Prescribed Pain: Exploring The Fine Line of Prescription Opioid Use

In 2023, opioid overdose resulted in the deaths of 217 people every day, as reported by the U.S. Centers for Disease Control and Prevention (CDC). This number is devastating and shocking – how did we end up here? The answer overwhelming turns to prescribed pain pills.

Living with chronic pain can affect nearly all aspects of your life, making it difficult to enjoy socializing, focus on work, and take care of yourself. To treat this debilitating problem, many providers prescribe individuals with opioid pain medications.

But you may be wondering, are prescription opioids safe, even if prescribed by a doctor? Will you develop an addiction? If you know anything about the opioid crisis, these are valid concerns and questions. Let’s dive into the history, risks, and best practices when using prescription opioids to answer these thoughts.

The Opioid Epidemic

“I was prescribed Roxicodone…and then they just took my Roxi’s. So, I started trying to find them on the streets. I wound up doing heroin at some point…then heroin turned to Fentanyl.”

In the mid 1990s, the opioid epidemic began, bringing devastation across the United States. The opioid epidemic can be described in three waves:

1. First Wave – Oxycontin: According to the Harvard School of Public Health, the drug promoted by Purdue Pharma and approved by the Food and Drug Administration (FDA), Oxycontin, triggered the first wave of overdose deaths connected to prescription opioids. Purdue Pharma deceived thousands of medical providers and organizations by presenting a fraudulent description of the medication as less addictive than other opioids, leading to multi-system failure of regulation.
2. Second Wave – Heroin: A second wave of fatalities was brought on by heroin, which attracted people who were already struggling with addiction. Many people turn to heroin when their doctor no longer prescribes them opioid medications.
3. Third Wave – Synthetic Opioids: In most recent years, a third wave of deaths from illegal synthetic opioids has increased, particularly fentanyl and xylazine.

But behind the headlines are real people whose lives have been turned upside down. Margaret, a BrightView patient, knows this reality firsthand.

Margaret: A Survivor of the Opioid Crisis

When Margaret was diagnosed with systemic lupus as a teenager, the doctors prescribed her Roxicodone, a brand name for oxycodone, while she was also on Xanax. Due to sudden changes in laws, Margaret lost access to her Roxicodone, leaving her feeling helpless and in pain.

“They changed the law that you couldn’t have opiates and benzos at the same time – and they just took my Roxicodone. So, I started having to find them on the street. I wound up doing heroin and at some point, it turned from heroin to fentanyl.”

When patients depend on medications, like Roxicodone, for long periods of time to treat their pain, it is not easy to stop. Withdrawal sets in and the pain that the medication was treating starts to return. For Margaret, opioids weren’t about chasing a high.

“It’s been a little over ten years, between heroin and fentanyl, that I used. And really, it wasn’t even to get high. It was just to get relief from my pain.”

Margaret’s story is a prime example of why we need to have more compassion and understanding for individuals with substance or opioid use disorder. Many of these individuals are just looking for a way to feel relief and don’t know where else to turn.

The CDC reports that well over 800,000 lives have been lost due to opioid overdose in the United States since the beginning of the epidemic. However, recent data reports that in 2023 we saw the first decrease in overdose deaths since 2018. There is hope for a better future, but we still have plenty of work to do.

What are opioids?

By definition from the CDC, opioids are natural or synthetic drugs that bind to receptors in your brain or body to reduce the intensity of pain signals reaching the brain. These include both prescription medications and illegal drugs, like heroin.

• Natural Opioids: Otherwise known as opiates, natural opioids are derived from the seeds of the opium poppy plant. They include morphine (MS Contin, Kadian), codeine, opium, and thebaine.
• Semi-Synthetic Opioids: Made in labs by chemically processing natural opioids, medications that fit into this category include oxycodone (OxyContin, Percocet, Roxicodone), hydrocodone (Vicodin, Norco), and oxymorphone. Heroin is also a semi-synthetic opioid.
• Synthetic Opioids: Manufactured entirely in labs and made of no natural ingredients, synthetic opioids, such as fentanyl, are manufactured entirely in labs and are made of no natural ingredients.

Although many of these medications are legal when prescribed by a licensed doctor, they can be just as addictive as illegal opioids. Reach out to your doctor if you have questions or concerns.

Understanding Fentanyl: Medical Vs. Illicit

One of the most notorious synthetic opioids is fentanyl. It is most known for increasing the number of overdose deaths in recent years. However, according to the DEA, fentanyl has legitimate medical use for treating severe pain when under the supervision of a licensed medical professional. Therefore, let’s examine the differences between fentanyl used for medical purposes and illicit fentanyl.

Medical Fentanyl:

• Doctor’s prescribe fentanyl to treat severe pain – completely normal medical practice
• Schedule II controlled substance
• Like morphine, but 100 times more potent
• Must be closely monitored and treated with extreme care and precision
• Safe to take if prescribed by a licensed medical provider

Illicit Fentanyl:

• Created in foreign labs then smuggled into the United States
• Mixed with other illicit substances to increase the potency even more
• Sold as powders, nasal sprays, and pressed pills – created to look like real prescription pills
• Impossible to know the potency of each counterfeit pill, making is impossible to know if it has a lethal dose
• Each time someone takes pills or other substances that were not given to them directly from a doctor or pharmacy they are risking overdose from illicit fentanyl.

How can I take opioid medication safely?

Being prescribed opioid medication for pain is common and safe when under the supervision and direction of a licensed medical provider. However, given the history and current state of the opioid crisis it is completely valid to have some concerns. Take these extra precautions, recommended by MedlinePlus, to take your opioid medication safely.

• Take medicine exactly as prescribed — never extra doses.
• Use one pharmacy for all medications to catch interactions.
• Read instructions carefully every time.
• Do not crush, chew, or dissolve pills.
• Watch for side effects (like drowsiness). Don’t drive until you know how the drug affects you.
• Contact your provider if side effects worsen.
• Never share prescriptions or take someone else’s.

Receiving Treatment for Opioid Use Disorder (OUD)

Opioid addiction is devastating, but it does not have to be the end of your story. Making the choice to start recovery may be intimidating, but it could also be life changing for you and your loved ones.

At BrightView, we offer comprehensive outpatient addiction treatment for opioid use disorder. Our treatment plan includes medication for addiction treatment (MAT), individual counseling, group therapy, case management at some centers, and allocation of outside resources.

Opioid addiction can be an isolating experience, but you don’t have to go through it alone.

Find a new beginning and hope at BrightView today. Call us at 888-501-9865 to start treatment and pave a path towards a better tomorrow.

Sources

Centers for Disease Control and Prevention. (2025, June 10). About Prescription Opioids. Centers for Disease Control and Prevention. https://www.cdc.gov/overdose-prevention/about/prescription-opioids.html#:~:text=Prescription%20opioids%20can%20treat%20pain,can%20become%20addicted%20to%20them.

Centers for Disease Control and Prevention. (2025a, June 9). Understanding The Opioid Overdose Epidemic. Centers for Disease Control and Prevention. https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html

Facts About Fentanyl. DEA: United States Drug Enforcement Administration. (2025). https://www.dea.gov/resources/facts-about-fentanyl

Feldscher, K., & Koh, H. (2024, November 22). What Led to the Opioid Crisis – and How to Fix It. Harvard T.H. Chan School of Public Health. https://hsph.harvard.edu/news/what-led-to-the-opioid-crisis-and-how-to-fix-it/

Focus on Broadband and Opioids. FCC: Federal Communications Commission Connect2Health. (2024). https://www.fcc.gov/reports-research/maps/connect2health/focus-on-opioids.html

U.S. National Library of Medicine. (2024, March 27). Safe Opioid Use. MedlinePlus. https://medlineplus.gov/safeopioiduse.html

Image provided by Adobe Stock Images.