The term “narcotic” refers to a drug that relieves pain while dulling the senses and inducing sedation. Some people refer to all drugs, especially those that are illicitly obtained, as narcotics. However, according to the DEA (Drug Enforcement Administration), narcotic(s) is a term that includes all opium-based products, both natural and partially or fully synthetic.
Opioids can be effective at relieving pain because they lessen a person’s perception of pain signaling in the CNS (central nervous system). However, they also produce rewarding and pleasurable effects, and therefore, have a high potential for abuse and addiction. The following is a list of several commonly used and abused narcotics.
Before scientists synthesized opiates for medical use, opium was the premium drug because it was useful for its intended purposes without much processing. Three alkaloids in opium (codeine, morphine, and thebaine) have served as the main components for the synthesis of many present-day opioids. Opium, in its original form, is not commonly found or abused in the U.S. and has minimal clinical use.
Heroin is an illegal semi-synthetic opiate derived from morphine, albeit much more potent than its source material. Because of its high potential for abuse and addiction, heroin is classified as a Schedule I controlled substance, indicating it has no legitimate medical purpose.
Potent opioids like heroin diminish pain sensations but also tend to impair cognitive ability and cause heavy sedation. Heroin can also slow respiration and heart rate dramatically to the point of being life-threatening. Due to the ongoing opioid crisis, heroin abuse in the U.S. has reached epic proportions and is involved in thousands of overdose fatalities each year.
Heroin is commonly sold in powder form, which can range from white to brown in color. It can also be found as a relatively unrefined, sticky, black substance known as “black tar heroin.” Heroin can be smoked, snorted, or injected for rapid results.
Oxycodone (e.g., OxyContin and Percocet) is one of the most popular and contentious drugs in recent history. It can be an effective treatment for moderate to severe pain, especially when coupled with acetaminophen (e.g., Tylenol). However, chronic or excessive use of oxycodone can result in chemical dependence and addiction and lead to the abuse of less expensive or easily obtained illicit substances, namely heroin.
Hydrocodone (e.g., Vicodin, Norco) is the most commonly prescribed, abused, and diverted drug in the U.S. In fact, Americans consume nearly all (99%) of the world’s hydrocodone supply. Hydrocodone and its many combination products are classified as Schedule II controlled substances.
Hydrocodone products are strictly intended for oral administration only and are considered effective for moderate pain. However, some people abuse the tablets by crushing and snorting, smoking, or injecting the residual powder.
As noted, morphine (e.g., M.S. Contin) is a natural alkaloid derived from opium. Morphine is used clinically for the management of pain and inducing sedation before medical procedures. Morphine is among the most widely used painkillers in hospital settings and can often be found as a liquid solution. For this reason, those who are morphine-dependent may prefer to inject the drug as it provides a faster and more intense onset of effects than when taken orally.
Hydromorphone (e.g., Dilaudid) is also derived from morphine. It is a powerful and potentially addictive semi-synthetic opioid commonly used in hospitals for pain management. However, it can also be found on the streets as a product of drug diversion. Like other opioids, people who abuse hydromorphone may attempt to smoke, snort, or inject it.
Fentanyl (e.g., Actiq, Duragesic) is an incredibly potent opioid that can be found in both prescription and illicit forms. It is up to 100 times stronger than morphine and 50 times more potent than heroin. When prescribed by a doctor, it comes in the form of a sublingual film, patch, or lozenge—methods that allow slow delivery into the bloodstream for an extended period.
However, street fentanyl is often manufactured illegally and found in powder form. It is often laced into heroin and other drugs or used as an outright substitute to extend the dealer’s supply and maximize profits. Furthermore, people who seek heroin are often not aware of fentanyl’s presence in the drug they are ingesting, which dramatically increases the risk of overdose and death. Even a minuscule amount may be sufficient to cause an overdose, especially among those who have not built a tolerance to it.
Codeine (e.g., Tylenol 3 and 4) is commonly used to manufacture prescription drugs, namely cough and cold formulas. It is a relatively mild analgesic and a less potent pain reliever than morphine. However, the drug may be abused by consuming tablets or oral solution in an amount that exceeds prescribed doses. It’s also sometimes mixed with soda and candy in a concoction known as “Lean” or “Purple Drank.”
Furthermore, it can also be combined with other intoxicating substances, such as alcohol, to enhance feelings of being drunk or high. This practice is very risky and could lead to life-threatening complications, including overdose.
Methadone (e.g., Dolophine, Methadose) is a purely synthetic opioid that also has analgesic properties. It is most often used for opioid replacement therapy among those addicted to more potent opioids, such as heroin. It is dispensed in pill, wafter, or liquid forms administered once per day through federally regulated clinics. Despite strict regulations on how, when, and to whom it can be dispensed, methadone is occasionally diverted and has the potential for abuse, dependence, and addiction.
Meperidine is used to treat moderate to severe acute pain, sometimes for before or after surgery. According to the FDA (Food and Drug Administration), prolonged use is highly discouraged. It can increase the risk of toxicity (e.g., seizures) from the accumulation of a metabolite known as normeperidine. Meperidine may be prescribed as in tablet or syrup form, and like all opioids, it has the potential for abuse and addiction.
In addition to pain-relieving effects, Tramadol (e.g., Ultram) blocks the reuptake of adrenaline and serotonin, two neurochemicals responsible for feelings of pleasure and reward. Tramadol is considered to have a relatively low potential for abuse and dependence, but nevertheless, is still classified by the DEA as a controlled substance, schedule IV.
Tramadol is most often misused by persons who are already opioid-dependent and/or experience chronic pain. Although tramadol appears to have less potential for addiction than most other opioids, long-term or excessive use can still lead to chemical dependence and addiction.
Carfentanil is an astonishingly potent opioid used to sedate large animals, such as elephants. It is believed to be around 10,000 times more potent than morphine and is not intended for humans due to its incredibly high toxicity. Fortunately, At the time of this writing, carfentanil’s presence in the U.S. illicit drug supply appears to be nearly non-existent. However, in 2016, hundreds of people in Ohio lost their lives to carfentanil-laced heroin.
Buprenorphine is a partial opioid agonist typically used for opioid dependence. It is often used with the opioid antagonist naloxone in the combination product Suboxone. Though widely used as a treatment for managing opioid addiction, it can still be abused. The placement of naloxone in the combination product is intended to deter abuse, as it becomes active when the drug is crushed or subject to tampering.
Getting Treatment for Opioid Addiction
If you or someone you know is abusing opioids or other substances, we urge you to seek help today! Just Believe Detox and Just Believe Recovery centers offer detox services as well as comprehensive, personalized programs that provide those we treat with the tools, education, and support they desperately need to achieve long-lasting sobriety and wellness.
If you are ready to take the first step, contact us today to discuss treatment options and discover how we can help!