Are you addicted to pain killers?

I have discussed the issues with opioid painkillers before in some of my earlier blogs, and I have also seen the problems they can cause first hand in some of my patients. So in an effort to raise more awareness about the risks and side effects of opioids I am delighted to give you a guest blog from Jason Shiers a Psychotherapist at UK Addiction Treatment.

How do I know if I’m addicted to my pain medication?

In 2017-18, 5.6 million adults in England were prescribed opioid painkillers – 13% of the population (ref). But when do the health risks of opioid medications cancel out the benefits? 

In the short term, opioids can be effective painkillers. They offer patients fast relief from severe or distressing pain. In hospital settings, opioids such as morphine, fentanyl and codeine are used routinely to manage pain associated with accidents, surgery, illness or childbirth.

Experts agree, however, that long-term opioid prescribing for chronic, non-cancer pain is not beneficial for most people. (ref) Over time, opioids become less effective at reducing pain, as the brain adapts and drug tolerance sets in.  

If you’ve been taking opioid painkillers for months or years for back pain, it’s essential to review your usage regularly with your doctor and/or an addiction expert. It isn’t always obvious that opioid addiction has set in, particularly if you also have symptoms from a chronic pain condition.

If you feel mentally or physically unwell or your pain becomes unmanageable again, please don’t assume the answer is more opioids – they may, in fact, be the cause of your worst symptoms.

Signs and symptoms of opioid dependence

1. Recurring or obsessive thoughts about opioids

Opioid addiction usually involves a mental preoccupation with getting and taking more drugs. The way people experience this is unique, however. For example:

  • Do you clock-watch until you can take your next dose of opioids? 
  • Is it often hard to concentrate at work or college?
  • Does the thought of running out of painkillers make you feel agitated or upset? 
  • Do you resent activities that get in the way of using painkillers – such as social events, driving or playing with your kids?  
  • Is it hard to imagine a life without opioids

2. Taking more opioids than your doctor has prescribed

Changing your dose of opioids without consulting your doctor is a sign of dependence. This includes taking more of an existing prescription drug, purchasing opioids online or from a dealer, stockpiling medications and taking over-the-counter codeine with another prescribed painkiller.

Of course, you can still get addicted to opioids if you stick to the prescribed dose – but it’s much more likely that you’ll get timely support if you discuss changes with your prescriber.

3. Your pain is getting worse

Due to changes in the brain, typically the same dose of an opioid drug will become less effective at blocking pain signals over time. If your back pain has returned or it’s getting worse, this can be a sign of opioid tolerance. 

It’s easy to mistake the return of your pain for an escalation in your original condition. Always seek an assessment for dependence, particularly if you’ve been taking more opioids to get the same effect.

4. Cycles of opioid withdrawal 

How do you feel as opioids wear off? What physical or psychological symptoms do you have? If you miss a dose, how do you feel?

Though it can be hard to track and measure symptoms objectively, it’s useful to build awareness of any negative side effects connected with your opioid use. 

It is essential to seek medical help to detox safely from opioids if you have become dependent.

 5. Hiding your opioid use

If you’re covering up your use of opioids, whether that’s from family, friends or co-workers, then it could be a sign of dependence.

This includes playing down the amount of opioids you use, visiting different pharmacies to buy over-the-counter codeine, hiding drugs at home or taking opioids in secret. 

6. Using opioid painkillers continuously for months or years

Opioids are physically and psychologically addictive. With continuous use over months or years, you will probably experience moderate to severe withdrawal symptoms if you stop suddenly without help. 

Often, this keeps people locked into addictive cycles of using more opioids to relieve physical or psychological discomfort. If you’re also dealing with a chronic pain condition, the addiction can also exacerbate your symptoms.

7. Withdrawal from the things you enjoy

Have you lost interest in your work or studies? Do leisure activities that you once enjoyed feel exhausting? Is it hard to sit through a family meal or enjoy a conversation with friends?

If you’re a regular opioid user, then shifts in your usual behaviour patterns may indicate an addiction – particularly if you feel less choice and control about what’s happening in your life. 

The Benefits of a Non-Drug Approach

If you get addicted to opioids, what is the best way to treat your addiction? And how can you manage a chronic pain condition going forward?

If you have a chronic pain condition, the thought of life without opioids may be very frightening. Understandably, you might be concerned about your pain becoming too much again. It’s vital to develop a range of support and skills to address your condition.

Talking therapies, peer support groups, treatments such as mental resilience techniques like mindfulness and meditation, graded exercise programmes (overseen by a professional fitness instructor), physiotherapy and non-addictive painkillers can all be useful alternatives to opioids.

If you need any further information or assistance then please check out the UKAT website here




  1. Perhaps it would be just as, if not more appropriate to substitute substance with behaviour, and pose the same question to physiotherapists as it relates to exercise addiction? Is physiotherapy aware that their love affair with all things physical may blind them to their own complicit enabling of the exercise addict? There seems to be an awful lot about psychosocial health that physio remains mostly ignorant of, much to the disservice of those in need.

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