Prescription Painkillers and Opioids

Prescription painkillers, or opioids, are drugs originally derived from the poppy plant to help manage pain. Opioids have a long history of being prescribed as strong pain medications, as well as a long history of being a drug of choice for recreational users as well. Understanding opioids and the opioid epidemic is critical to getting people connected with the help they need.

Opioids is an umbrella term that covers a variety of psychoactive drugs that mimic the brain’s neurotransmitters to dull pain and induce euphoria. The term encompasses any number of pills, patches, liquids and powders that have been formulated for maximum effect. When ingested, prescription painkillers or opioids enter into the bloodstream and ultimately the brain. In the brain, opioids convert to morphine, and binds to opioid receptors in the brain, relieving pain and spreading euphoria.

In recent years, opioid abuse has increased dramatically, in what is being called the opioid epidemic. This sharp increase in the number of people struggling with opioid abuse disorders and overdoses starts with the use or abuse of prescription painkillers. Roughly 1 in patients who are prescribed prescription painkillers misuse them. Between 8 and 12 percent of patients who misuse prescription painkillers develop an opioid use disorder.

Repeated prescription painkiller abuse can result in disruption in what is called the reward pathway, the brain functions that control motivation, reward-seeking and the perception of pleasure. It is this disruption that makes opioids incredibly addicting. Tolerance begins to build quickly, and you find yourself needing higher and higher doses, taken more frequently. As legitimate prescriptions run out, some people begin seeking out off-label prescriptions, or street drugs like heroin. The spiral of addiction can take hold rapidly; if you believe you or a loved one are struggling with an addiction to prescription painkillers, please reach out to our treatment professionals.

Signs of Abuse

This section covers a wide variety of drugs, including prescription painkillers and a variety of opiates and opioids. All of these drugs create similar reactions in the brain, and active users share some of the same signs of abuse. These are powerful substances that affect many of the body’s systems, including the brain, and can have deadly repercussions.

  • Physical symptoms:
    • Dilated pupils
    • Dry mouth
    • Shortness of breath, shallow breathing
    • Disorientation
    • Drowsiness
    • Slurred speech
    • Nausea
    • Vomiting

Withdrawal Symptoms

Withdrawal does not always look the same, every individual will go through it differently. There are a number of factors that influence what withdrawal symptoms you will face, and how long they will last. These include how long you were taking opioids, what dose you were taking, and how you were taking them.  Withdrawal symptoms can start 6-12 hours from the last time you used, and peak 24-72 hours from that time. Acute symptoms generally begin to subside after 7 days, but can last longer depending on a number of factors. Withdrawal affects many of the body’s systems, heart rate, blood pressure, breathing and body temperature can fluctuate to extreme degrees; it is highly recommended that you seek medical care when attempting to stop taking opioids.

  • Shaking, tremors
  • Runny nose
  • Sweats
  • Chills
  • Nausea, vomiting or diarrhea
  • Cramps
  • Goosebumps
  • Bone or joint pain
  • Muscle pain or spasms
  • Rapid heartbeat
  • Hypertension
  • Depression
  • Anhedonia, difficulty feeling pleasure
  • Drug cravings
  • Fatigue
  • Difficult breathing
  • Agitation, restlessness
  • Difficulty concentrating
  • Anxiety
  • Insomnia
  • Fatigue

Prescription painkillers can be ingested, or broken down to be smoked, snorted or injected. Identifying common paraphernalia can help determine whether an individual is abusing prescription painkillers.


  • Empty pill bottles – determine whether prescription painkillers are being used quicker than intended


  • Lighters/ Candles – heat source
  • Straws or similar – used to capture smoke and steam given off by heat
  • Aluminum foil, cigarettes, rolling papers, pipes – All can be improvised to smoke crushed prescription painkillers


  • Rolled dollar bills, cut straws or similar – used for snorting crushed prescription painkillers
  • Razor blades or similar – used to cut crushed prescription painkillers into “lines” for snorting
  • Small mirrors or glass – surface for snorting of crushed prescription painkillers


  • Hypodermic needles – used to inject liquefied prescription painkillers
  • Cotton balls – used to filter liquefied prescription painkillers for impurities
  • Shoelaces, rubber hoses, length of string or similar – used to “tie off,” restricting blood flow on one’s limbs to make veins pop out

Brand/ Type/ Generic

There are a number of opioids distributed under a number of brand names. The following are some names to look out for as prescription painkillers that may be abused.

  • Acetaminophen with codeine- Tylenol #2, #3, #4
  • Buprenorphine – Butrans
  • Butorphanol
  • Fentanyl – Actiq, Duragesic, Fentora
  • Hydrocodone – Zohydro ER, Hysingla ER
  • Hydrocodone with Acetaminophen – Lorcet, Lortab, Norco, Vicodin, Elixir
  • Hydrocodone with ibuprofen – Vicoprofen
  • Hydromorphone – Dilaudid, Exalgo
  • Meperidine – Demerol, Merpergan
  • Methadone – Dolophine, Methadose
  • Morphine – MS-Contin, Avinza, Kadian
  • Nalbuphine – Nubain
  • Oxycodone – OxyContin, OxyFast, Roxicodone
  • Oxycodone with acetaminophen – Roxicet, Endocet, Percocet
  • Oxycodone with aspirin – Percodan
  • Oxycodone with ibuprofen – Combunox
  • Oxycodone and naloxone – Targiniq ER
  • Oxymorphone – Opana, Opana ER
  • Pentazocine – Talwin
  • Pentazocine with naloxone – Talwin NX
  • Propoxyphene with aspirin
  • Propoxyphene with acetaminophen
  • Tapentadol – Nucynta, Nucynta ER
  • Tramadol – Ultram
  • Tramadol with acetaminophen – Ultracet

Detox Process


Amatus Health detox facilities offer medically assisted detox for individuals facing acute withdrawal from prescription painkiller addiction, as well as inpatient and outpatient therapy programs designed to build the skills for long term recovery.

While we are an abstinence-based treatment program that medications administered under medical supervision can be a valuable resource during acute withdrawal. Our staff will assess each individual’s needs, and help design a plan for them to taper their use smoothly and safely, with the least amount of discomfort.

Further Treatment Options


At Amatus Health we off the full continuum of care, from intensive inpatient programs through a number of outpatient levels of care. We believe, supported by evidence, that a longer stay in treatment sets patients up for a better chance at long term recovery.

We are committed to helping every individual achieve long term recovery. This means treating not only physical addiction, but addressing the mental and spiritual aspects as well. Our staff will create an individualized treatment plan with you, using a variety of therapeutic modalities to help every individual build the skills for long term recovery.

If you or a loved one is struggling with prescription painkiller abuse, dealing with acute withdrawal, have just completed detox or another level of care and are looking for the next step in recovery, call us now to speak with a treatment professional.

What it means to be an Amatus Managed Recovery Center

  • Person First Philosophy

    Our mission is to get you in the best facility that will allow you to heal and find long term recovery. Whether you enter one of our facilities or another facility, we will help everyone who contacts us find the appropriate place for them to heal.

  • National Footprint, Community Focus

    Our nationwide network of treatment centers and referral partners allows us to make an impact in multiple communities. We want every individual to thrive, and become a positive force in your community. We desire to help people and communities recover.

  • Facility and Treatment

    We are committed to providing the highest level of care, delivered in cutting-edge facilities designed to support your recovery. Every individual gets an individualized treatment plan, with the highest-level of care standards and quality.

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