How Do You Become Addicted to Prescription Painkillers

It didn’t begin with a sports injury or from rummaging through someone’s medicine cabinet. There was no root canal gone wrong or a fall from a ladder. For Brett O., a recovering addict and Discovery Place alum, using prescription painkillers was, initially, purely recreational. They were an add-on or supplement to some other mood-altering substance.

“I liked to change the way I feel,” says Brett, 43. In his teens, he started drinking and smoking marijuana. By his mid-twenties, and for the next decade, alcohol and cocaine were his drugs of choice. “I would start drinking about five in the afternoon, and I would drink until the sun came up, doing cocaine.” The hangovers, however, were so debilitating that he wouldn’t want to drink or use for several days. But he needed something to get him through the hangovers.

Xanax and prescription painkillers, drugs he’d dabbled in on and off when they were available, became his remedy. The pills would help Brett get through his hangovers until he was ready to drink and do cocaine again. This cycle of drinking and using cocaine for a few days followed by a few days of using painkillers went on for years, slowly—then quickly—destroying
his life.

Anatomy of Painkiller Addiction

Data just released last month from the Centers for Disease Control and Prevention report that more than 42,000 Americans died of opioid overdoses in 2016. While 2017 data isn’t yet available, it’s estimated the numbers will meet and likely surpass the previous year. Though heroin and fentanyl grab most of the headlines these days, it’s prescription painkillers, like oxycodone and hydrocodone, where many opioid addicts often get their start.

“Whether you’re introduced [to painkillers] recreationally or by a physician, the same underlying processes are there as far as what’s happening in the body,” says Dr. Jan A. Mayer, a Nashville-based psychiatrist and expert on addiction. “We have a reward system which drives us toward things . . . and then we also have an avoidance system. That’s the fear side of things.”

Opioids, like Percocet or Lortab, attach themselves to naturally occurring opioid receptors found in the body. When this happens, the result is blocked (or reduced) pain, as well as, initially, euphoria or feelings of pleasure. Heart rate drops, breathing slows, a sense of calm spreads throughout the body. The reward system lights up, and the brain records this experience.

Over time, with continued use or abuse, the body begins to experience tolerance. The same amount that once produced a calm, euphoric feeling no longer has the same effect, or any effect at all. The body’s natural pain blocking receptors are not getting enough naturally occurring pain signals, and the effect in the user is more pain, not less, as the body seeks to find homeostasis or internal balance. Now the avoidance system kicks in and the addict is no longer seeking to activate the reward system but rather to avoid pain, specifically withdrawal.

“It sneaks up on people,” says Dr. Mayer. “You’re [using], then using a little more. Then all of a sudden one morning you wake up, and you feel like you have the flu. You haven’t had any [drugs] in a day, day and a half. You don’t feel quite right, and you’ve never had that [experience] before. Then you take a pill, and all of a sudden you’re better. That just gets worse and worse and worse. Initially, it was the feel-good part of it and not feeling anxiety and not feeling pain, but then you’re chasing trying to feel normal. Your brain is now abnormal, and you lose control. The brakes are gone.”

Of the patients Dr. Mayer sees recovering from opiate addiction, there is a common thread. “They’re not using to get high anymore. It’s about not getting sick, not feeling like you want to die,” he says. “Opiate withdrawal won’t kill you, but it will make you wish you were dead.”

Signs of Prescription Drug Addiction

“I really thought I could manage it”

Between 2008 and 2011, Brett waded deeper into prescription painkiller abuse. His marriage was falling apart; divorce was on the horizon. “My wife wouldn’t leave her purse in the living room when she went to take a shower,” recalls Brett. “I stole from my daughter’s piggy bank.” He’d lost his long-time career in the auto industry and was hopping from job to job every six months.

He first experienced what Dr. Mayer describes after switching from Percocet and Lortab to oxycodone, a synthetic opiate known on the street as Roxy. “That was when things really took a turn for me,” he recalls. “I obsessed about [the pills] when I didn’t have them. I had to have them.” The first time he couldn’t get his oxycodone for a couple of days, he couldn’t sleep. His legs kicked involuntarily. “I had no idea what was going on, and it really freaked me out.”

It disturbed him so much that he said he was done. He went through acute opiate withdrawal in his home over a period of a week. After that, he didn’t take any pills for three months. “It was ruining my life. I was spending all my money on it. I was obsessing about it.” But when a co-worker told Brett she had access to Percocet, the cycle began again.

“I really thought I could manage it. I thought I could take some here and there, and it wouldn’t be a big deal,” he says. “It was spiraling out of control again. I was hooked.”

Painkiller Addiction Treatment

Nothing Left and Nowhere to Go

Brett checked into Discovery Place in August 2011. He’d never been to treatment before and had no previous experience with recovery. After sixty days at Discovery Place, he moved more than a thousand miles away from his family in Atlanta to take a job in Boston. And like before, Brett started to believe he could manage his addiction to painkillers again. “I really thought I could take pills on the weekend and be fine,” he recalls. “It got 100 times worse. It was complete hell.”

Now skilled at doctor shopping, Brett would fake kidney stones to get prescriptions for painkillers when his drug dealer couldn’t come through. Even though he had upwards of fifty doctors in his rotation, all it took was one to acknowledge what he was doing for him to realize the jig was up. “This one doctor said to me, ‘Brett, we know you’re going to doctors. I’m not going to turn you in, but you need to get help.’”

With nothing left and nowhere to go, Brett moved to Dickson, Tenn., fifteen minutes from Discovery Place, in January 2013. He moved into a sober living house and showed up to Discovery Place every morning for four months to volunteer until there was a job available. He immersed himself in the DP community, and in recovery. “I was done,” says Brett. “It was time to get sober.”

Drug Addiction Recovery

A Community Built for Long-term Recovery

For Dr. Mayer, community is a vital component of recovery. “What’s important in early recovery is that you can’t trust your brain,” he says. “That’s why it’s so important to have that community support. If treatment can get you to the point where you can trust other people enough, then you can lean on other people to benefit from what they’ve experienced.”

Sober now for five years, Brett’s life today would be unrecognizable to the Brett of five years ago. Relationships once considered ruined have now been rebuilt. He’s present for his daughter, and he and his ex-wife co-parent in a way that would have never been possible before. Today, people call him for advice.

“No one is going to give you a support group and a toolkit to draw upon like Discovery Place will,” says Brett. “That support they provide you is laying the foundation for a twelve-step program. Anybody can stay sober in treatment, but what are you going to do when you get out there in the real world? That’s where the twelve-step program continues recovery and sobriety.”

Unlike many other treatment centers, the support guests receive during their time at Discovery Place continues even after they leave. Whether it’s the long-term recovery and continuing care programs, access to local sober living houses, resources for family members, or an always open door to return as a volunteer, the connection to Discovery Place can be as strong as you want it to be.

For Brett today, it’s very simple: “Discovery Place gave me a second chance at life.”