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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Pain Pills, A Real Pain

Allan Schwartz, LCSW, Ph.D. Updated: Jul 20th 2010

Pain Pills, A Real PainAs many of my readers know, I underwent painful surgery for a shoulder condition last April, 2010. I was prescribed Vicodin for pain management at home during my recovery. While I did experience some feelings of euphoria while on the drug, I also became violently sick with nausea, delusions and hallucinations that so alarmed myself and the family that I was immediately taken off the drug and another, milder medication was prescribed. When I recovered from the surgery I had no difficulty completely ending the use of the milder medication. I never became dependent or addicted to these opioid drugs.

The United States government reported a 400% increase in the abuse of opioid medications with resulting addiction. Among those who end up in hospital emergency rooms are people who range in age from 12 years old and into adulthood at all ages. Why is this happening? Why do some people, like myself, not become addicted while others develop an immediate love for the drug that causes them to use it and at ever larger doses?


"It's clear that some people have a genetic predisposition to addiction," says Andrew Saxon, MD, professor of psychiatry and director of the addiction psychiatry residency program at the University of Washington. For people with an inborn vulnerability to opioid addiction, taking pain pills can lead to an intoxicating rush that makes the brain want more."

The Amygdala is the pleasure center of the brain. Among other things, it registers the good feelings that come from eating, breathing, sexuality and so on. The sense of pleasure motivates repetition. That is the reason why people like having sex as often as possible.

People with a genetic predisposition to opioid addiction feel so happy and euphoric after taking an opioid drug such as Vicodin, that they want to repeat its use because the Amygdala has been stimulated. The more they repeat the use of these drugs the more addicted they become. If they try to withdraw from the addiction without medical intervention, they experience dangerous withdrawal symptoms and that is why detox programs are needed to safely allow withdrawal.


Genetics is only one of the reasons why people become addicted to these pain killers. Environmental factors contribute heavily to why some people want to repeat the use of this type of medication. Here are some of the factors leading to addiction to opioids:

1. A history of having been sexually or, physically abused during childhood.

2. Co existing psychiatric problems such as depression, anxiety, Bipolar Disorder and other serious behavioral disorders.

3. A history of alcohol and drug abuse prior to the use of opioids.

The point is that these pills create such a powerful euphoria that it feels like there is an escape from daily problems.

There is virtually no difference between the impact of these opioid pain killers and heroin. This means that the addiction is particularly powerful. The brain becomes so altered from this addiction that, even after attending detox programs there is a strong chance that there will be a relapse some time in the future.

There are now new medications that help block the craving for opioids and reduce the chance of relapse. Continued psychotherapy is an important adjunct during the recovery process as is attendance in some type of program such as NA, AA, Smart Recovery, and etc.

Non Judgmental:

It is really important that those caught in the web of opioid addiction not be judged and condemned. The physical and genetic nature of this disease clearly points to the fact that the addicted person did not choose this disease.


It is really important that, if you were prescribed one of the many pain killers that, after recovery from your illness, the remaining pills be tossed in the garbage. It is not safe to keep these around in the medicine cabinet.

It is equally important that the drugs be used strictly according your MD's instructions.

If you find yourself becoming either dependent or addicted to these medications, immediately report it to your MD who will help you gradually withdraw before the condition worsens.

What are your experiences with pain medications. Your comments and questions are strongly encouraged.

Allan N. Schwartz, PhD 

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

bipolar disorder and chronic back pain - ray - Apr 1st 2013

I have bulging disks herniated disks and arthritius,so I take oxycodone for my back,but I also just found out I have bipolar disorder. The pain meds don't seem to work very well and I found myself taking three times more than directed, now I have an addiction problem on top of bipolar,so I am going to get treatment on my own and take some thing called suboxon treatment. I want to see if this works and I can get off the pain meds,the pain could be partly innmy mind,so I have to experiment and see if it is true,if it is then I don't need to take the pain killers and take naproxen instead.

None In My Bloodlines - Cathy - Jul 20th 2010

So, the couple times I got a precription for such, I threw it in the trash - the doctor insisted I take the prescription with me. We avoid all precription medications and the doctors also.  I don't think that I would become addicted simply because I have self-discipline/self-control, that while I have things unpleasant in my life - that makes me experience the good things with increased pleasure and appreciation.  Also, I have no one that suffered addictions of any sort in my bloodlines - is that genetics, no it is the environmental forces that the family had/has.  Also, sexual addiction is on the rise, not because they get so much joy out of it but because they are addicted and using it for an escape.  Most of the population is "escaping" but what they don't realize is that if you feel no pain, you also feel no real pleasure.  Of course, we continue to say that no one is responsible for their actions, continued actions, etc. - the loss of personal responsibility is far worse than the addiction to any one of the vises.  Any idea how many of these people seek out these prescriptions?  How many different doctors they use to get what they are addicted to?  But, it is genetic so................................. 

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