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4 min read

The Thin Line Between Pain Relief and Opioid Addiction

No one wants to live in pain. Seeing our spouse, friend, or family member constantly suffering and not being able to do anything to aid them is devastating. Which is why we might be initially relieved when a doctor prescribes an opioid for pain relief. Despite the current epidemic sweeping the nation, that initial relief our loved one feels and a small bounce in their step outweigh your initial concerns. Plus, you probably take some comfort in the idea that doctors should be monitoring the intake, adjusting at the first signs of red flags.

Unfortunately, that may not be the case. There have been countless studies citing that some doctors still prescribe these medicines even when seeing red flags in a patient. Anna Lembke, an addiction psychiatrist, wrote an article for Stanford Medicine way back in 2012 highlighting the different pressures pushing doctors into a corner when it came to treating their patients, including customer satisfaction surveys and the ‘fix it now’ culture.

Which is why it’s important that you know the signs for when opioid use pivots from pain relief to addiction.

If you have a loved one who has been prescribed opioids to manage pain, these are the signs you need to watch for.

Decreased Tolerance for Pain
Contrary to popular belief, some painkillers can actually make the pain worse over time. This also decreases an individual’s tolerance to pain generally. To test this theory, imagine dunking your arm into a bucket of ice water. How long do you think you could last before the ice forced you to pull your hand back? On average, healthy individuals could last around two minutes.

Patients being treated with large doses of narcotics lasted 15 seconds in the ice bucket.

You can dive deeper into that University of Adelaide study in the Science magazine article here. It goes in depth into the damaging effects that long-term opioid use have on us.

Increased Tolerance for Prescriptions
The most important monitoring action is to be queued into your loved one’s treatment plan. Take note when they start the opioids and have open conversations about how the treatment is going. Prescriptions often come with ranges for doses, such as take one pill every four to six hours. Talk about when that switches from every six hours to every four, and what their doctor says about the movement.

Also, what is the long-term plan for care? Most opioid prescriptions are designed to be short-term fixes, a temporary solution until the body can heal. Our CEO Scott Silverman warns of any use that lasts more than 30 days. At that point, the body chemically changes in response to the drugs. The Centers for Disease Control and Prevention indicated that several days of taking opioid pain relievers for acute pain increases probability of long-term use. Other sources, including the New York Times, classify long-term use after six months, or 180 days out of the year.

Unfortunately, in today’s world, it’s often easier to extend a prescription than to dig into the root of the problem or discover alternative options for care. If your loved one’s treatment plans requires longer use or has transgressed into that long-term use, it’s time to start having hard conversations with doctors about options.

Here are the red flags to watch out for:

Increased complaints about pain and higher tolerance for current prescriptions;
Going through prescriptions faster;
Doctor shopping for additional prescriptions resulting in different doctor names on prescription bottles or filling at unusual pharmacies.

Physical and Social Indicators
Increased tolerance for prescriptions isn’t the only indication of a bigger problem. That’s a good thing since that’s an activity that most individuals will work to hide as their dependency increases. gives these additional warning signs:

Noticeable elation/euphoria
Marked sedation/drowsiness
Constricted pupils
Slowed breathing
Intermittent nodding off, or loss of consciousness
Your loved one’s social life will start to suffer as well. You’ll likely notice that they begin to blow off formerly favorite activities. Work will suffer. Former close friends will start to slip off their radar. Your relationship will start to feel strained as well.

Withdrawal Signs
Another sign that use has gone beyond pain relief is what happens when your loved one misses a dosage or is out of their prescription. If the opioid is strictly treating the pain, the only sign of missing it should be the reemergence of pain. Withdrawal, on the other hand, brings with is a cacophony of additional symptoms. paints these symptoms as red flags:

Nausea and vomiting
Inability to sleep

Getting Help
If a few too many of these red flags struck a chord, it’s time to get help. It starts with a call.

Calling to talk with someone isn’t an indication that your loved one has a problem. It’s just an opportunity to talk to an expert to see if what you’re noticing is putting your loved one at risk. At Confidential Recovery, every day we talk loved ones through warning signs and help identify the best next steps to addressing addiction. From pursuing a medical detox to referral to an in-patient treatment to seeing if they would benefit from our program, our first goal is helping you find the best path forward.

Call (619) 452-1200 or text (619) 993-2738 today.



Read Full Bio
Scott H. Silverman
CEO / Founder
Scott found himself "hitting bottom" in 1984 and accepted that he needed help for his problem and pursued treatment and long-term recovery. After pursuing his own recovery, Scott dedicated his life to helping others who struggle with the same mental health and addiction issues that caused him so much pain. Scott has made an indelible mark on the lives of many in San Diego. He has been on KUSI dozens of times to raise awareness about the dangers that we face, and to speak a message of recovery.