Pain Relievers & Substance Abuse – Do You Have a Problem?

Very sad youg man sitting on the floor crying due to his grief

Asking yourself, “Do I have a problem with pain relievers and substance abuse?” is one of the first steps to getting help. Because addiction to pain relievers usually begins through the use of a prescription given by a doctor, and for those misusing pain relievers, it can be difficult to tell when the problem first started or if it is even a problem at all.

With the help of the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), we can get a clearer picture of what constitutes a problem with pain relievers and substance abuse. The DSM-V sets for eleven criteria for Substance Use Disorders. Read through these to better understand the nature of your problem.

Using substances in larger amounts or for longer than intended:

Those with substance use problems will surpass the prescriptions given by their doctor and continue using beyond what the doctor intended. This is one of the first signs of a problem:

  • Wanting to cut down/stop using, but not managing to
  • Trying to stop using a substance and not being able to, is a classic sign of addiction and results in diminishing self-esteem and perception of choice.

Injured Knee and fighting Pain Relievers and Substance AbuseSpending a lot of time to get/use/recover from substance use:

Those with substance use disorders become consumed with obtaining the substance, planing for using it, and recovering from the effects physically and psychologically.


That powerful sensation of longing for a pill, drink, or some other form on the substance is what makes being dependent feel so intolerable. With persistent and chronic use, the cravings in the brain become stronger and harder to resist.

Inability to manage commitments due to use:

When you are dependent on a substance, it will interfere with your ability to keep your commitments to work, family, and friends.

Continuing to use, even when it causes problems in a relationship:

This relates to the inability to manage commitments. Many who have struggled with substance abuse will describe it as having a relationship with the substance itself—one that steals from and destroys the real relationships in their lives. And yet they continue to choose the drug over loved ones.

Giving up important activities because of use:

You will have difficulty staying engaged in other activities. This may be because:

  • Your energy is used up getting more of the drug
  • The substance use negatively impacts your energy level
  • Your sense of shame and guilt result in wanting to avoid others

Continuing to use, even when it puts you in danger:

This danger can be physical risks of the substance itself, threats to your relationships, financial risk due to spending on the drug, missing work, or legal danger.

Continuing to use, even when physical or psychological problems may be made worse by use:

Guy tripping out from LSDMany who struggle with substance use know that they are not who they could be without the drug, and yet they feel compelled and powerless to stop.

Increasing tolerance:

This classic sign of dependence and addiction means that the amount you use today will not provide the same high or relief in the same in the future. You will continue to need more of the drug to create the desired mental state.

Withdrawal symptoms:

If you attempt to cease using the drug, you will experience unpleasant physical and psychological effects.

According to the DSM-V, the following scale will give you some idea of the severity of the problem:

  • Fewer than two symptoms, there is no diagnosable disorder
  • 2-3 symptoms – a mild disorder
  • 4-5 symptoms – a moderate disorder
  • 6 or more symptoms constitute a severe disorder

With that being said, even if you identified only 2-3 symptoms, the very fact that you are asking the question, “do I have a problem” is a sign in and of itself. If you have concerns about pain relievers and substance abuse, reach out to a professional for help.


[1] McLellan, A. T. (2017). Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare? Retrieved November 18, 2019, from

About the Author:

Travis StewartTravis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. Travis’ website is

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Reviewed and Approved by Jacquelyn Ekern, MS, LPC on December 3, 2019
Published December 3, 2019, on

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.