Drug Facts: Pain Killers (Prescription)

What is a prescription pain killer?

A prescription pain killer (typically an opioid pain killer) is designed to alleviate pain, though the specific substance prescribed is often related to the level of pain (morphine, for example, is typically used for more severe pain than codeine).  Opioid pain killers are among the three most commonly abused prescription substances  and include morphine, codeine, oxycodone (Oxycontin™), propoxyphene (Darvon™), hydrocodone (Vicodin™), and other preparations. 

How, why, and how often are prescription pain killers abused?

If an opioid pain killer is used in a managed medical situation, the chance of becoming addicted is fairly low.  However, long-term use can cause physical dependence and increased tolerance to the substance (as distinct from addiction).   Abuse of prescription pain killers is prevalent among several different populations.  The National Survey on Drug Use and Health (NSDUH), one of the more prominent national tools for measuring drug use and abuse finds that 3.2% of adolescents reported having abused prescription (not OTC) painkillers within the last month in 2002.   College-aged students also abuse prescription pain killers, with some respondents to one survey noting that their motivation for abuse is either recreational (for intoxication) or self-medication for pain. 

Among undergraduate college-aged students, there are several channels through which individuals obtain prescription pain killers for the purpose of abuse, but the two most prominent categories are peers and family.  Several different studies note that undergraduates who are abusing prescription pain killers commonly obtain them from other undergraduates.     The second most prominent source of opioid pain killers (for abusers) is other family members,  and, interestingly, African-Americans who abuse prescription pain killers are significantly more likely to have obtained the substance from family members than members of any other ethnicity (p<.001). 


What problems can arise from prescription pain killer abuse?

Opioid painkillers “can affect regions of the brain that mediate pleasure, resulting in initial euphoria.”  This is suspected to be a significant component of recreational use.  However, they can also produce drowsiness, constipation, and depressed breathing.  A large single dose can be lethal or cause severe respiratory depression.  Withdrawal symptoms can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, and other effects. 

Opioid pain killers should not be taken in conjunction with a number of different substances, including alcohol, antihistamines, barbiturates, and benzodiazepines. 

What else should I know about prescription pain killers?

Addiction to prescription pain killers is treatable, and there are a variety of means available to do so, each with its own up-sides and down-sides.   Recent studies suggest that abuse of prescription drugs is perceived by youths to be “responsible” “controlled” or “safe” as compared to use and abuse of illicit drugs; this is something to keep in mind when addressing these issues. 

  Staff. (2008). A prescription for danger – Use of painkillers on the rise. Retrieved online on 8/17/08 from: http://family.samhsa.gov.

  Staff. (2006). NIDA Infofacts – Prescription pain and other medication. Retrieved online on 8/17/08 from: http://www.nida.nih.gov/infofacts.

  SAMHSA Office of Applied Studies. (2002). National survey on drug use and health. Retrieved online on 7/14/08 from: http://oas.samhsa.gov/.

  McCabe, S., Teter, C., and Boyd, C. (2004). Illicit use of prescription pain medication among college students. Drug and Alcohol Dependence, 77(1), 37-47.

  McCabe, S.E. & Boyd, C.J. (2005). Sources of prescription drugs for illicit use. Addictive Behaviors, 30(7), 1342-1350.

  Friedman, R.A. (2006). The changing face of teenage drug abuse – The trend toward prescription drugs. The New England Journal of Medicine, 354, 1448-1450.