Narcotic drugs, also known as narcotic analgesics, opioids, or painkillers are used primarily for the treatment of moderate-severe acute (short-term) pain, such as that experienced following an injury or surgery. They are also sometimes used to relieve chronic pain, such as in the case of cancer or palliative care, and can also treat diarrhea and coughing.
Some narcotic drugs such as oxycodone and codeine are legal if they are obtained through a prescription. However, these drugs are commonly diverted for their pain-relieving, feel-good effects. They are also found in completely illicit versions on the black market (e.g. heroin and fentanyl.)
Regardless of their origin, all narcotics have a high potential for abuse, addiction, and overdose. For this reason, they are considered very dangerous when not administered as prescribed under the care of a physician. In a nutshell, narcotics are depressant drugs that dull pain but can also impair cognition and senses, cause sedation, and slow autonomic functions of the central nervous system to a life-threatening extent.
Although the word narcotic tends to have a negative connotation regarding the illegal drugs associated with it, it is also a standard term used in health care. From one to another, narcotic analgesics vary in their ingredients, strengths, dosages, and cost. Many are taken orally as tablets, capsules, or liquids, while others can be injected or administered as a transdermal patch.
List of Narcotic Drugs
The following is an extensive list of both prescription and legal narcotic drugs.
Opium is the raw, natural foundation for all narcotics. It is derived from the somniferum papaver poppy plant and contains several opiate alkaloids including morphine, codeine, and thebaine. These chemicals have pain-relieving properties and are also the basis for many modern drugs, including oxycodone (thebaine) and heroin (morphine.)
Opium is not as commonly abused in the United States as derived opiates and opioids due to its limited availability as a natural substance, although it is classified as a Schedule I drug per the Drug Enforcement Administration (DEA.) However, when it is encountered, it is usually found as a brownish powder and can be smoked, drank as a tea, taken in pill form, or injected.
Morphine (MS Contin, Kadian, and Arymo ER)
Morphine, as noted above, is an opiate derived directly from the opium poppy that is used as an analgesic for the treatment of both acute and chronic pain, and is also used as a sedative before surgical procedures. Morphine is considered to be one of the most effective pain relievers on the market and is available in oral solutions, tablets, suppositories, and injection preparations.
Is the U.S, morphine is not misused nearly as often as heroin and prescription opioids, but still has a high potential for addiction and is most often abused via injection by those dependent on opioids.
Codeine is used as an analgesic and cough suppressant, but for pain, is widely considered to be less effective than morphine. In the U.S., codeine is only available in generic form or in combination products, such as Tylenol with codeine.
Codeine is generally thought to be less addictive than many more potent narcotics – that said, however, it still has the potential for abuse, dependence, addiction, and overdose.
Heroin is an illicit, semi-synthetic opiate, and like opium is heroin is classified as a Schedule I controlled substance in the U.S., as it has no accepted medical use and a high potential for abuse and addiction.
It is commonly distributed as a brown-to-white powder or a less pure version known as “black tar heroin” which resembles a dark sticky tar-like substance.
Heroin can be snorted, smoked, or injected. Heroin creates a very intense and rapid rush of euphoria, but can also cause extreme sedation. Therefore, users often cycle between an awake and unconscious state, also known as being “on the nod.”
Overdose deaths due to heroin and its far more potent cousin fentanyl (see below) have increased dramatically since the turn of the century, and are involved in tens of thousands of deaths each year.
A heroin overdose is a medical emergency and is characterized by labored/difficult breathing, stupor, lethargy, confusion, clammy/cold skin, slow heart rate and blood pressure, a bluish tinge (cyanosis) to the nails and lips, and potentially, a complete loss of consciousness.
Oxycodone (OxyContin, Percocet)
Oxycodone is an effective painkiller for moderate to severe pain, but if used for longer than a few days or abused, however, can quickly result in drug tolerance and dependence. Oxycodone is generally dispensed in tablet form and may be combined with an over-the-counter analgesic, such as acetaminophen.
Oxycodone is a Schedule II controlled substance, meaning that it does have an approved medical use. However, it is also commonly abused – in fact, OxyContin (and other oxycodone products) contain a black-box warning concerning their high diversion (theft), abuse, dependence, addiction, and overdose potential.
Oxycodone pills/tablets can be crushed and the powder can be snorted, smoked, or injected. These methods increase the effects of oxycodone, but also increase the risk of addiction and overdose.
Hydrocodone (Vicodin, Norco, Lortab)
Hydrocodone is an effective painkiller and the #1 prescribed and most often diverted and abused opioid drug. Prescribed in tablets, capsules, and syrups, hydrocodone medications can be swallowed, snorted, smoked, or injected.
The DEA has warned that hydrocodone is one of the top drugs found to be involved with prescription opioid overdose deaths, and it is considered to have a high potential for addiction. It is also frequently found in combination formulations with acetaminophen (Norco, Vicodin) which increases the risk of health complications when abused.
Hydromorphone (Dilaudid and Exalgo)
Another Schedule II narcotic derived from morphine, hydromorphone is dispensed in tablets, vials, suppositories, and injectables. The drug is frequently diverted via “doctor shopping” – e.g., forged prescriptions and sketchy prescribers – and through pharmacy and nursing home theft.
When abused, hydromorphone can be smoked, snorted, swallowed, and injected. It is very potent, highly addictive, and has a carries a significant potential for overdose when abused.
Demerol is a pain medication marketed as a table or syrup, and abuse often begins with a legitimate prescription for pain. A patient using Demerol for severe pain may become tolerant to prescribed doses and begin to escalate use (and evolve into abuse.)
Even when Demerol is used as directed with a prescription, a patient can become dependent on the drug and experience withdrawal symptoms when they attempt to quit – therefore, it can be challenging to stop using Demerol, resulting in misuse/abuse and addiction.
Methadone (Dolophine, Methadose)
Methadone is an opioid analgesic, although it is frequently prescribed for opioid dependence and detox as a replacement for faster-acting, more potent opioids such as heroin. It can be dispensed as a pill, wafer, or in liquid form, often administered through federally-regulated clinics.
Methadone is one of the longer-acting opioid agonists, as it remains active in the bloodstream for close to a full day. This means that it can be prescribed in lower doses and less often than other narcotics for the management of opioid withdrawal symptoms.
Buprenorphine (Subutex, Buprenex, Butrans, Probuphine and Suboxone, Zubsolv, and Bunavail)
Buprenorphine is a long-acting, partial opioid agonist drug approved by the Food and Drug Administration to treat opioid dependence, both on its own and included in buprenorphine/naloxone formulations such as Suboxone. However, it can still be abused and has a potential for dependence.
The inclusion of naloxone in combination with buprenorphine products acts as an abuse-deterrent. Moreover, naloxone is an antagonist drug – if buprenorphine combination products are altered for abuse, effects of the opioid agonist are blocked.
Tramadol (ConZip, Ultram, and Ryzolt)
Tramadol is a different kind of narcotic analgesic. It not only has opioid agonist effects but also blocks the reabsorption of norepinephrine and serotonin for additional painkilling properties.
Although Tramadol is considered to have a relatively low potential for abuse and addiction, it is still a controlled substance and those who are already dependent on opioids and chronic pain sufferers may be more likely to abuse it.
Fentanyl (Actiq, Fentora, Duragesic, Subsys, Abstral) and Carfentanil
Fentanyl is a very potent narcotic (up to 50 times more potent than heroin) prescribed for the treatment of chronic and severe pain in those who are tolerant to other opioids. As a prescription, is it often administered as a transdermal patch. In a hospital setting, it is also used for general anesthesia.
On the black market, fentanyl is not usually a product of drug diversion, however. Rather, it is illicitly made in Chinese labs and frequently cut into other drugs such as heroin to increase the potency of the product and maximize profits. It the last few years, it has been involved in an escalating number of overdose deaths, now numbering in the thousands each year.
Carfentanil is similar to fentanyl but 100 times more potent. It is not indicated for any medical use in humans, and in the U.S. is only used by large animal handlers for sedation. The drug can be lethal to adults in tiny doses of two milligrams or less and is extremely dangerous to even handle it, less alone consume it.
Treatment for Addiction to Narcotic Drugs
After detox, narcotic drug addiction is most effectively using a comprehensive, evidence-based approach that includes behavioral therapy, counseling, and group support. Our center offers these therapeutic services in inpatient, partial hospitalization, and outpatient formats.
Our professional medical and mental health staff specialize in addiction and can provide clients with the knowledge and tools they need to recover and enjoy long lasting sobriety and wellness. Recovery from addiction is a lifelong endeavor, but you don’t have to do it alone.