How to Stop Using Painkillers
Prescriptions for opioid painkillers increased from around 76 million in 1991 to almost 207 million in 2013. This increase in availability has been accompanied by a spike in the prevalence of opioid dependence, rising numbers of emergency room visits, and more deaths due to overdose.2
Quitting opioid painkillers is incredibly challenging. If you or a loved one is attempting to quit using painkillers, read on to learn more
Benefits of Quitting Painkillers
Many people begin using prescription painkillers for chronic or moderate to severe pain. Over time, however, they may become dependent due to the feelings of euphoria and wellbeing produced by the drugs.
While painkillers can be highly therapeutic for those suffering from pain, they come with many physical side effects as well as psychological and social problems when tolerance and addiction develops.
The benefits of confronting a painkiller addiction include:
- Better physical health: Some of the physical side effects that may be avoided by discontinuing use of opioid painkillers include unhealthy weight loss, risk of brain damage due to respiratory depression and a resultant lack of oxygen to the brain, decreased libido, fertility problems, opioid-induced hyperalgesia (increased sensitivity to pain), weakened immune system, and gastrointestinal problems. 2,3,4, 13
- Eliminated risk of overdose: According to the Centers for Disease Control and Prevention, the United States is in the middle of an opioid overdose epidemic. More than 28,000 people died due to opioids in 2014. More than half of those deaths involved a prescription painkiller. 12
- Reconnection with other people: Substance use disorders cause people to isolate and spend less time with family and friends. Even when people addicted to painkillers are around others, they may not be fully present due to the effects of the drug. Getting help for an addiction offers the chance to repair damaged relationships and once again spend quality time with loved ones.
- Improved mental health: Painkiller addiction can lead to mood swings due to the effects of the drug or the withdrawal symptoms. Over time, users can develop depression and anxiety disorders. Giving up painkillers provides the opportunity to address these problems and feel genuine emotions again.
- Enhanced overall functioning :Many people who abuse prescription painkillers miss work, school, or other professional or personal duties. They have may poor hygiene, undergo personality changes, go into debt, and suffer from impaired mental functioning. 5 Quitting painkillers allows the user to regain control over his or her life.
Painkillers Addiction Treatment Center and Recovery Program Options
Quitting painkillers without professional help is extremely difficult and could have life-threatening outcomes due to the risk of overdose after a relapse. People trying to quit may benefit from entering a substance abuse treatment program to maximize the chances of making a full, long-term recovery.
Types of Treatment
There are many different forms of treatment and recovery program options for addiction to opioid painkillers. These include: 6,7,8,9,10
- Medically supervised detox: The first step to recovery is detox. Medically supervised detox is advised for painkiller addiction due to intense withdrawal symptoms and risk of relapse. Medication assistance is a common method of detox using partial or full opioid agonists as a means of controlling withdrawal symptoms and discouraging relapse. Medications used in detox and long-term maintenance include methadone, naltrexone, and buprenorphine. Depending on the severity of your addiction, you may need to be monitored in a 24/7 facility. Or you may slowly taper off your maintenance medication under the care of a physician on an outpatient basis.
- Individual counseling or group counseling: Medication assistance is more effective when combined with behavioral treatment such as individual and group counseling or therapy. Individual counseling and therapy can help users address the psychological aspect of their addiction and develop skills that they can use to cope with stressors and triggers and prevent relapse. Group therapy provides users with the support of peers and may be more effective than individual therapy alone. Family therapy may also be used to help families cope with the negative impacts of addiction as well as help the user maintain sobriety through awareness and support.
- 12-step programs: Twelve-step programs are support groups that offer a step-by-step process toward recovery and sobriety with the support of other people who are going through a similar struggle. Many 12-step programs promote abstinence. However, some groups such as Methadone Anonymous de-stigmatize the use of methadone and other maintenance medications on the road to sobriety.
- Inpatient treatment: Inpatient treatment may offer a combination of medically supervised detox, medication-assisted maintenance treatment, individual and group counseling/therapy, 12-step programs, support groups, and other alternative treatments in a residential setting on a 24/7 basis for a specific time period. The average program lasts approximately 28 to 30 days. Some programs last 60 days or 90 days. In severe cases, programs can last a year or longer.
- Outpatient treatment: Outpatient treatment typically offers a similar range of services and treatment approaches as residential or inpatient programs. However, outpatient care takes place on a part-time basis and participants reside at home rather than at the facility. This is ideal in cases of less severe addictions and/or when the user wants to remain active in his personal and professional life outside of the rehab environment.
Recovering from addiction to prescription painkillers is an ongoing process that can last a lifetime. In order to maintain sobriety and prevent relapse, aftercare programs are put in place to help recovering users learn to cope with stressors and remain sober outside of the rehab environment.
Some common forms of aftercare treatment include:
- Relapse prevention: Relapse prevention is the main goal of aftercare treatment. Recovering users learn strategies and techniques to help them cope with stressors that may trigger a relapse. Relapse prevention skills can be taught in a number of environments, such as outpatient programs, 12-step meetings, and individual and group therapy sessions.
- Sober living communities: Sober living communities are residential facilities where painkiller users can continue the recovery process by living in a safe and supportive environment free of drugs and alcohol. Services often provided at these communities include job placement, recovery coaching, social activities, support groups, and relapse prevention.
- 12-step programs: Many users continue to attend 12-step meetings after treatment. These meetings take place on a daily or weekly basis. Twelve-step groups will often provide sponsors the user can call for support if he or she feels at risk of relapse.
- Outpatient visits: Outpatient visits with a physician or psychiatrist are an important part of maintaining sobriety and monitoring ongoing mental and physical health.
- Counseling and therapy: Many recovering users may choose to continue counseling and therapy long after completing treatment. Continued therapy can help users address any underlying mental health conditions or traumas as well as help provide support and strategies for coping with stress and relapse triggers.
Painkiller Withdrawal Symptoms and Side Effects
Prescription painkiller withdrawal has many uncomfortable and painful symptoms. These symptoms typically aren’t life-threatening, but the risk of relapse is high because the experience is so unpleasant.
Symptoms will usually begin approximately 12 hours after the last dose in those who are physically dependent. 1 Withdrawal symptoms can persist for several days and even weeks depending on the severity and duration of addiction as well as the person’s individual physiological responses.
Symptoms of withdrawal from opioid painkillers include: 1,2
- Severe negative mood.
- Drug cravings.
- Muscle aches and pains.
- Cold chills/goose bumps.
- Increased tearing/watery eyes.
- Dilated pupils.
- Runny nose.
- Nausea and vomiting.
- Abdominal cramps.
As mentioned above, medically supervised detox is recommended for those recovering from an addiction to opioid painkillers. Several medications can be used during the detox phase to eliminate withdrawal symptoms, reduce cravings, and prevent relapse through long-term maintenance. These include naltrexone, methadone, and buprenorphine. Medically supervised detox may take place in a residential inpatient setting, a hospital setting, or on an outpatient basis if the dosage is slowly tapered over time rather than rapidly. 2,8
Tips for Quitting
- Address the reasons you started using: Many people become addicted to painkillers when using them for the treatment of chronic pain. Seek out other forms of pain management and address any underlying mental health conditions that may be contributing to your use, such as anxiety or depression.
- Learn to cope with triggers and stress without painkillers: Many people who become addicted to painkillers use drugs to cope with daily stress. To avoid relapse, recovering users should learn healthy means of coping with stress without taking drugs. These may include deep breathing, relaxation techniques, meditation, talking with a loved one, going for a walk, or taking a hot bath.
- Seek professional help: Quitting painkillers can be incredibly difficult to do alone due to uncomfortable withdrawal symptoms and a high potential for relapse. To maximize your chances of long-term recovery, seek professional help and consider attending an inpatient rehab facility.
- Reach out to friends and family: Quitting prescription painkillers may be the hardest thing you ever do in your life. Don’t hesitate to reach out to your loved ones for support when you need it.
- Attend support groups and 12-step programs: Support groups are an excellent way to maintain sobriety through a step-by-step process under the support of peers who can relate to your situation. Attending support groups on a weekly basis can help maintain sobriety and prevent relapse in the long term.
- Avoid triggers and learn to cope when you can’t avoid them: Certain people, places, situations, and experiences will trigger you to want to use. Try to avoid these triggers if at all possible. For triggers you can’t avoid, have a plan of action for how you can cope in a healthy way.
- Engage in a hobby:Hobbies can help keep us busy and add meaning to our lives. Engaging in a hobby that doesn’t involve drug use can help increase your self-esteem, improve overall happiness and wellbeing, and reduce the risk of relapse. Some hobbies you might try include cooking, writing, reading, painting, sports, woodwork, fishing, camping, hiking, or biking.
- Practice healthy habits: Healthy habits such as proper nutrition, exercise, and getting enough rest can help reduce the physical and psychological effects of withdrawal and help prevent relapse.
How to Help an Addict Quit
It can be hard to watch someone go through a prescription painkiller addiction. They may be causing serious harm to themselves or even to you.
If you’re ready to speak to someone about his or her painkiller abuse, here are some suggestions for how to approach them as well as some things to avoid. 11
Things You Can Try
- Get educated on addiction to prescription opioid painkillers.
- Express your concerns about their addiction and point out any behaviors that have personally impacted you or other loved ones.
- Encourage the person to seek professional help as soon as possible rather than trying to quit alone.
- Recommend that the person taper off painkillers slowly or use an alternative medication as a means of detoxing.
- Approach the person alone first rather than in a group. This will make him or her feel less vulnerable and more likely to respond positively to your suggestions.
- Be supportive, compassionate, and loving in your approach.
What to Avoid
- Do not approach the person from a place of anger, judgment, guilt, or blame.
- Do not lecture, preach, or make bribes, threats, or ultimatums.
- Avoid enabling behavior that allows the person to continue with his or her destructive behavior. Stop making excuses for the person or taking over personal responsibilities they may have neglected due to his or her addiction.
- Seek the help of an intervention professional if the person refuses treatment.
- Stay involved in the recovery process and offer continuous support before, during, and after treatment.
Can I Quit Cold Turkey? Is It Dangerous?
Quitting cold turkey can lead to cravings and relapse.
While it may be possible to quit cold turkey, it is not recommended. Quitting suddenly can cause withdrawal symptoms, which can lead to cravings and relapse.
Withdrawal symptoms will be far less severe if you taper off painkillers slowly or use an alternative medication such as methadone or buprenorphine.
Those seeking to quit should talk to their doctor about their medication or tapering options or consider attending a medically supervised detox program at a recovery center. 1,2,8
Find a Rehab Center
If you or a loved one is struggling to quit prescription opioid painkillers, recovery is possible. Professional therapy and support can help you achieve and maintain sobriety in the long-term.
. Heller, J. (2013). Opiate Withdrawal. U.S. National Library of Medicine.
. Volkow, N.D. (2014). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. National Institute on Drug Abuse.
. National Institute on Drug Abuse: Easy to Read Drug Facts. Signs of Pain Medicine Abuse and Addiction.
. National Institute on Drug Abuse. (2014). What are the possible consequences of opioid use and abuse?
. Berger, F. (2014). Substance Use Disorder. U.S. National Library of Medicine.
. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide: Behavioral Therapies.
. Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Treatment for Substance Use Disorders.
. Stotts, A., Dodrill, C., and Kosten, T. (2009). Opioid Dependence Treatment: Options in Pharmacotherapy. Expert Opinion Pharmacotherapy 10(11):1727-1740.
. National Institute on Drug Abuse. (2012). Opioid Addiction: Methadone.
. McGonagle, D. (1994). Methadone anonymous: a 12-step program. Reducing the stigma of methadone use. Journal of Psychosocial Nursing and Mental Health Services 32(10):5-12.
. National Council on Alcoholism and Drug Dependence Inc. (2015). Helping a Family Member or Friend.
. Centers for Disease Control and Prevention. (2016). Injury Prevention and Control: Opioid Overdose.
. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition. Washington, DC.