Pain Pill Addiction Signs

How Can I Tell if a Friend or Family Member Is Abusing Pain Pills?

People who are misusing prescription pain pills often hide their misuse from family and friends. . Asking them direct questions may not get a straight answer. MATClinics gets lots of calls from people looking for pain clinics but calling us mistakenly. We have had conversations with mothers and other family members who are trying to find a pain clinic for their loved ones who, after a short discussion, reveal that they have been finding one pain clinic after another to help their family members find new prescriptions. Even when the signs are clear, family members can convince themselves there is no problem.

Opioid-based pain pills are incredibly effective at relieving pain and even inducing a feeling of euphoria. Take them for too long, however, and one can become physically dependent. People like how the medications make them feel, take more, and one day find that if they stop taking them, they start to experience withdrawal symptoms.  So how can you tell if a family member is misusing pain pills? Let’s be familiar with what these pills are first.

Names of Popular Prescription Pain Pills

These are the names of some popular prescription pain pills that contain opioids (not an exhaustive list):

  • Vicodin and Lortab (hydrocodone + acetaminophen)
  • OxyContin, Percocet, Endocet, Roxicet (oxycodone)
  • Morphine
  • Fioricet with Codeine, Tylenol 3, Cotabflu (Codeine)
  • Darvon (propoxyphene)
  • Dilaudid (hydromorphone)
  • Demerol (meperidine)

The United States consumes over 80% of all prescription opioids in the world, despite being only 5% of the world's population. Doctors and other prescribers are still flooding our medicine cabinets with pain pills. So how can you tell if someone you love starts to misuse pain pills?

Initial Signs of Pain Pill Addiction

Some of the signs of pain pill addiction include:

  1. Early in their use, the medications can make people itchy and even nauseated when taken more than prescribed.  They might even throw up as the medications start to take effect.
  2. Taking a dose above what is prescribed can cause people to "nod out," looking tired and drowsy. They often don't recognize that they are becoming sedated  and continue to try to talk.  People can also start to show signs of apathy or depression.
  3. In an attempt to get the medications to behave more powerfully, they might try to snort or inject the medications. Paraphernalia could include straws or rolled dollar bills to snort crushed pills, pipes to smoke it, and syringes for injection.

Physical Dependence on Pain Pills


Long-term opiate use causes an increase in the number of opioid receptors in the brain (technically known as "upregulation"). The more opiates one uses, the more receptors one develops and the higher the dose of opioids is needed to occupy those receptors. This is called tolerance. Dependence is a vicious cycle of use and tolerance building.

Long-term use creates an overabundance of these receptors that, without opiate replacement therapy, makes abstinence very difficult. The receptors are numerous and screaming for both endogenous (natural) and chemical opioids.  At that point, people are described as "physically dependent" on opioids. The physical dependence on opioid-based pain pills will drive them to more and more compulsive behavior. They will have strong cravings and will do what it takes to avoid withdrawal.

Behavioral Changes From Pain Pill Addiction

The behaviors that people adopt to satisfy their physical dependence are called addiction.  We define addiction as behaviors that people engage in to satisfy their cravings despite doing harm to themselves or others. This is an important distinction. Physical dependence is what it sounds like; it's a change in the brain that drives the demand for more opioids. Addiction is the resulting destructive behaviors.

Once people are addicted, they may start to see these lifestyle and behavioral changes.

  • They might start to isolate themselves from old friends and activities that used to be important in their lives. They might start to hang out with a new and unfamiliar group.
  • They could stop being successful in their work or school.
  • They might start to get in trouble with law enforcement.
  • Their social interactions with friends and family could start to fray, showing strange outbursts of anger.
  • They are likely to allow grooming and physical appearance to deteriorate.
  • Mental disorders, like depression, that might have been under control, may start to show themselves again. Your family member or loved one might show less interest in addressing their mental and emotional challenges than they did before.
  • There will be changes in their financial situation.
  • Less money - They used to have money to spend on life's general needs. Now, despite their isolation, they never have enough money.
  • More money - If they are selling drugs, they might start to buy expensive items that they could not previously afford.
  • Loans - Are they asking for loans that go to fund unseen acquisitions?
  • Stealing - Are items missing from friends' and families' homes?

From Pain Pills to Heroin

It's estimated that more than 70% of people who develop an addiction to pain pills eventually move on to heroin. Heroin is much less expensive and is very easy to get. Not all users of heroin will inject it, and many rationalize that they do not have an addiction by restricting their use to snorting or smoking. If your family member or loved one does begin to inject, you might see these signs:

  • They start to wear long-sleeved clothing to cover up injection marks (also called “track marks”), or
  • They leave intravenous paraphernalia around.

When pills or heroin are not available, people go into withdrawal, and the physical signs of pain pill addiction become more noticeable. What does withdrawal look like? It looks like the flu. If you are seeing your family member consistently showing signs of the flu, which miraculously cures itself but then comes back quickly, you might want to take a closer look.

Pain Pill Addiction Risks

While there is no way to tell if a person will become addicted to pain pills, it often starts with the need to use pain medications for something other than what the doctor prescribed for them. The risk factors that can lead a person to misuse pain pills include:

  • Wanting to reduce stress and feel more relaxed
  • Increasing alertness and mental focus
  • Wanting to experience being "high"
  • Improving performance and productivity
  • Peer pressure
  • Being curious about feeling different mental states

According to the Mayo Clinic, certain lifestyle and gene factors can also predispose a person to addiction, including:

  • Heavy alcohol and tobacco use
  • Poverty and unemployment
  • Thrill-seeking or risk-taking behavior
  • Family history of addiction
  • History of legal problems or criminal activity
  • Problems with family and friends
  • History of mental health problems

Preventing Pain Pill Addiction

The most important step in preventing pain pill addiction is acknowledging that nobody is safe from it. Although certain factors may increase the likelihood of a person misusing pain pills and other prescription drugs, there are no clear and proven linkages. In some cases, pain pill addiction can happen just because the person has easy access to the drugs, such as a person working in healthcare or living with somebody who uses pain pills as treatment, and has a desire to use the medications for reasons other than pain.

If you have been prescribed pain pills, you can prevent yourself from falling into the path of dependency by taking them under the supervision of a medical professional, as well as seeking other ways to manage your symptoms, such as exercise, meditation, behavioral therapy, group activities, and other alternative strategies. Seek a pain treatment plan that can help you manage the discomforts without relying solely on pills.

MATClinics Can Help

If you suspect a loved one or family member is addicted to prescription pain pills, you need to think about how to help them deal with their addiction. Remember that as a result of a prescription pain pill addiction, your loved one or family member's brain has undergone physical changes. Finding a solution will require their buy-in and work.

For a long time, people thought that addictive behaviors could be controlled by a strong mind. If only people tried hard, went to meetings, and stopped using, they would "recover." What science has found is that it’s definitely not that simple for the vast majority of users. It’s confounding that some people can quit cold-turkey, but the evidence is clear that they are few in number. More than 9 out of 10 people who try an abstinence-only opioid rehab treatment regimen relapse within a month.  

Please reach out to us at MATClinics if you suspect your loved one or family member is addicted to prescription pain pills. Medication-Assisted Treatment is the most effective method to help people dependent on opioids get their lives back in order.

Speak to a member of our team to schedule a New Patient visit, or just to get more information.

Thank you for your inquiry, we will reach out to you soon. If you don’t want to wait, please call or text us at 410.220.0720.
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