Dealing with Substitute Addictions: Prescription Painkillers


This article is the first in a series about substitute addictions, written by Richard Hartnett

When people have broken the hold of their primary addiction, they may not realize how cunning their inner Addict is until they find themselves confronting a replacement.

It’s as if their inner Addict were still trying to seduce them, and if it can’t succeed with their favorite addiction, then it will try to lure them with a substitute. This experience demonstrates just how deeply ingrained the proclivity to get high is, and how our inner Addict keeps itself alive by tempting us with promises it has no intention of fulfilling.

Of course in the back of its mind, the inner Addict wants us to revert back to our favorite way to get high, but for the time being it will settle for something less. So let us look at some of the most prevalent forms of substitute addictions, and learn how to attain sobriety with each of them. Otherwise it is likely we will relapse with our primary addiction.

We can learn a lot about how addictions have so much power over us as we deal with substitute addictions. We may, for example, discover the particular weakness of ours that the inner Addict exploits to control us. Our goal is to attain complete sobriety, a state of mind in which we are not likely to succumb to temptations again. They may occur, but we will no longer be vulnerable to their allure.

Prescription Painkillers

Nowadays this seems to be the most popular form of substitute addiction. Painkillers are the drugs that many addicts seek to alleviate almost any kind of physical or psychological discomfort. They can either be prescribed by a doctor or purchased on the street for an exorbitant price. The common ones used are Percoset, Percodan, Tylenol with codeine, Demerol, OxyContin, and Opana. All of these are derived from opium, as is heroin. For this reason, when the pills are unattainable, heroin takes their place.

Because these medications are prescribed by physicians, they have a stamp of approval. And as long as they are taken as prescribed and under appropriate medical supervision, they have helped many people deal with their physical pain. But addicts are inclined to exceed the dosage and frequency of these medications, and to do so they resort to shopping for multiple doctors for prescriptions or they find an unofficial dealer. They need to increase their supply, and their morals may suffer as a result, as they engage in some form of illegal behavior, such as stealing or prostitution, to pay for their supply.

Counselors who deal with addicts on a regular basis know that this pattern foretells a major relapse back to the patient’s preferred addiction. Sometimes both addictions become active, each one reinforcing the other. In other words, the individual will continue using the painkiller when they resume drinking or taking other recreational drugs. In such a case, they will shortly receive a double whammy, in the sense that they will hit bottom fast and hard.

Inpatient treatment may be necessary to overcome this addiction, because it is so insidious. If this is not feasible, then some participation in Narcotics Anonymous may suffice. Resorting to painkillers indicates that the basic appeal of a quick fix has not been addressed, because a shift to a different moodchanger reveals a lack of insight into how the inner Addict operates.

Next week: compulsive sexuality as a substitute addiction

Richard G. Hartnett, MA, MS, LCADC is a former Jesuit priest who now lives with his wife, Kathy, by a lake in northwestern New Jersey. He has served as the chaplain at Hazelden New York, pastoral counselor at the Chemical Dependency Department of the International Center for the Disabled in NYC, and continuing care counselor at the outpatient Chemical Dependency Program of High Focus Centers in New Jersey. Currently he maintains a private practice in New Jersey. He is the author of The Presence at the Center, Renewing Your Fourth Step, The Three Inner Voices: Uncovering the Spiritual Roots of Addiction and Recovery, and Sobriety and Inspiration: Entrusting Ourselves to the Source of Our Healing and Creativity.


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