In the Victorian setting, I'm working on, Painkillers are, obviously, going to be opiates of various forms (laudanum &c.). Considering Mr. de Quincey's Confessions and other contemporary accounts, moreover more recent events, addiction does seem to be an issue with those. As I'm planning the inclusion of the Obligation mechanic, anyhow, using it to depict above complication comes to mind. The question remains how crippling its effect to handle.
The ideas range from requiring
a simple Resilience check on any day the whole allotment of five Painkillers have been consumed (rather mild),
to a Resilience check on any day Painkillers are used, the difficulty determined by the number of doses consumed (quite harsh);
a failure resulting in an increase of Obligation (Addiction) by +1, of course.
I wouldn't mind any useful suggestions, by no means!