Pain Medication Addiction: Have You Crossed the Line?

It can start innocuously enough. You throw out your back, and the doctor hands over a prescription for a painkiller. Or maybe you're taking a medication to relieve a chronic headache or an arthritic knee. If you or someone you know has been taking painkillers for awhile, you might wonder about the risks of prescription drug abuse. It's unquestionably a major health issue today.

"Prescription drug abuse has become the number one cause of accidental death," says Jeff Lewis, associate dean of the School of Pharmacy at Cedarville University in Cedarville, Ohio. "More people die from this than from motor vehicle accidents."

And, he adds, drug addiction today is very different from 30 years ago, when the drug in question was typically cocaine or heroine. Today, drugs that are legally prescribed are the problem.

Can you tell if you or someone you know is heading toward abuse, or addiction? Here are some signs.

1. If a patient starts trying to fill a particular prescription early or taking more medicine than was prescribed, this could be a sign of abuse, says Neil Kirschen, MD, who runs the Pain Management Center of Long Island. "If the person is going to multiple providers to get their medication, this is a problem," he adds. 

2. Selling prescription drugs, prescription forgery, stealing or "borrowing" drugs from others, injecting oral formulations, and obtaining prescription drugs from non-medical sources are all "red flags," according to guidelines from the American Society of Addiction Medicine. "If friends or family start noticing these behaviors, it is probably a good idea to consider the question of addiction," says Philip A. Gilly, MD, Chief of Inpatient Services at the Henry Ford Maplegrove Center in West Bloomfield, Michigan.

3. If a patient is taking a medication for a reason outside of why it was prescribed, this is worrisome. "Now you've crossed the line from legitimate use to abuse and there may be the potential for addiction," Lewis says. And, he adds, it's typical to not recognize when you've crossed this line. "In fact, very few people recognize when they have crossed it," he says.

4. Other signs that can point to drug abuse or addiction include drug hoarding during periods of reduced symptoms, requesting specific drugs, multiple episodes of prescription "loss," and aggressive complaining about the need for more of the drug, according to the American Society of Addiction Medicine.

5. It's helpful to know which individuals are more at risk for drug abuse and addiction. These include a family history of prescription drug or alcohol abuse, cigarette smoking, a high level of anxiety or pain intolerance, a history of motor vehicle accidents, and prior legal problems. Those younger than age 45, as well as men, are at a higher risk than women.

If you suspect that you or someone you love has a drug dependence, Gilly recommends contacting the doctor about your concerns, and getting in touch with a pain management specialist to review various treatment options. You may also want to get in touch with an addiction medicine specialist for an assessment, or your local chapter of Narcotics Anonymous or Alcoholics Anonymous.




"Definition of addiction." American Society of Addiction Medicine.