Painkiller Overdose

What are Painkillers?

The term “painkillers” is another common word used to refer to pain relievers. These types of medications help to treat health problems, such as:

• Headaches
• Sore muscles
• Arthritis 
• Postoperative or chronic pain

Painkillers can be either over-the-counter (OTC) or prescription medicine. If you need a specific type of painkillers, your doctor will determine which one is the most appropriate for your case. Some individuals may find that pain relief sets in with one particular painkiller than another.

Here is a list of the generic (and brand name) OTC painkillers:

• 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®).

In cases in which OTC medication is not enough for pain relief, your doctor may have you on other types of 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. 

However, if some individuals have underlying risk factors like prior substance abuse, painkillers could lead to misuse or chronic abuse. This means that there are the added risks of overdose or, in severe cases, death.

According to the Centers for Disease Control and Prevention (CDC), a woman will visit the emergency room for prescription painkiller misuse or overdose every 3 minutes. 

Commonly Abused Painkillers 

Some painkillers have an increased risk of misuse. For example, opioids are known to build physical and psychological dependence. This means that you could face more intense withdrawal symptoms if you take a particular opioid longer. 

Some common prescription opioid pain medication (also known as opiate analgesics) 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. 

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Side Effects & Risks of Taking Painkillers

The side effects and risks associated with painkillers can vary. 

For example, if you take acetaminophen, serious side effects may include:

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

The risk of a severe event occurring is low. 

However, if you take NSAIDs, like aspirin, common side effects could include:

• Mild indigestion (stomach aches) — doctors may recommend that you take aspirin with food to lessen your chances of digestive problems. 
• Bleed more easily — 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, side effects could also be as follows:

• 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 bleeding, or holes in the stomach or intestine. Also, this risk increases when you consume alcoholic beverages while taking this particular painkiller.  

Finally, if you take opioids, side effects could include:

• 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 (a higher dose is needed to achieve the same effects as initially) and psychological dependence. 

If you take opioids for an extended period, there is the risk of developing physical dependence. This means that you will experience withdrawal symptoms after taking the drug. 

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. 

What Causes a Painkiller Overdose?

Some painkillers have a higher potential for abuse and dependence. If individuals are not careful, 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. 

What Happens if I OD on Painkillers?

If you or someone you are with overdoses, do not hesitate to call the local emergency number (911) or the national toll-free Poison Help hotline (1-800-222-1222).

If you or someone else overdoses on opioids, then you should administer Naloxone. Naloxone helps reverse the effects of an opiate overdose. It is available without the need for a prescription. You can get the drug as an intranasal spray or as an intramuscular injection.

A person who overdoses on painkillers can face life-threatening symptoms (like stopped breathing) and experience long-term health consequences. If that person does not receive proper medical assistance right away, permanent damage may set in the brain and other organs. 

Overdose death may also occur. 

Painkiller Overdose Symptoms

The most common symptoms of painkiller overdose are as follows:

• Extreme sedation (tiredness)
• Cold, clammy skin
• Pinpoint pupils (pupillary constriction)
• Loss of consciousness
• Coma 
• Respiratory depression (slow, ineffective breathing)
• Seizures
• Low blood pressure (hypotension)
• Death

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 are with overdoses, call the local emergency number (911) or 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. Naloxone can counteract the effects of an opiate overdose, and you do not need a prescription for this drug. It comes as an intranasal spray or as an intramuscular injection.

Treatment for a Painkiller Overdose

In cases of painkiller overdoses, you should take the container with you to the emergency department, if possible. 

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

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

Treatment for Painkiller Misuse/Addiction

If you or a loved one have problems 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.

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