Table of ContentsView AllTable of ContentsHow Addictive Are Pain Relievers?The Opioid CrisisSymptoms of Opioid MisuseMost Addictive PainkillersTreatment
Table of ContentsView All
View All
Table of Contents
How Addictive Are Pain Relievers?
The Opioid Crisis
Symptoms of Opioid Misuse
Most Addictive Painkillers
Treatment
What is the most important information I should know about painkillers?
One of the most common reasons Americans visit their doctors is to get help with pain relief. Pain causes distress and can even be debilitating. Doctors sometimes prescribe opioid pain relievers to their patients who are in pain. While these drugs can provide much-needed relief, they also have the potential for misuse and addiction.
This article discusses why these substances are so addictive, the signs and symptoms of opioid misuse, and the painkillers with the higher potential for addiction.
There are different medications that can ease short-term or chronic pain. Many of these drugs fall into the opioid category. These drugs are also known as narcotic pain relievers and include morphine and codeine, as well as several synthetic modifications of these drugs.
It is important to be cautious when taking medication for pain. In some cases, the treatment can pose more risk than the underlying cause of the pain. While you can’t remove all risk, you are less likely to become addicted to pain-relieving drugs when you take them exactly as prescribed.
Still, many of these medications produce a high that can become addictive for some patients. Some people become psychologically dependent on this feeling of euphoria. There is also the risk of physical dependence on highly addictive pain relievers.
Dependence is most likely to happen if a person takes a higher dose of an addictive pain medication than they were prescribed or if the medication was improperly prescribed.
Pain medication overuse (sometimes called medication or narcotic abuse) is one of the most prevalent forms of drug misuse in the United States.
One of the reasons is that addictive pain medications are sometimes over-prescribed. For example, a person might not need such strong pain relief, or a pain medication might be prescribed for longer than a person needs it.
Prescription opioid addiction has risen substantially over the last few decades. What begins as dependence can lead to seeking pain medications on the black market or using illicit opiates such as heroin.
The current issue of narcotic misuse in the U.S. started in the late 1990s, according to the National Institute on Drug Abuse (NIDA): “Pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates.”
As of 2018, the NIDA estimated that between 8% and 12% of patients in the U.S. who are prescribed opioids develop a use disorder.
Of patients who develop anopioid use disorder, 4% to 6% eventually turn to heroin.The U.S. Centers for Disease Control and Prevention (CDC) reports that, in 2019, an average of 38 people died each day from prescriptionopioid overdoses.
According to the CDC, the first line of defense is reducing the number of addictive pain medications that are prescribed. This initiative involves working with physicians and pharmacies to ensure that they use powerful painkillers only when absolutely necessary.
Treatment for Opioid Addiction
Signs and Symptoms of Opioid Misuse
Unfortunately, the nature of painkillers is that they become less effective over time. This is partly because your body adjusts to the medication and develops a tolerance, which means your body requires higher doses of the drug to get the same effect.
There are certain signs that therapeutic use of opioids has crossed into the territory of addiction.
Verywell / JR Bee
Signs to be aware of include:
If you recognize these behaviors in a loved one or are concerned about your own use of pain medication, it’s important to talk to your healthcare provider.
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These are the top 10 most addictive pain medications currently available, according to the National Institute on Drug Abuse.Most of these drugs are prescribed for the treatment of chronic pain, though some are intended for short-term use.
Note that this is not a complete list. There are other painkillers and prescription medications that can be addictive.
1
Fentanyl
More potent than morphine, fentanyl (which is sold under the brand names Actiq, Duragesic, and Sublimaze) is most often prescribed to treat patients with severe or post-surgical pain.It is also used for patients who have become physically tolerant of opiates.
It has also become common for fentanyl to be used in counterfeit drugs or cut into illicit drugs such as heroin and cocaine. People using those drugs are often unaware that they contain fentanyl,and just a very small amount can lead to severe illness and even death.
If you believe someone has overdosed on fentanyl or another opioid painkiller, call 911 immediately and administer naloxone if it is available. Naloxone is a medication that canreverse an opioid overdoseif administered quickly enough.
2OxyContinOxyContinis a brand name for extended-release oxycodone. It is taken as a tablet and is used as an around-the-clock treatment for patients with moderate to severe pain that is expected to last for an extended period.
2
OxyContinOxyContinis a brand name for extended-release oxycodone. It is taken as a tablet and is used as an around-the-clock treatment for patients with moderate to severe pain that is expected to last for an extended period.
OxyContin
OxyContinis a brand name for extended-release oxycodone. It is taken as a tablet and is used as an around-the-clock treatment for patients with moderate to severe pain that is expected to last for an extended period.
3DemerolDemerol is a brand name for meperidine. This addictive painkiller is often used with anesthesia. Demerol is also used to treat moderate to severe pain (such as that experienced in childbirth).It is available as an oral solution, injectable solution, and oral tablet.
3
DemerolDemerol is a brand name for meperidine. This addictive painkiller is often used with anesthesia. Demerol is also used to treat moderate to severe pain (such as that experienced in childbirth).It is available as an oral solution, injectable solution, and oral tablet.
Demerol
Demerol is a brand name for meperidine. This addictive painkiller is often used with anesthesia. Demerol is also used to treat moderate to severe pain (such as that experienced in childbirth).It is available as an oral solution, injectable solution, and oral tablet.
4
Hydrocodone
5MorphineMorphine is a natural opiate sold under the brand names Duramorph and MS Contin. It is prescribed to treat severe and ongoing pain (such as that related to cancer or cancer treatment).Morphine can be given in several forms, such as an injectable solution, capsule, tablet, and suppository.
5
MorphineMorphine is a natural opiate sold under the brand names Duramorph and MS Contin. It is prescribed to treat severe and ongoing pain (such as that related to cancer or cancer treatment).Morphine can be given in several forms, such as an injectable solution, capsule, tablet, and suppository.
Morphine
Morphine is a natural opiate sold under the brand names Duramorph and MS Contin. It is prescribed to treat severe and ongoing pain (such as that related to cancer or cancer treatment).Morphine can be given in several forms, such as an injectable solution, capsule, tablet, and suppository.
6PercocetPercocet is similar to OxyContin. It contains a combination of acetaminophen (which is sold in the U.S. under the brand name Tylenol) and oxycodone. It is available as a capsule, tablet, and oral solution.
6
PercocetPercocet is similar to OxyContin. It contains a combination of acetaminophen (which is sold in the U.S. under the brand name Tylenol) and oxycodone. It is available as a capsule, tablet, and oral solution.
Percocet
Percocet is similar to OxyContin. It contains a combination of acetaminophen (which is sold in the U.S. under the brand name Tylenol) and oxycodone. It is available as a capsule, tablet, and oral solution.
7CodeineCodeine is a natural opiate and commonly prescribed pain reliever. The effects only last for a few hours, which is why it is often prescribed in formulations with acetaminophen or aspirin, such as Tylenol 3.Codeine can also be found in some prescription cough medicines. Codeine is available as a tablet, capsule, or liquid.
7
CodeineCodeine is a natural opiate and commonly prescribed pain reliever. The effects only last for a few hours, which is why it is often prescribed in formulations with acetaminophen or aspirin, such as Tylenol 3.Codeine can also be found in some prescription cough medicines. Codeine is available as a tablet, capsule, or liquid.
Codeine
Codeine is a natural opiate and commonly prescribed pain reliever. The effects only last for a few hours, which is why it is often prescribed in formulations with acetaminophen or aspirin, such as Tylenol 3.Codeine can also be found in some prescription cough medicines. Codeine is available as a tablet, capsule, or liquid.
8MethadoneMethadone is most often associated with people who are trying tosafely quit heroin. It can also be used as an opiate pain reliever, though it can also be misused for this purpose.Methadone can be taken in tablet or liquid form and is sold under the brand names Dolophine and Methadose.
8
MethadoneMethadone is most often associated with people who are trying tosafely quit heroin. It can also be used as an opiate pain reliever, though it can also be misused for this purpose.Methadone can be taken in tablet or liquid form and is sold under the brand names Dolophine and Methadose.
Methadone
Methadone is most often associated with people who are trying tosafely quit heroin. It can also be used as an opiate pain reliever, though it can also be misused for this purpose.
Methadone can be taken in tablet or liquid form and is sold under the brand names Dolophine and Methadose.
9DilaudidDilaudid is a brand name for hydromorphone. It is intended for short-term pain relief and used mostly in a hospital setting, where it can be administered intravenously (most often following surgery).Dilaudid can also be given as an oral solution, tablet, and suppository.
9
DilaudidDilaudid is a brand name for hydromorphone. It is intended for short-term pain relief and used mostly in a hospital setting, where it can be administered intravenously (most often following surgery).Dilaudid can also be given as an oral solution, tablet, and suppository.
Dilaudid
Dilaudid is a brand name for hydromorphone. It is intended for short-term pain relief and used mostly in a hospital setting, where it can be administered intravenously (most often following surgery).Dilaudid can also be given as an oral solution, tablet, and suppository.
10OxymorphoneOxymorphone is sold under the brand names Opana, Numorphan, and Numorphone. It is prescribed to treat moderate to severe pain.This addictive painkiller comes in both immediate- and extended-release tablets.The pill is blue and has an octagon shape.
10
OxymorphoneOxymorphone is sold under the brand names Opana, Numorphan, and Numorphone. It is prescribed to treat moderate to severe pain.This addictive painkiller comes in both immediate- and extended-release tablets.The pill is blue and has an octagon shape.
Oxymorphone
Oxymorphone is sold under the brand names Opana, Numorphan, and Numorphone. It is prescribed to treat moderate to severe pain.
This addictive painkiller comes in both immediate- and extended-release tablets.The pill is blue and has an octagon shape.
Treatment for Painkiller Addiction
Even when addictive pain medications are prescribed for legitimate reasons, it is important to remain aware of their addictive potential. If you are concerned about any medication that you have been prescribed, talk to your doctor or pharmacist.
If you think you might be addicted to painkillers, treatments are available that can help. The type of treatment that is best depends on the individual, their symptoms, and their needs. In many cases, treatment may involve therapy, medication, or a combination of the two.
Psychotherapy
There are many different types of therapy that can be helpful in the treatment of addiction to painkillers. Some that are often used include:
Medications
Medications may also be prescribed to treat addictions to painkillers. Some of these medications include:
If you or a loved one are struggling with substance misuse or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with substance misuse or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
24 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Drug Abuse.What are prescription opioids? Prescription Opioids DrugFacts.
Manubay JM, Muchow C, Sullivan MA.Prescription drug abuse: Epidemiology, regulatory issues, chronic pain management with narcotic analgesics.Prim Care.2011;38(1):71-90. doi:10.1016/j.pop.2010.11.006
National Institute on Drug Abuse.Opioid overdose crisis.
Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN.Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis.Pain. 2015;156(4):569-576. doi: 10.1097/01.j.pain.0000460357.01998.f1. PMID: 25785523.
Carlson RG, Nahhas RW, Martins SS, Daniulaityte R.Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study.Drug Alcohol Depend. 2016;160:127-34. doi: 10.1016/j.drugalcdep.2015.12.026
Centers for Disease Control and Prevention.Prescription opioid overdose death maps.
Centers for Disease Control and Prevention.Understanding the epidemic.
Centers for Disease Control and Prevention.Improve opioid prescribing.
Cicero TJ, Ellis MS.The prescription opioid epidemic: a review of qualitative studies on the progression from initial use to abuse.Dialogues Clin Neurosci. 2017;19(3):259-269. doi:10.31887/DCNS.2017.19.3/tcicero
National Institute on Drug Abuse.Commonly used drugs charts.
Garimella V, Cellini C.Postoperative pain control.Clin Colon Rectal Surg.2013;26(3):191-6. doi:10.1055/s-0033-1351138
Kuczyńska K, Grzonkowski P, Kacprzak Ł, Zawilska JB.Abuse of fentanyl: An emerging problem to face.Forensic Sci Int.2018;289:207-214. doi:10.1016/j.forsciint.2018.05.042
Centers for Disease Control and Prevention.Lifesaving naloxone.
Aquina CT, Marques-Baptista A, Bridgeman P, Merlin MA.OxyContin abuse and overdose.Postgrad Med. 2009;121(2):163-7. doi:10.3810/pgm.2009.03.1988
Molina DK, Hargrove VM.What is the lethal concentration of hydrocodone?: a comparison of postmortem hydrocodone concentrations in lethal and incidental intoxications.Am J Forensic Med Pathol.2011;32(2):108-11. doi:10.1097/PAF.0b013e3181dd5a75
Balch RJ, Trescot A.Extended-release morphine sulfate in treatment of severe acute and chronic pain.J Pain Res.2010;3:191-200. doi:10.2147/JPR.S6529
Bekhit MH.Profile of extended-release oxycodone/acetaminophen for acute pain.J Pain Res.2015;8:719-28. doi:10.2147/JPR.S73567
Bhandari M, Bhandari A, Bhandari A.Recent updates on codeine.Pharm Methods.2011;2(1):3-8. doi:10.4103/2229-4708.81082
Anderson IB, Kearney TE.Use of methadone.West J Med. 2000;172(1):43-6. doi:10.1136/ewjm.172.1.43
Gulur P, Koury K, Arnstein P, et al.Morphine versus hydromorphone: Does choice of opioid influence outcomes?.Pain Res Treat. 2015;2015:482081. doi:10.1155/2015/482081
Sloan P.Review of oral oxymorphone in the management of pain.Ther Clin Risk Manag.2008;4(4):777-87.
Petry NM.Contingency management: what it is and why psychiatrists should want to use it.Psychiatrist. 2011;35(5):161-163. doi:10.1192/pb.bp.110.031831
Substance Abuse and Mental Health Services Administration.Methadone.
Centers for Disease Control and Prevention.Opioid data analysis and resources.National Institute on Drug Abuse.What classes of prescription drugs are commonly misused?.National Institute on Drug Abuse.Commonly abused drugs.
Centers for Disease Control and Prevention.Opioid data analysis and resources.
National Institute on Drug Abuse.What classes of prescription drugs are commonly misused?.
National Institute on Drug Abuse.Commonly abused drugs.
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