Woman holding prescription pain medicine

When Does Prescription Pain Medicine Become a Problem?

Just this morning, my husband said, “My knee hurts. Must have slept on it funny.” 


I chimed in, “Yeah? I did something to my shoulder. It’s been giving me trouble for days.” 


And here we are, folks. 


Our bodies—these glorious things that once rolled around on the ground with friends, powered through all-nighters and took us on grand adventures—are failing. That’s how it feels anyway. 


But pain is just part and parcel of the aging experience. 


Pain affects younger folks too. After injuries or surgeries. To tame headaches and migraines. Even for active guys and gals—like a good friend of ours, out there running and winning marathons with pain medication by his side. 


After all, pain medication allows us to power through. To be young at heart. To keep on adulting. To reach our goals and then some. Until they don’t. 


And that’s what we’re going to talk about today: the line where pain medication moves from helpful to harmful. We’ll discuss what it looks like to cross that line and how we might steer clear of it in the first place. 


How The Average Person Ends Up Taking Pain Medication

For the purposes of our discussion, let’s talk about a made-up gal named Susan. 


Susan played tennis growing up. It started as a hobby—a fun way to spend a Saturday morning with her mom and later with her friends. And she was good too. By the time Susan entered her senior year of high school, she had her pick of colleges offering scholarships. 


The tennis team paid for her bachelor’s degree—thank you very much. And Susan returned her racket to hobby status as she began her career and found footing as an adult. But the years of intense practice left their mark. 


Two decades later, Susan entered her primary care doctor’s office as a successful businesswoman and busy mom with nagging elbow pain. An hour later, she walked out with a prescription for Vicodin and a new lease on life! 


Susan rejoined her friends on the court, chased her kids on the playground and sat through meetings without a passing thought for her elbow. 


What a gift, right? And it is. Modern medicine allows us so many benefits, just like those that Susan and many others enjoy. 


Exactly how many others? In 2017 alone, American doctors wrote more than 191 million prescriptions for opioid pain medication. To put this in perspective: in that same year, the U.S. population equaled 325 million. So we’re talking about health care providers offering more than one prescription for every two people. 


And nearly half of these prescriptions came from primary care doctors—not specialists! No wonder folks like Susan have such easy access to opioids. 


And it’s also no wonder people with no prior history of substance misuse find themselves in a tricky situation when it comes to opioid addiction. 


What Happens to Your Body When You’re on Prolonged Medication

Let’s check back in with Susan. 


Her prescription comes to an end, and the pain ramps up again. She sees a specialist who recommends surgery and prescribes more Vicodin to hold her over until they can fix the problem. This time, though, the prescription doesn’t seem to be enough. 


Susan’s body has developed a tolerance to the prescription, which means the same dosage as before doesn’t quite provide the same relief. She might feel as though she needs a higher dosage in order to keep her pain at bay. 


Susan’s doctor doesn’t think this is a good idea, but no worries! A friend from her tennis team has leftover OxyContin from  recent surgery and doesn’t mind sharing to help Susan out. 


Susan is now misusing her pain medication. And she’s not alone. In 2017, more than 11 million people took prescription opioids outside of a doctor’s direction. 


And depending on the person, opioid use and misuse may lead to dependence or addiction. 


The difference between dependence on pain medication and an addiction to it: 

Though these two states—dependence and addiction—can go hand-in-hand with one another, they don’t always. A person can be dependent on opioids without also being addicted. So it’s important to understand the main distinctions between the two. 


Addiction includes compulsive drug use regardless of negative outcomes. 


Dependence happens when the body begins to rely on the drug in such a way that a person will experience physical and mental symptoms of withdrawal when they stop taking the drug.


These problems can occur separately, together or one may lead to another. 


For Susan, the progression looks something like this: 

She continues to supplement her one prescription with additional pills from friends. After some time passes, she has surgery on her elbow and receives a third prescription to help her through recovery. 


One week later—her elbow problem effectively solved—Susan takes her last Vicodin pill and throws the bottle in the trash. It isn’t long before her heart begins to race, her breathing speeds up and her body is covered in sweat. 


Scared, she reaches out to her friend group for help, and they deliver—one little bottle of pills at a time. Susan has moved from tolerance to dependence and, within a few months, she crosses the threshold into addiction. 


This respected businesswoman, mom and community member finds herself searching in increasingly dangerous places to tamp down the pain that threatens to overtake at every moment. As she does, she wonders, “How on earth did I get here?”


With emergency departments treating roughly 1,000 people every day for misusing opioid addictions, Susan’s “here” is a scary place.


Thankfully, she’s about to recognize a few red flags in her life and reach out for real help—the kind that comes with compassionate understanding and a call to action. 


How to Recognize a Pain Medication Problem in Yourself or Others

When a person is in genuine pain, it might be hard for them—or their loved ones—to know when pain medication crosses the line from helpful to harmful. 


VeryWell Mind offers a list of behaviors that act as red flags for addiction: 


  • Taking opioids on a schedule different than prescribed
  • Doubling up on doses
  • A person who consistently loses their pills
  • Suspicions of stealing others’ pills
  • A person who makes appointments with multiple doctors for the same problem
  • Taking opioids for something other than pain relief
  • Refusal to try alternative methods of pain management
  • A person who spends more and more time alone


If you recognize any of these signs in yourself or a loved one—or if you notice a growing physical dependence or tolerance—reach out to a professional treatment center for help. 


That’s just what Susan did. She found herself hiding from her husband and kids, sneaking pills when they weren’t looking, and even taking opioids to numb the other adverse effects of life now that her elbow had healed. 


One day, she came across a list much like this one and finally answered the question, “How did I get here?” with a new question, “Who cares? I just know I want out.” 


Professional treatment centers like The Right Step Houston understand what opioids do to the unsuspecting brain and body. Our 24-hour medical staff can assist you through the early withdrawal days. And our trained counselors will walk with you as you work to reach and maintain sobriety. 


How to Avoid Pain Medication Problems in the First Place

Ask Susan or any other person who’s struggled to overcome opioid addiction, and they’ll likely suggest you find ways to prevent an opioid problem before it starts. 


You can start by having a frank conversation with your doctor. Say, “I’m well aware of the risks of opioid use and misuse, even in people with no history of addiction. Can you tell me your ideas for managing my pain without prescription pain medication? If you feel like opioids are necessary, how can we work to limit my dosage amount to the absolute minimum?” 


If you receive pushback of any kind—or get a too-casual vibe about the nature of opioids—consider a second opinion. Advocating for yourself now may save you a world of trouble in the future. 


In the meantime, consider this list of alternative pain management strategies from Harvard Health Publishing: 


  • Ice and heat packs
  • Regular exercise
  • Weight loss
  • Physical therapy
  • Occupational therapy
  • Transcutaneous electrical nerve stimulation
  • Iontophoresis
  • Ultrasound
  • Cold laser therapy
  • Meditation or mindfulness
  • Yoga
  • Biofeedback
  • Massage therapy
  • Chiropractic
  • Acupuncture
  • Psychotherapy
  • Pain-relieving devices such as splints, braces, canes, crutches and more
  • Topical pain relief
  • Over-the-counter pain medications
  • Corticosteroid injections


Research your options and apply whatever methods you can to try and temper your pain without opioids. And if you can’t? Proceed with caution, keeping an open dialogue with your doctor and loved ones. 


Yes, we’re all getting older. And we’ll experience pain for one reason or another. But now we’re informed too. And we can power through—going after our goals and then some—without worry. 


It might feel scary to recognize dependent or addictive behavior in yourself or a loved one, but The Right Step Houston can help you figure out your next steps. Give us a call at 844.768.0169


By Stephanie Thomas

Contributing Writer with Promises Behavioral Health

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