What are Painkillers and Can You Overdose on Them?

The term “painkillers” is simply a common word for pain relievers. These types of medications treat pain such as headaches and sore muscles.

They can also help manage pain associated with chronic health problems and injuries, such as:

• Headaches
• Stomach ulcers
• Gallbladder disease
• Arthritis and osteoarthritis
• Postoperative surgery
• Cancer
• Fibromyalgia
• Multiple sclerosis
• Acquired Immunodeficiency Syndrome (AIDS)

Painkillers can be either over-the-counter (OTC) or prescription medications. Your doctor will determine which type of painkiller is the most appropriate for your case. 

People respond to painkillers in different ways. Some individuals may find certain pain medications to work better than others.

OTC pain relievers are usually recommended for mild to moderate pain. Below is a list of some common generic (and brand name) painkillers that can be purchased over the counter:

Acetaminophen

This drug helps alleviate mild to moderate pain caused by muscle aches, colds, or menstrual periods. The brand name for acetaminophen is Tylenol®. However, you will find that acetaminophen is combined with another active ingredient (or more) to treat more symptoms. 

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These types of pain relievers combat inflammation and are available at high prescription doses, if necessary. Examples include aspirin, naproxen (Aleve®), and ibuprofen (Advil® or Motrin®).

When OTC medication doesn’t provide enough pain relief, your doctor may have you on stronger prescription drugs, such as opioids. Prescription painkillers can bring on a sense of euphoria (extreme happiness) because it binds to receptors in the brain and lowers pain perception. 

Can You Overdose on Painkillers?

Yes. It is possible to overdose on OTC and prescription painkillers. Although it tends to be more common with the latter. An overdose happens when a person exceeds the recommended dose.

Individuals with underlying risk factors like prior substance abuse are more likely to misuse painkillers.¹ This means that there are the added risks of painkiller addiction, overdose, or in severe cases, slowed breathing and death.

However, accidental overdose can also occur in people who:

• Don’t know they’ve developed painkiller dependence and tolerance
• Take prescribed painkillers with alcohol
• Do not follow the doctor’s prescription

A woman will visit the emergency room for prescription painkiller misuse or overdose every 3 minutes. 

Centers for Disease Control and Prevention (CDC)

What Causes a Painkiller Overdose?

Some painkillers have a higher potential for abuse and dependence than others. If people are not careful with their use, the risk of overdose could occur. However, other reasons may also contribute to an overdose.

Here is a list of some causes of painkiller overdose:

Taking higher doses

People may double or triple their doses to compensate for skipped doses throughout the day, or they cannot experience the same sense of pain relief as before. This is dangerous, though. Without proper medical supervision, people could take toxic amounts of the drug and experience an overdose.

If you believe that a painkiller is not as effective as it was initially, you should talk with a doctor to adjust your medication, if necessary. 

Suicidal thoughts

Some people may overdose on painkillers to die by suicide. If a person has too much of a painkiller, serious health problems arise. An example is life-threatening respiratory depression (slow and ineffective breathing) when a person overdoses on an opioid (a central nervous system depressant).

Mixing with other substances

Painkillers can interact with other substances, like alcohol or benzodiazepines (e.g., diazepam) to get a more intense high. If this happens, though, side effects can be severe and even lead to coma or death. 

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What Happens When You Overdose on Painkillers?

If you or someone you are with overdoses, do not hesitate to call 911 immediately. You can also call the national toll-free Poison Help Hotline (1-800-222-1222).

A person who overdoses on painkillers can face life-threatening symptoms like stopped breathing. Those who survive the ordeal will have to live with long-term health consequences. If that person does not receive proper medical assistance right away, it may result in permanent damage to the brain and other organs. 

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What Does a Painkiller Overdose Look Like?

Opioid painkillers are central nervous system (CNS) depressants. Meaning, they reduce activity in the brain and nerves. Unfortunately, an opioid overdose may cause dangerously low brain function. 

Physical Signs of Painkiller Overdose

Opioid overdose results in a general lack of activity throughout the body. The person will appear weak and barely responsive to external stimuli. This is because opioids slow down the transmission of nerves throughout the body, which is necessary for basic functions such as cognition, moving, breathing, and so on.

Painkiller Overdose Symptoms

The fastest way to detect an opioid painkiller overdose is to be on the lookout for easily observable signs.

These include:

• Extreme sedation (tiredness)
• Lethargy
• Muscle weakness
• Disorientation and confusion
• Slurred speech
• Restlessness
• Agitation
• Euphoria
• Cold, clammy skin
• Pinpoint pupils (pupillary constriction)
• Dry mouth
• Slowed breathing

You can also monitor for slow heart rate, low blood pressure (hypotension), and complaints of blurred or double vision.

In more severe cases of opioid overdose, the following signs and symptoms may show:

• Bluish lips or fingertips
• Pale, cold skin
• Respiratory depression (less than 10 breaths per minute)
• Slowed reflexes
• Memory loss
• Extreme confusion
• Sudden and intense mood swings
• Nausea and vomiting

Severe opioid overdose can lead to coma and overdose death. It requires immediate medical care, so you need to call 911 right away.

Men face a higher risk of dying of prescription painkiller overdoses than women, although the gap between the two sexes is closing.  

What to Do if You Suspect an Overdose

If you or someone you overdosed on painkillers, call 911 immediately. You can also get in touch with the national toll-free Poison Help hotline (1-800-222-1222).  

If possible, try to have the following information ready for emergency assistance:

• The person's age, weight, and condition
• Name of drug(s) (and the ingredients and strength, if known)
• The time it was taken
• The quantity taken
• If the drug was prescribed for the person

Also, if you or someone else overdoses on opioids, then you should administer Naloxone if possible. It can reverse the effects of an opiate overdose, and you do not need a prescription for this drug. Naloxone comes as an intranasal spray or as an intramuscular injection.

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Treatment for a Painkiller Overdose

In cases of painkiller overdose, you should take the container of the drug with you to the emergency department. That way, doctors can identify the exact cause of the overdose.

Doctors will also examine and monitor the person’s vital signs (e.g., temperature and blood pressure) and design a treatment plan to address overdose signs and symptoms. 

A person who overdosed on painkillers may receive or undergo the following tests or procedures:

• Activated charcoal (some form of charcoal that helps bind drugs or toxins to it)
• Airway support, including oxygen, intubation (a breathing tube), or a ventilator (to assist in breathing).
• Blood and urine tests
• Chest x-ray
• CT scan
• Electrocardiogram
• Intravenous fluids 
• Laxative
• Other drugs to treat symptoms, including naloxone

A person suspected of painkiller overdosing should receive emergency help as soon as possible. Any delay in treatment increases the risk of irreversible brain damage or death. 

Treatment for Painkiller Misuse/Addiction

If you or a loved one struggle with painkiller misuse and dependence, you have different addiction treatment options, including:

• Supervised detoxification or withdrawal process
• Rehab and support groups 
• Medical treatments (including methadone, buprenorphine, and naltrexone for opioid use disorder)
• Inpatient and outpatient treatment facilities
• Cognitive-behavioral therapy (CBT)
• Medication-assisted treatment (MAT)

According to Substance Abuse and Mental Health Services (SAMHSA), MAT has delivered the following benefits in individuals with an opioid use disorder (OUD):

• Increased patient survival
• Increased retention rates
• Decreased illicit (not accepted by standard norms or illegal) opiate use and other criminal activity among those with an OUD
• Improved a person’s ability to get and keep a job
• Improved birth outcomes among pregnant women with an OUD 

With the many promising treatments available, the path to recovery is within sight.

Commonly Abused Painkillers 

Some OTC drugs can be abused — but not OTC pain medications. Prescription painkillers have a higher risk of misuse due to their highly addictive nature.^2,3

For example, opioids (also known as opiate analgesics) are known to cause physical and psychological dependence with prolonged use. This means that you could face more intense withdrawal symptoms if you take a particular opioid longer. 

Some common prescription opioid pain medications include:

• Hydrocodone (Vicodin®)
• Oxycodone (OxyContin® and Percocet®)
• Oxymorphone (Opana®)
• Morphine (Kadian® and Avinza®)
• Codeine
• Meperidine (Demerol®)
• Fentanyl (Abstral®, Actiq®, and Fentora®)

Oxycodone and heroin are equally powerful, and both affect the central nervous system in the same way. 

Side Effects & Risks of Taking Painkillers

The side effects and risks associated with painkillers can vary depending on the type of medication used.

Acetaminophen

Acetaminophen doesn’t produce many side effects as it is a highly tolerated drug.

But it can lead to adverse reactions which may include:

• Rashes 
• Hives
• Swelling in the face, arms, lower legs, throat, tongue, feet, and ankles
• Trouble breathing or swallowing
• Red, peeling, or blistering skin

Allergic reactions to acetaminophen are life-threatening. If you experience them shortly after taking the meds, you need to call 911.

Acetaminophen overdose may also occur if you exceed the recommended dose. According to one study, the rates of acetaminophen poisoning and liver toxicity are increasing in the United States.⁴ 

Nonsteroidal Anti-Inflammatory Drugs (NSAID)

NSAIDs like aspirin produce common side effects such as:

• Mild indigestion (stomach aches) — doctors may recommend that you take aspirin with food to lessen your chances of digestive problems. 
• Higher risk for bleeding — Aspirin is a blood thinner, which means that your body will have trouble producing platelets for clotting. Individuals taking aspirin could have nosebleeds, bruise more quickly, or bleed for a longer than expected time when cut. 

In more serious cases, they can lead to the following adverse effects:

• Red, blistered, and peeling skin 
• Blood in pee, stool, or vomit
• Jaundice (yellow skin or eyes) caused by liver damage
• Joint pain/swelling in the hands and feet

It is important to know that NSAIDs increase the risk of stomach problems, such as ulcers or holes in the stomach or intestine, and gastric bleeding. This risk further increases when you consume alcoholic beverages while taking this painkiller.  

Prescription Opioids

Taking opioids causes the following side effects:

• Dry mouth
• Stomach pain
• Drowsiness 
• Flushing
• Headache
• Slowed breathing
• Mood changes

Opioid effects will depend on the dose, administration route (how you take the drug), and prior exposure to the opioid in question. However, in general, opioid use runs the risk of tolerance and psychological dependence. When this happens, you’ll need a higher dose to achieve the same effects you previously experienced.

If you take opioids for an extended period, you will also develop a physical dependence to the drug. This means that you will experience withdrawal symptoms after stopping your intake 

In the most extreme cases, you could develop opioid use disorder (OUD). OUD is a medical diagnosis given to individuals who experience serious impairment or distress because of continuous opioid misuse.

In 2016, approximately 2.1 million people in the United States were living with a substance use disorder (SUD) related to prescription opioid pain medication. 

Treatment Options for Opioid Abuse & Addiction

Opioid use disorder is challenging to overcome. Fortunately, there are several options for help.

These include:

Medication-Assisted Therapy (MAT)

There are three types of medication-assisted therapy for opioid use disorder:

• Buprenorphine
• Methadone
• Naltrexone

Buprenorphine and methadone help manage withdrawal symptoms as you detox.

Naltrexone blocks the receptors that opioids bind to, making it impossible to get high from them.

Medication-assisted therapy (MAT) is most effective when combined with other treatments.

Inpatient Programs 

Inpatient programs are the most intensive addiction treatment options.

These programs guide you through:

• Medically supervised detoxification
• Behavioral therapy
• Other services like medication-assisted therapy

They typically last 30, 60, or 90 days. However, they may be longer if necessary.

Partial Hospitalization Programs (PHPs)

Intensive outpatient programs are the next level of addiction treatment. These programs provide similar services to inpatient programs such as detoxification and behavioral therapy.

The difference is that the patient will return home to sleep. Some programs also include transportation and meals.

PHPs are ideal for new patients and those who have completed inpatient treatment but still need intensive care.

Outpatient Programs

Outpatient programs provide well-rounded treatment for people with a high motivation to recover. These programs are flexible and can be made around your schedule. They can also be customized to work best for you.

These programs work for new patients and those that complete an inpatient or partial hospitalization program.

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