We're facing an opioid addiction crisis in America. Opioid (narcotic) pain medications killed an estimated 14,000 people in the U.S. in 2014 through overdose. A further 14,000 people overdosed on heroin, another opioid that many people turn to when they can't access prescription painkillers.1

See Opioid Pain Medications

Opioid painkillers like hydrocodone can trigger dependency and increased sensitivity to pain. See Pain Killer Addiction Treatment

This epidemic is why physicians and pharmacists are increasingly raising the bar on who can receive opioid medications, how much, and for how long. It's not just the addiction risk that calls for caution when using opioids to treat chronic pain though—long-term use of opioids can actually make pain worse.

See Opioid Medication Potential Risks and Complications

Physical impact of painkillers

Becoming addicted to pain medication is a disease. This is because these painkillers (oxycodone, hydrocodone, methadone, fentanyl) cause a change in your brain chemistry that is not under your control.

See Opioids for Back Pain: Potential for Abuse, Assessment Tools, and Addiction Treatment

Most people who take opioids for more than 2 to 4 weeks will develop a tolerance to the medication. Tolerance means your body may need an increased dosage to feel the same effect. Opioid tolerance can cause withdrawal symptoms when the medication is stopped. This is a natural process, and it is not to be confused with addiction.

See Opioid Detoxification and Withdrawal

In his recent blog on the subject, Dr. Ullrich explains: "Pain medication addiction is a more complicated process. It involves manipulative behavior to obtain narcotic medications and a refusal to discontinue a medication even though it is no longer being used for a medical purpose. Some, including those at significant risk of overdosing, will go to multiple doctors to get medications."

See The Difference Between Opioid Addiction and Physical Dependence

For those who are addicted to opioid medications, a detoxification program is often needed. Painkiller addiction is a chemical, physical disease, one that requires expert medical treatment in a safe, humane environment.

See Pain Killer Addiction Treatment


Painkillers may increase pain

Most people know that painkillers can be addictive, but they don't know that taking opioids over a long period of time may in fact increase a patient's sensitivity to pain (hyperalgesia). This happens because long-term use of opiate painkillers causes a decrease in your ability to tolerate pain and an increase in sensitivity to pain. In fact, people taking opioids long term may keep having pain, or may see their pain increase, long after the original cause of pain has healed.

See Chronic Pain As a Disease: Why Does It Still Hurt?

Stopping opioid use can solve this problem—but it may not seem as if the pain is gone at first, because the discomfort of withdrawal can mimic the original pain. Dependency is not easy to deal with, but it shouldn't be an excuse to stay on the opioid medication and raise the risk for addiction. This is why physicians are encouraged to only prescribe opioids for short durations and be cautious when using them to treat chronic pain.

Since long-term use of opioid painkillers is a risky option for controlling chronic pain, patients are often advised to focus on other safe, proven methods for managing chronic pain, such as:

Learn more:

Assessment Tools for Opioid Misuse, Abuse, and Addiction

Opioid and Substance Use Disorder Rehabilitation and Maintenance


  • 1."Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014." Morbidity and Mortality Weekly Report (MMWR). January 1, 2016 / 64(50);1378-82