Pain pill addiction: Top 10 signs and symptoms

Some people, even doctors, confuse prescription drug dependency with addiction. Dr. Burson describes pain pill addiction signs and symptoms here. Plus, 10 questions to ask yourself about pain pill use (and possible addiction) here.

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By definition, addiction is psychological

There’s still much misunderstanding about what it means to have the disease of addiction. Some people, even doctors, still believe that physical dependency to a drug is the same thing as addiction. It’s not. You don’t have to be physically dependent to have addiction. On the other hand, you can have physical dependency without having the disease of addiction. This is because addiction is more about the psychological processes that go on in the mind of the addict. There’s an obsession to think about the drug, worry about running out of it, and a compulsion to take the drug, even if it causes problems.

You might be a pain pill addict if…

Many people taking opioid pain pills prescribed by their doctors wonder if they are addicted. Here are a few questions that anyone who is taking prescription medications that are potentially addictive can ask themselves.

10 signs of pain pill addiction

1. Do I take more medication than prescribed? Do I take early doses, or extra doses?

2. Do I take medication in ways it’s not intended? For example, do I snort it, or chew it for faster onset? Do I inject it?

3. Do I get medication from friends, family, or acquaintances because I run out of my prescription pills early?

4. Do I become intoxicated, or high, from my medication? Without telling my doctor?

5 Do I get prescriptions from more than one doctor, without telling them about each other?

6. Do I look forward to my next dose of medication?

7. Do I get impaired from my medication, to the point I’m unable to function normally?

8. Do I take pain medication to treat bad moods, anxiety, or to get to sleep?

9. Do I spend a great deal of time worrying about running out of medication?

10. Do I spend a great deal of time thinking about my medication, and how it makes me feel?

3 more prescription pain med questions

* Do I drink alcohol with medication, even though the pharmacist advised against this?

* Do I use street drugs like cocaine, marijuana, or others?

* Have I driven when under the influence of pills, when I know I shouldn’t be driving?

How do I know if I’m addicted to pain pills?

One “yes” answer to any of these questions is worrisome, though not necessarily diagnostic of addiction. Addiction is easier to diagnose with multiple “yes” answers. Sometimes addiction only becomes apparent over time. This is why doctors need to see patients frequently who are prescribed potentially addicting medication, like pain pill, stimulant, and benzodiazepines.

I think of addiction as a continuum. Some people taking prescriptions may have a few worrisome symptoms, like taking an extra pill occasionally. Perhaps they did this because of a transient increase in pain. Without any other symptoms, I probably wouldn’t diagnose addiction. At the other end of the spectrum, if a patient is crushing pills to inject or snort, I feel confident making the diagnosis of addiction. The in-between patients need careful, in-depth evaluation to decide if addiction is present.

Struggling with painkiller addiction?

You can give an end to your opioid pain pill abuse and addiction problem, and learn more about what happens when you seek help in this Painkiller Addiction Treatment Program and Help GUIDE…and get rid of opioids once and for all.


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Call 1-877-265-7020.

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About the author
Jana Burson M.D. is board-certified in Internal medicine, and certified by the American Board of Addiction Medicine. After practicing primary care for many years, she became interested in the treatment of addiction. For the last six years, her practice has focused exclusively on Addiction Medicine. She has written a book about prescription pain pill addiction: "Pain Pill Addiction: Prescription for Hope." Also see Dr. Burson's blog here.


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  1. Hi Trey. Thanks for sharing your experience. I’m so glad to hear that you are using Percocet and Exalgo as prescribed. It sounds like they are helping you a lot. One thing I might mention is to see if you might try other pain management techniques as you age. There may be other medications or therapies on the market that might be able to help you. I have had 4 surgeries on my knees as well (high school b-ball, ACL reconstruction both sides) and have found that a diet with lots of fruits, vegs, and low starch helps my arthritis. Also, practicing yoga helps keep me strong and my joints lubricated. Just some ideas….hope it helps!

  2. I played division1 college football for university of Wisconsin, I tore up my knee pretty bad after having numerous surgeries to finally get it fixed, I still have sever chronic pain. Mainly because I was a OT and naturally big. My knee pain never goes away. But I suck it up and made it on the as a federal game warden with the US fisheries and wildlife service After I graduated. I was also attacked by a wild boar 3 Years ago, I got tusked real bad in my back by a 10 inch tusk. Even though I’m a federal agent and game warden. I’ve been on narcotic pain medications since college. Percocet and Exalgo So about 6 years now and I take them like I’m supposed to, never to early, never to late. I get a months worth in the mail every month and see the Dr. every 5 months. Since I’ve been taking them for so long I’ve become very much immune to the side effects, from when I first started taking them. Now all they do is kill the pain, and I’m good to work, drive, shoot my gun, and make arrests. Even go to the gym, and I only use them when I’m in an extreme amount of pain. I went from taking 6 Percocet a day to 3 a day, and one exalgo. I wish I didn’t have to take them at all but when your 6’10” and 359lbs with 3% body fat, it takes a tole on my knee, and back from doing day to day activities.

  3. Hi Lisa.

    It sounds like you know that something is really wrong and are concerned about your daughter. The vomiting could be brought on by withdrawal from pain medications…but you cannot really conjecture. I’d suggest that you check out Al-Anon…which is for loved ones of people who may have possible addictions. Or talk with a social worker / psychologist in your area and get some advice. It sounds like you need to talk it out with a professional in order to know what the options are and what you can do to help your daughter and grandson.

  4. My daughter have been DX with Fiber Myalgia. She have been on pain pills for two years. Several time now I have seen her and her pupilsare like pin wgole she always conplains of sweaty.At time she vomets for she saids no reason. I know she some time drinks even thow she is on many med percocet zanex an anti depressant. I,m not sure what else. I know some thing is very wrong and I just do not know what to do with it. plea can you help me,she have a little boy thats two years old . How can I help them! I just do not know what to do!

  5. I don’t understand why doctors are so reluctant to prescribe pain medication and benzo’s. If someone is in pain that is real. I hate when i go to the doctor ( I have chronic pain) and they try prescribe non narcotic medication as a first line of treatment or throw anti-depressants in your face. Sometimes I get such severe pain in my knee and hip that no over the counter in a high dosage can take it away. I want to to take pain medication so i can start working out again and livinging normally. I feel that if I can take a pain medication I do my exercising and strengthen my muscles and take vitamins and then eventually I won’t need them. I can’t exercise when I am in pain, sometimes my pain is so bad I can’t get out of bed. Doctors treat as what they refer to a drug seeker when i tell them I would like a pain medication. It’s the only thing that works. I have tried everything and all the new medications out to treat certain chronic pain have really bad side effects. Morphine, Hydrocodone, and Oxy are very safe medications if you use them right. You won’t loose your hair or have a stroke if you take Hydrocodone. But if you take Meloxicam, tramadol, or Imitrex and you smoke or eat acidic foods you are at high risk for stroke and ulcers. They gave me imitrex for my headaches and I felt like my heart was going to jump out of my chest and my heart was running a million miles per hour. I just don’t understand what the big deal is. My sisters life has taken a hellish turn because the doctors won’t give her pain medication for her back problem so she seeks it through the streets. She needs help. And the doctors don’t believe her. She fell 500ft when she was 16 years old and hit the ground and the doctor won’t help her. There is so much stigma attached to these drugs, give the people their medication. Their better off under the care of Doctor than a Pimp.

  6. Thank you for that article Dr. Burson. I have RA, and just had my second knee replacement, my 13th operation in 52 years of life. I also have a brother with chronic severe pain and he may have Lupus. My sister has diagnosed him (she is a school counselor and recovering addict 21 years) as addicted to pain medicine. Your article articulated what I have been trying to tell her and my mother. Pain meds have gotten such a bad rap because of the drug problems and abuse in this country. However, I know how important they are to people like me and my brother. He sees a pain doctor once or twice a month, and is under the care or several doctors trying to figure out what is wrong with him. I always worry when I have to take pain meds but are thankful they are there. Just because you have to take them on a daily basis sometimes it is the only way to have any quality of life. I could say so much more, I wish we could chat. But thank you for the information.

    Sincerely, Sheryl Biermann

  7. Can you experience euphoria if you take pain medications as required….but over a longer time period? For example, percocets daily in the AM and PM for 35+ years? Would this type of use affect mood or mental health?

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