Now that Purdue Pharma and other big drug manufacturers have lined up to pay billions of dollars in opioid settlement money, it might seem that the prescription painkiller addiction crisis in this country is turning a corner and that the worst is behind us. Actually, though, last year saw the highest overdose rates so far in the epidemic.
“Over 81,000 drug overdose deaths occurred in the United States in the 12 months ending in May 2023, the highest number of overdose deaths ever recorded in a 12-month period,” read a report by the Centers for Disease Control and Prevention (CDC) in December 2023. The same CDC report noted that synthetic opioids like fentanyl were the “primary driver” of overdose deaths, increasing roughly 40 percent between June 2019 and June 2023.
Such statistics drive home the urgency of this public health crisis, as well as the need for effective responses. (Learn how treatment for opioid and prescription drug addiction at FHE Health is helping people achieve recovery and saving lives.) Greater public awareness about how to prevent opioid addiction is one key. For example, when more Americans know what factors make them more susceptible to painkiller addiction, they will be better able to protect themselves. What follows are nine risk factors for painkiller addiction that everyone should know about. Some of them may come as a surprise….
People ages 16-45 are at higher risk of developing a painkiller problem. That’s according to the Opioid Risk Tool, a clinical assessment that can shed light on predictors of addiction. The finding may fly in the face of what many people might assume—that seniors and older Americans are more susceptible to prescription painkillers because they tend to have more health and pain issues than younger people.
2. Severity of Pain
A 2016 study at Columbia University Medical Center—reportedly the first to make a direct link between pain and addiction risk—found that moderate to severe pain increases the risk of opioid addiction by 41 percent. The researchers analyzed data from a survey of 34,000 adults, three years apart, and examined pain levels as measured on a scale of 1-5. Participants who reported pain and had prescription opioid disorders were also more likely than others to report recent substance use, mood, or anxiety disorders, or have a family history of alcohol use disorder.
Sorry to say it ladies, but women are more at risk of prescription painkiller addiction than men, according to the same Columbia University study. Why this higher vulnerability among women? “Women are more likely to have chronic pain, be prescribed prescription pain relievers, be given higher doses, and use them for longer time periods than men,” the American Society of Addiction Medicine said. Another study, this one in 2015, found that women generally are more likely than men to be introduced to opioids through a painkiller prescription.
4. A Family and/or Personal History of Substance Abuse
Whether alcohol, medication or illicit drugs, a history of substance abuse in the family can be another risk factor for prescription painkiller addiction. In fact, it is “the most significant risk factor for developing a painkiller addiction,” in the words of a Harvard Health report, which was summarizing a conclusion by the American Pain Society. And the research seems to support this inference: Patients with chronic pain who also had a current or past opioid use disorder were about 17 times as likely to develop a painkiller addiction as other patients, according to a review of 24 studies.
5. A History of Childhood Trauma, Especially Abuse
As with other substance addictions, a person is more prone to a prescription painkiller addiction when they have experienced trauma in their childhood. Sexual abuse in one’s childhood, especially one’s preadolescent years, is a significant predictor of opioid addiction. So is emotional abuse, according to a 2017 study at the University of Vermont. (Strikingly, at least in this particular study, child emotional abuse more often correlated with opioid misuse later in life than even physical or sexual abuse.)
6. An Underlying Mental Health Condition
Someone with ADD, OCD, bipolar disorder, schizophrenia, or depression is more predisposed to prescription painkiller addiction also. Rates of addiction among this population tend to be significantly higher. For example, research published in the Journal of the American Board of Family Medicine found that “16 percent of Americans who have mental health disorders receive over half of all opioids prescribed in the U.S.”
7. Family Dynamics
The risk of painkiller addiction increases when there are high or unrealistic expectations for family members, for example. An at-risk family member may have an exaggerated sense of responsibility of taking care of the household by doing all the chores, raising children or their siblings on their own, and/or carrying the burden of family finances. The stress of these responsibilities may cause someone to seek painkillers for relief. There may be a higher chance of developing an addiction if there is a lack of communication in the family and problems are ignored and feelings suppressed. Opioid addiction enables avoidance of these problems and numbs the related emotions.
8. Social Factors
When someone is part of a peer group where high-risk behaviors are the norm, they may be more susceptible to painkiller addiction. High-risk behaviors, such as sky diving, high-speed driving, partying with drugs or alcohol, and/or engaging in criminal behavior, tend to involve an adrenalin rush. The body can become used to that adrenalin rush, as a means of soothing pain; and when adrenalin is missing, painkillers become attractive ways to create similar pain-relieving and pleasure-boosting effects. Difficulty bonding with others can be another social factor that causes people to turn to painkillers to relieve feelings of social discomfort and disconnection.
9. Low Self-Esteem
When researchers at Binghamton University wanted to know what life stressors were most associated with an increased risk of opioid use, they found that health, family, and romance problems were leading contributors—and that poor self-esteem was associated with high opioid misuse and a significant tie between each of these problems and opioid misuse.
When more people know about these risk factors for prescription painkiller addiction, that greater public awareness can help save lives.
The article was provided by Dr. Sachi Ananda, PhD, LMHC, MCAP who directs a trauma-based treatment program for first responders, at the national behavioral health provider FHE Health.