Author: Ruben Bermea, LPC

Narcotic pain meds like oxycodone and hydrocodone are typically prescribed to manage moderate to severe pain. However, many people misuse them for their euphoric and relaxing effects.¹ Narcotic painkillers are also commonly referred to as prescription opioids—contrary to what some may think, there is no difference between narcotic and opioid drugs.²

Effects of Narcotic Painkillers

Opioids activate pain receptors throughout your body and central nervous system. By binding to opioid receptors in these different parts of your body, narcotic painkillers can relieve sensations of pain as well as increase feelings of well-being.

This rewarding experience can cause you to want to continue narcotic pain meds, even when you do not have a medical need for doing so. However, narcotic painkiller use can lead to serious side effects, including overdose and death.

Other effects of narcotic pain meds may include:¹

• Nausea
• Constipation
• Extreme sleepiness
• Confusion
• Increased sensitivity to pain
• Dry mouth
• Dizziness
• Depression
• Low levels of testosterone, which can result in reduced energy, strength, and sex drive
• Itching
• Sweating
• Respiratory depression

Narcotic Pain Medications

Some narcotic pain meds are made from the opium poppy plant and others are synthetic, meaning they were made in a lab.¹ This list includes some of the most common narcotic pain meds, or opioid painkillers.

Codeine

Doctors may prescribe codeine to treat mild to moderate pain symptoms or to treat a cough.4 Codeine manufacturers produce various codeine formulas and combinations and offer them under dozens of brand names. While codeine used to be available over the counter, it is now strictly controlled and only available with a prescription. People may try to mix codeine cough syrup with alcohol or other liquids to make “sizzurp” or “purple drank.”

Manufacturers have created codeine medications combined with the following substances:³

• Guaifenesin
• Brompheniramine
• Phenylephrine
• Salicylic acid
• Promethazine
• Potassium Iodide
• Diphenhydramine
• Chlorpheniramine
• Caffeine

These medications can come in different formulas including:⁴

• Tablets
• Liquid
• Capsules
• Oral solutions

Street names for codeine-based medications and combination narcotics include:⁴

• Loads
• Schoolboy
• Coties
• Sizzurp
• Doors and Fours
• Purple Drank
• Captain Cody
• Lean
• Pancakes and Syrup

Fentanyl

Government and other public health agencies recognize fentanyl for its potency and high likelihood for misuse, addiction, and overdose.⁵ Though the effects of fentanyl are similar to other opioids included on this list, the potency of this opioid medication contributes to its unique risk for devastating health consequences.⁵

Fentanyl formulas that the U.S. government has approved for pharmaceutical use include:⁵

• Lozenges, or “lollipops”
• Nasal sprays
• Mouth sprays
• Tablets
• Patches for use on the skin
• Injectable solutions

Illicit manufacturers of fentanyl may sell this medication in powder or other tablet formulas.6 Drug dealers often cut drugs like cocaine, heroin, methamphetamine, and MDMA with fentanyl, unbeknownst to the individual buying and using the drug. This often leads to overdoses since people don’t know they’re using fentanyl.

The methods of fentanyl misuse vary depending on the formula and include methods such as:⁵

• Modifying patches
• Soaking blotter paper in fentanyl for oral consumption
• Snorting fentanyl
• Smoking this medication
• Injecting solutions
• Oral consumption of pills, tables, or capsules

People may sell or misuse fentanyl under street names such as:^4,5

• Lollipops
• Tango and Cash
• He-Man
• Jackpot
• Murder 8
• King Ivory
• Dance Fever
• China Town
• China Girl
• Friend
• Apache
• Great Bear
• Goodfellas

Hydrocodone

Hydrocodone is a commonly prescribed narcotic pain med that can manage the symptoms of severe pain.
Some brand names for hydrocodone include:⁴

• Norco
• Hysingla
• Vicodin
• Zohydro

Despite the government’s approval of hydrocodone use for medicinal purposes, the risk for misuse and addiction still exists, especially when people divert this medication for non-medicinal use.^4,7 People may sell this medication under street names such as:⁴

• Lorries
• Dones
• Idiot
• Droco
• 357s
• Bananas
• Pills
• Lemonade
• Veeks
• Scratch

Hydromorphone

Manufactured under the brand name Dilaudid, hydromorphone also constitutes an opioid medication with a high risk for misuse and addiction. When compared to morphine, hydromorphone has a significantly higher potency, risk for misuse, and negative health consequences when consumed.⁴

Manufacturers have developed multiple hydromorphone formulas approved for medicinal use by the U.S. government, including:⁴

• Rectal suppositories
• Oral solutions
• Injectable solutions
• Tablets
• Capsules

When purchased from illicit sources, hydromorphone may go by several street names including:⁵

• Juice
• Footballs
• Dust
• Smack
• D
• Dillies

Meperidine

Meperidine also has approval from the U.S. government for managing moderate to severe pain symptoms.9 Prescribers may offer this medication in tablet or liquid formulas.⁴

Misuse can occur in several ways, including:⁴

• Intranasal ingestion, snorting
• Injection
• Oral consumption

Brand names for meperidine include:^4,8

• Demerol
• Isonipecaine
• Pethidine
• Demmies
• Pain Killer

Morphine

Morphine is often given intravenously at a hospital to manage severe pain, especially after a surgery. It can also be prescribed for use at home. Several morphine formulas exist, including:⁴

• Extended-release tablets
• Extended-release capsules
• Rectal suppositories
• Liquid solutions

Manufacturers market and sell this medication under several brand names, including:^4,5

• Oramorph SR
• RMS
• MSIR
• MS-Contin
• Roxanne
• Duramorph

The names for morphine sold on illicit or illegal markets can vary and include:⁴

• Unkie
• Emsel
• God’s Drug
• Morpho
• Mister Blue
• White Stuff
• Monkey
• First Line
• Dreamer
• Joy Juice

Oxycodone

A report by the U.S. DEA recognizes oxycodone’s popularity with communities and individuals who misuse opioids.⁵ Manufacturers produce oxycodone in several formulas, including:^4,5

• Extended-release tablets and capsules
• Immediate-release tablets and capsules
• Liquid solutions

Prescribers who offer this medication for pain management may offer it under different brand names and formulas that combine oxycodone with other substances.⁵ Brand names for oxycodone-based medications include:^4,5

• Roxicet
• Percodan
• OxyIR
• OxyContin
• Percodan

Street names for oxycodone include:^4,5

• Hillbilly Heroin
• Percs
• Kickers
• Roxy
• Killers
• Buttons
• Beans
• Cotton
• Blues
• Ox
• OC
• Oxy
• 512s
• 40s
• 30s

Methods of oxycodone medication misuse may include:⁵

• Smoking
• Injection
• Snorting
• Oral consumption

Oxymorphone

Like all of the other narcotic painkillers on this list, oxymorphone can be prescribed for the treatment of moderate to severe pain.¹⁰ Legal manufacturers of oxymorphone produce this medication under the brand names Opana and Opana extended-release. When manufactured and sold illegally, this medication goes by several non-pharmaceutical monikers, including:^4,10

• O Bomb
• Blue Heaven
• Biscuits
• Stop Signs
• Blues
• Octagons
• Mrs. O

How Addictive Are Narcotic Pain Meds?

Narcotic pain meds fall under varying drug schedule classifications, ranging from Schedule V to Schedule II. Schedule V substances, such as cough medications with less than 200 mg of codeine, have the lowest potential for abuse and addiction, while Schedule II drugs like hydromorphone and oxycodone have a high potential for addiction.¹¹

The addictive potential of narcotic pain meds constitutes a significant concern for their use.⁵ The U.S. National Institute of Health describes the process of opioid addiction as complex and the result of “a combination of genetic, environmental, and lifestyle factors, some of which have not been identified.”¹²

As noted above, the potency and function of some opioid medications can contribute to differences in risks associated with misuse and health problems.⁵ Other factors relating to opioid addiction include:¹²

• A history of substance misuse
• A history of psychiatric disorders
• Ease of ability to access opioid substances
• Poverty or other financial challenges
• Other lifestyle factors

If you have concerns that you or someone you know misuses opioids, call 800-934-1582(Who Answers?) to find out about the range of treatment options in substance use recovery.

Resources

1. National Institute of Drug Abuse. (2021, May 13). Misuse of Prescription Drugs Research Report.
2. Drug Enforcement Administration. (2021). Narcotic Drug Fact Sheet.
3. U.S. National Library of Medicine. (2020). Codeine.
4. National Institute on Drug Abuse. (2020, August 20). Commonly used drugs charts. 
5. Drug Enforcement Administration Community Outreach and Prevention Support Section. (2020). Drugs of abuse: A DEA resource guide/2020 edition.
6. U.S. National Library of Medicine. (2021, January 15). Hydrocodone.
7. American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
8. U.S. National Library of Medicine. (2021, February 15). Meperidine.
9. U.S. National Library of Medicine. (2021). Morphine.
10. U.S. National Library of Medicine. (2021). Oxymorphone.
11. Drug Enforcement Administration. (n.d.). Drug Scheduling.
12.  U.S. National Library of Medicine. (2020). Opioid addiction.