Is paranoia and confusion typical for someone who uses pain medication?

A fellow caregiver asked...


I know 3 different patients that are have been receiving pain medication for a long time. They do not know each other, but each of them thinks someone is stealing their medication. Is this a common reaction to long term pain medicine use? Could it be they forget how many they take?

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

In my practice, which is in the nursing home, most of my patients are on strong pain medications. But, I have not run into the problem of patients thinking their medications are being stolen. In our facility, our medications are given at scheduled times, and we have a strict process where a licensed nurse is giving out medications and keeping track of them.

Since the 3 people you know are at home and doing their own medication management, it is possible that they are forgetting how much pain medication they are taking. What I would recommend is that they start writing down how much they take, to see if they really are missing pills. If they should discover after keeping track of their medication usage that someone is stealing their pain medications, they should try to find out who is taking it. Many pain pill addicts often steal supplies of pain meds from people who are taking them chronically, as the addict believes that the person will never notice the difference. Your friends can try locking up their meds in a locked cabinet or lock box to see if this will stop the behavior. They can also try and confront the person who is stealing the med, not to accuse them of stealing, but saying something like, "I noticed that some of my pills are missing. Did you take some?". If someone is stealing pain meds from someone else, they clearly have a problem and need rehab.