"Pain medication is ... not really meant to be a way to maintain or manage chronic pain.” -- Joe Schrank, MSW
Chronic pain affects over one third of all Americans and many manage that pain through prescription medication. Some people worry that taking narcotic painkillers will lead to addiction. While these drugs are designed to reduce sensitivity to pain, they also create a sense of euphoria – a feeling that some people may come to crave. If your doctor prescribed medication to treat your pain and you take it as directed, you are less likely to have a problem.
But some people do get addicted, and there are usually warning signs along the way, like these:
1. You think about your medication a lot.
One of the first signs of addiction is becoming preoccupied with two things: when you can take your next dose and whether your supply is enough, says Debra Jay, co-author of Love First: A Family’s Guide to Intervention.
Watching the clock so you can take your next dose may be a concern, notes Joe Schrank, MSW, co-founder of Rebound Brooklyn recovery center in New York.
“If it’s fresh dental work and you’re in pain, it makes sense," he says. But if it’s gone on for a while, it’s possible you’ve become dependent on the medication.
Dependency and addiction are not the same thing. You can be physically dependent on a drug but not addicted.
Confused? Here's the difference. When you're physically dependent on a drug, your body has built up a tolerance to it, and you need higher doses of the medication to get the same effect.
When you're addicted to a drug, it's more than physical, it’s also emotional. The addiction can be associated with uncontrolled behaviors. You keep using the drug, even though it's causing you serious problems at work or school, in your family, or in your social life.
2. You take different amounts than your doctor prescribed.
Maybe you take more than you should or take it more often than your doctor prescribed. If you think your doctor doesn’t understand your level of pain or that he meant you should take it whenever you need to, even if that’s not what he ordered, it may be a warning sign.
Do you stretch out the time between doses or shrink some doses you take so you can take more later? If you're trying to control how you take your painkillers instead of following your doctor's instructions, you may have a problem.
“Whenever we are trying to control things, it can be a really good indication of how out of control we are,” Schrank says.
3. You’re “doctor shopping.”
Do you go to more than one doctor for the same prescription?
Once you stop working with your doctor and try to find someone else who will write you another prescription, something may have shifted.
Your goal may be to boost your supply of painkillers so you have as much as you need. But if it’s not in line with what your doctor ordered, that's reason for concern.
Do you seek out doctors who are known for overprescribing, or “pill mills”? Have you lied and said you lost your prescription or been dishonest to a doctor about what you have already been prescribed?
“If we are telling different doctors different things to get medication, that’s a real red flag,” Schrank says.
4. You get painkillers from other sources.
You feel like you don’t have enough medication to ease your pain, so you try to get more. These ways of stocking up signal the possibility of addiction:
- Ordering drugs over the Internet.
- Stealing other people’s leftover or long-forgotten prescription drugs from their medicine cabinets.
- Stealing drugs from a sick relative or friend.
- Buying other people’s prescription drugs.
- Stealing prescription pads from doctor’s offices and illegally writing your own prescriptions.
- Hurting yourself so you can go to a hospital emergency room and get a new prescription.
- Buying drugs on the street.
5. You’ve been using painkillers for a long time.
You probably started taking pain medication because something hurt. If you’re still using narcotic painkillers long after the pain should have gone away, Schrank says it is time to ask for help.
Maybe you’re taking them because you like the way they make you feel, instead of to relieve pain. Or maybe you’ve started to have physical cravings. Both are signs of an issue.
“Pain medication is intended to bridge a gap or get you through a rough patch,” Schrank says. “It’s not really meant to be a way to maintain or manage chronic pain.”
6. You feel angry if someone talks to you about it.
Have your friends or family tried to talk to you about how you’re using your medication? If you feel defensive or irritated when they approach you, you may be getting in too deep, Schrank says.
In fact, studies show the degree of that anger is not just a sign that you may need treatment, but it can actually be a predictor as to how effective treatment would be.
7. You’re not quite yourself.
Maybe you’re not taking care of yourself like you usually do. You’re less concerned about your personal hygiene or the way you look.
Or you feel moodier than usual. Do you feel angrier? Have your eating habits changed? Do you feel nervous or jittery?
Have you stepped back from your responsibilities? Maybe you haven't been paying your bills like you used to, neglected household chores, or called in sick to work. If you’re ignoring your children, your responsibilities, or life in general, it’s time to ask for help, Jay says.
What to Do
If you recognize yourself or someone you love in any of these signs, even if you're not sure it's addiction, your next step is to ask for help and get more information.
It can be easy to misuse painkillers, even when you try not to. “The key is honesty -- honesty with physicians, trusted friends, addiction professionals, but most of all with ourselves,” Schrank says.
Don't be afraid to talk to your doctor. He can refer you to a treatment center or addiction specialist.
Or you can call a local drug treatment center, which has addiction experts who are trained to recognize the signs and give you the help you may need. Look for a center that’s certified by the state you live in.
You can also call 800-662-HELP (4357), the national helpline run by the U.S. government's Substance Abuse and Mental Health Services Administration. It provides free, confidential information and referrals about substance abuse and mental health.