17 abuse a prescription painkiller for the first time.
  • Prescription drug abuse causes the largest percentage of drug overdose deaths.
  • It’s believed that 23% of people who use heroin develop an addiction to opioids.
  • From the period from 1998 to 2088, overdose deaths, sales, and treatment admissions for substance use disorder related to prescription pain relievers increased in parallel with one another.
  • The overdose death rate in 2008 was almost four times the rate in 1999, the sales of prescription pain relievers in 2010 was four times what was seen in 1999, and admission to substance use disorder treatment programs in 2009 was six times the rate in 1999.
  • Four in five new heroin users started by abusing prescription painkillers.
  • 259 million opioid prescriptions were written in 2012.
  • Between 1999 and 2010, 48,000 women died from prescription painkiller overdoses.
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The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.