One of the most common reasons Americans visit their doctors is to get help with pain relief. Pain causes distress and can even be debilitating. Doctors sometimes prescribe opioid pain relievers to their patients who are in pain. While these drugs can provide much-needed relief, they also have the potential for misuse and addiction.
How Addictive Are Pain Relievers?
There are different medications that can ease short-term or chronic pain. Many of these drugs fall into the opioid category. These drugs are also known as narcotic pain relievers and include morphine and codeine, as well as several synthetic modifications of these drugs.
It is important to be cautious when taking medication for pain. In some cases, the treatment can pose more risk than the underlying cause of the pain. While you can’t remove all risk, you are less likely to become addicted to pain-relieving drugs when you take them exactly as prescribed.
Still, many of these medications produce a high that can become addictive for some patients. Some people become psychologically dependent on this feeling of euphoria. There is also the risk of physical dependence on highly addictive pain relievers.
Dependence is most likely to happen if a person takes a higher dose of an addictive pain medication than they were prescribed or if the medication was improperly prescribed.
Pain medication overuse (sometimes called medication or narcotic abuse) is one of the most prevalent forms of drug misuse in the United States.
One of the reasons is that addictive pain medications are sometimes over-prescribed. For example, a person might not need such strong pain relief, or a pain medication might be prescribed for longer than a person needs it.
The Opioid Crisis
Prescription opioid addiction has risen substantially over the last few decades. What begins as dependence can lead to seeking pain medications on the black market or using illicit opiates such as heroin.
The current issue of narcotic misuse in the U.S. started in the late 1990s, according to the National Institute on Drug Abuse (NIDA): “Pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates.
As of 2018, the NIDA estimated that between 8% and 12% of patients in the U.S. who are prescribed opioids develop a use disorder.
Of patients who develop an opioid use disorder, 4% to 6% eventually turn to heroin. The U.S. Centers for Disease Control and Prevention (CDC) reports that, in 2019, an average of 38 people died each day from prescription opioid overdoses.
The number of opioid-related deaths increased by 5% between 2018 and 2019. The epidemic has hit rural America as hard as it has the nation’s cities. In response, multiple government agencies have created initiatives to curb the epidemic.
According to the CDC, the first line of defense is reducing the number of addictive pain medications that are prescribed. This initiative involves working with physicians and pharmacies to ensure that they use powerful painkillers only when absolutely necessary.
Signs and Symptoms of Opioid Misuse
Unfortunately, the nature of painkillers is that they become less effective over time. This is partly because your body adjusts to the medication and develops a tolerance, which means your body requires higher doses of the drug to get the same effect.
There are certain signs that therapeutic use of opioids has crossed into the territory of addiction.
Signs to be aware of include:
- Exhibiting compulsive behaviors to get the drug and continue to use it (even in the face of negative consequences)
- Taking the medication to get high or relieve anxiety rather than to relieve pain
- Needing to take a higher dose of medication to feel the effects previously experienced at lower dosages (especially if snorting or injecting the drug is required to get the desired effect)
- Using pain medication in amounts or at times that are not consistent with a doctor’s prescription—especially if someone is misleading their doctor or pharmacist to do so
If you recognize these behaviors in a loved one or are concerned about your own use of pain medication, it’s important to talk to your healthcare provider
Most Addictive Painkillers
These are the top 10 most addictive pain medications currently available, according to the NIDA. Most of these drugs are prescribed for the treatment of chronic pain, though some are intended for short-term use.
Note that this is not a complete list. There are other painkillers and prescription medications that can be addictive.
More potent than morphine, fentanyl (which is sold under the brand names Actiq, Duragesic, and Sublimaze) is most often prescribed to treat patients with severe or post-surgical pain. It is also used for patients who have become physically tolerant of opiates.
Fentanyl is available as a lozenge, injectable solution, or skin patch.
While it can be legally prescribed by a doctor, this highly addictive drug might also be obtained illegally. Common street names for fentanyl include:
- China Girl
- China White
- Dance Fever
- Murder 8
- Tango and Cash
It has also become common for fentanyl to be used in counterfeit drugs or be cut into illicit drugs such as heroin and cocaine. People using those drugs are often unaware that they contain fentanyl, and just a very small amount can lead to severe illness and even death.
OxyContin is a brand name for extended-release oxycodone. It is taken as a tablet and is used as an around-the-clock treatment for patients with moderate to severe pain that is expected to last for an extended period.
When sold illegally, this highly addictive painkiller is sometimes called “OC,” “Oxycet,” “Oxycotton,” “Oxy,” or “hillbilly heroin.”
Demerol is a brand name for meperidine. This addictive painkiller is often used with anesthesia. Demerol is also used to treat moderate to severe pain (such as that experienced in childbirth). It is available as an oral solution, injectable solution, and oral tablet.
Street names for Demerol include “demmies” and “pain killer.”
Hydrocodone (sold under the brand names Vicodin, Norco, Zohydro, and others) is used to treat moderate to severe pain caused by a chronic condition, injury, or surgical procedure. It’s available as an oral syrup and tablet.
On the black market, hydrocodone is sometimes called “Vike” or “Watson-387.”
Morphine is a natural opiate sold under the brand names Duramorph and MS Contin. It is prescribed to treat severe and ongoing pain (such as that related to cancer or cancer treatment). Morphine can be given in several forms, such as an injectable solution, capsule, tablet, and suppository.
Morphine is often simply called “M” on the street, though it’s also known as “Miss Emma,” “Monkey,” and “White Stuff.”
Percocet is similar to OxyContin. It contains a combination of acetaminophen (which is sold in the U.S. under the brand name Tylenol) and oxycodone. It is available as a capsule, tablet, and oral solution.
On the street, it is sometimes called “hillbilly heroin” or “percs.”
Codeine is a natural opiate and commonly prescribed pain reliever. The effects only last for a few hours, which is why it is often prescribed in formulations with acetaminophen or aspirin, such as Tylenol 3. Codeine can also be found in some prescription cough medicines. Codeine is available as a tablet, capsule, or liquid.
Codeine is sold under many brand names. The drug and its many varieties have a number of street names, including:
- Captain Cody
- Purple Drank
Methadone is most often associated with people who are trying to safely quit heroin. It can also be used as an opiate pain reliever, though it can also be misused for this purpose.
Methadone can be taken in tablet or liquid form and is sold under the brand names Dolophine and Methadose.
Street names for methadone include “amidone” and “fizzies.” When used with MDMA, it is known as “chocolate chip cookies.”
Dilaudid is a brand name for hydromorphone. It is intended for short-term pain relief and used mostly in a hospital setting, where it can be administered intravenously (most often following a surgery). Dilaudid can also be given as an oral solution, tablet, and suppository.
When used illicitly, Dilaudid is often simply called “D.” It is also known as “dillies,” “footballs,” “juice,” and “smack.”
Oxymorphone is sold under the brand names Opana, Numorphan, and Numorphone. It is prescribed to treat moderate to severe pain.
This addictive painkiller comes in both immediate- and extended-release tablets.20 The pill is blue and has an octagon shape. The drug’s most common street names reflect its appearance:
- Blue Heaven
- Mrs. O
- O Bomb
- Stop Signs