Types of Opioids

Opioids are powerful painkillers that are available with a prescription. They work to change the way the brain perceives pain as well as its emotional response to it.

While opioids offer several therapeutic benefits in pain management, they also pose many serious risks. Many people abuse opioid medications for the euphoric feeling they produce. This abuse can lead to subsequent addiction, overdose and even death.

Due to their potentially deadly risks, opioid medications are considered controlled substances and classified as Schedule II drugs. This classification means that opioids have a high potential of abuse and can potentially lead to severe psychological and physical dependence. They are also considered to be dangerous.

Opioids, Opiates and Narcotics: What’s the Difference?

The terms opioids, opiates and narcotics are often used interchangeably which can make learning about them confusing.

Narcotics include opioids and sometimes other controlled drugs. An opiate is a natural alkaloid or organic compound derived directly from the resin of the opium poppy. Morphine is an example of an opiate. All opiates are opioids.

Opioids include natural opiates and synthetic opioids like fentanyl and heroin. As mentioned, the terms are often used interchangeably, but it’s important to remember that all opiates are opioids, but not all opioids are opiates. If it’s synthetic in any way, it’s not an opiate.

List of Common Opioids

Opioids have a high likelihood for abuse. According to the American Academy of Neurology (AAN), nearly half of all people who take opioid medications for at least three months are still using opioids five years later.

And the Centers for Disease Control and Prevention estimates that more than 115 people die every day in the United States from overdose by prescription painkillers.

Some of the most commonly used opioids include morphine, codeine, hydrocodone, oxycodone and fentanyl.

1. Morphine

Morphine is one of the most well-known opiates because it is a highly potent pain reliever. It comes as a liquid or in extended-release tablets or capsules intended to relieve chronic severe pain that cannot be controlled by other, less powerful pain medications.

Morphine works by changing the way the body perceives pain. It bonds to certain opioid receptors in the brain and spinal cord preventing them from receiving pain signals. These receptors reside on the surfaces of nerve cells. The chemical bond formed between the receptors and morphine also activates the receptors which results in various side effects – some of which can be dangerous.

Brand names of morphine include:

  • Arymo ER
  • Morphabond
  • MS Contin
  • Roxanol-T

2. Codeine

According to the World Health Organization, codeine is the most commonly used opioid in the world.

Codeine is used to treat mild to moderate pain and is used in combination with other medicines to reduce coughing and diarrhea. It is available in combination with acetaminophens such as in Tylenol, aspirin, carisoprodol and promethazine.

Codeine targets specific areas of the brain depending on what it is used for. It can change the way the brain and nervous system respond to pain or it can decrease activity in the part of the brain that causes coughing. It begins working after being broken down by the liver into morphine.

Codeine can be taken by mouth in tablet, capsule or liquid form. It is not recommended for use in children under 12 years of age. While codeine is generally safe when taken properly, misuse can lead to physical and mental dependence that can progress to addiction.

Brand names of codeine and combination medications that include codeine are:

  • Tuzistra X
  • Airacof
  • Maxiphen CD
  • Antituss AC
  • Demi-Cof
  • Codafen
  • Pentazine VC
  • Robitussin AC
  • Dicomal-PH
  • Glydeine

3. Hydrocodone

Hydrocodone is used to treat severe pain. It is intended for patients who need 24-hour pain relief that cannot be treated with other medications or procedures. According to the U.S. Drug Enforcement Administration (DEA), hydrocodone is equally as effective or more effective, depending on the patient, than codeine for cough suppression and nearly as effective as morphine for pain relief.

The drug is primarily prescribed and distributed in the United States. The International Narcotics Control Board previously reported that 99 percent of worldwide consumption of hydrocodone occurred in the United States.

Brand names of hydrocodone and combination medications that include hydrocodone include:

  • Hysingla
  • Zohydro ER
  • Vicodin
  • Lortab
  • Lorcet
  • Norco
  • Maxidone

4. Oxycodone

Oxycodone is used to treat moderate to severe pain. It is only available to be taken orally as a tablet, capsule or solution (liquid) in the United States. Other countries, such as the United Kingdom, have approved oxycodone to be used intravenously.

Oxycodone is a powerful opioid. Research shows that it is approximately 1.5 times more powerful than hydrocodone. Oxycodone comes in immediate- and extended-release tablets and capsules. Extended-release versions are used for continuous pain relief.

Similar to morphine, codeine and hydrocodone, oxycodone works by stimulating opioid receptors in the brain. This stimulation serves to increase a person’s pain tolerance rather than eliminate the actual pain.

Brand names of drugs containing oxycodone include:

  • OxyContin
  • Endocet
  • Percocet
  • Percodan
  • Taxadone
  • Xolox

5. Fentanyl

Fentanyl is a powerful synthetic opioid and anesthetic. According to the Centers for Disease Control and Prevention, fentanyl is 50 to 100 times more potent than morphine. The CDC confirmed that fentanyl is more powerful than heroin and affects the body much quicker than heroin as well.

Fentanyl is used to treat sudden severe pain primarily in cancer patients who are already taking and can tolerate narcotic pain medications or opiates. It can also be used to manage pain after surgery.

In 2017, the sharpest increase in overdose deaths according to the National Institute on Drug Abuse (NIDA), was related to fentanyl. Fentanyl products accounted for nearly 30,000 overdose deaths out of more than 72,000 drug overdose deaths overall.

Brand names of fentanyl include:

  • Abstral
  • Duragesic
  • Actiq
  • Fentora
  • Onsolis
  • Sublimaze

Opioid Warnings

Opioid medications contain a warning that the drugs may be habit-forming.

Taking more of the drug than what is prescribed, taking it more often than recommended or taking it in other unintended ways can increase a person’s risk of dependency, addiction or overdose and death.

Common side effects of opioid medications include headache, stomach pain and difficulty urinating. Side effects that may be a sign of serious or life-threatening reactions include:

  • Agitation
  • Hallucinations
  • Fever
  • Sweating
  • Confusion
  • Fast heartbeat
  • Shivering or tremors
  • Severe muscle stiffness or twitching
  • Irregular menstruation
  • Decreased sexual desire or inability to achieve an erection in men
  • Loss of coordination
  • Nausea or vomiting
  • Diarrhea
  • Weakness
  • Difficulty breathing or swallowing
  • Rash, itching or hives
  • Changes in vision
  • Seizures

Opioid addiction affects people throughout the United States every day. If you or a loved one live with an opioid addiction, contact The Recovery Village at Palmer Lake to talk to a representative about treatment and detox programs. Through treatment and recovery, people living with addiction can obtain the healthy future they deserve.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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