Opioid Drugs List: Common Prescription and Illegal Drugs

There's a lot of talk about the opioid epidemic and the challenges opioids can bring. But what is an opioid drug?

Opioids, which are made from the opium poppy plant, are often used as prescription medicines that help manage pain. Opioids interact with the opioid receptors in your body's cells to relieve discomfort. But the drug can also create a euphoric feeling. That high can become addictive and lead to opioid use disorder (OUD) in some people. Opioids also include illegal drugs, such as heroin.

During the 1990s, healthcare providers commonly overprescribed opioids as pain relievers. Eventually, that led to the widespread misuse of prescription and non-prescription opioids. In 2017, the Department of Health and Human Services declared a public health emergency to combat the opioid crisis.

In the United Stats, from 1999 to 2020, about 564,000 people died from the misuse of prescription and illegal opioids.

What Are Prescription Opioids?

According to the National Institute on Drug Abuse (NIDA), healthcare providers commonly prescribe five opioids to help manage pain.

Usually, the following opioids are only used to treat people who need medication to relieve moderate to severe pain around-the-clock for a long time. Healthcare providers typically only prescribe the drug if the person cannot be treated with other medicines or treatments.

Also, many pre-existing conditions may prevent you from taking the following opioids. So, discussing your personal and family health history with a healthcare provider is essential. 

Oxycodone

Oxycodone is available in immediate-release and extended-release forms. In immediate-release forms, taken every four to six hours, oxycodone manages moderate-to-severe pain.

In extended-release forms, taken every 12 hours, oxycodone treats severe pain that requires daily, around-the-clock, long-term treatments. A healthcare provider may prescribe extended-release forms when other treatments have failed.

Oxycodone is available under the brands OxyContin, Xtampza ER, Oxaydoo, and Roxicodone. Healthcare providers may prescribe oxycodone with other pain relievers, like ibuprofen, aspirin, or acetaminophen.

Oxycodone may cause some side effects, which include the following:

• Dry mouth
• Drowsiness
• Headache
• Mood changes

Additionally, severe side effects that require immediate medical attention include nausea, vomiting, irregular menstrual bleeding, hives, and difficulty breathing.

Some pre-existing conditions that may prevent you from taking oxycodone include the following:

• Allergy to oxycodone
• History (or family history) of substance use disorders or mental illness, like depression
• Blockage in your stomach or intestine
• Low blood pressure
• Seizures
• Urethral disorders or problems urinating
• Heart, kidney, liver, pancreas, thyroid, or gallbladder disease
• Certain types of cancer
• Breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)
• Trying to become pregnant or breastfeeding

Hydrocodone

Hydrocodone is a medication used for severe pain. Hydrocodone works as an extended-release capsule, taken every 12 hours, or as an extended-release tablet, taken once daily. The drug is available under the brand name Hysingla ER. Some healthcare providers may prescribe hydrocodone in combination with ibuprofen or acetaminophen.

Hydrocodone may cause some side effects, which include the following:

• Dry mouth
• Back pain
• Headache
• Drowsiness
• Difficulty sleeping
• Ringing in the ears

Severe side effects that require immediate medical attention include nausea, vomiting, changes in heartbeat, irregular menstrual bleeding, hives, and difficulty breathing.

Some pre-existing conditions that may prevent you from taking hydrocodone include the following:

• Allergy to hydrocodone
• Blockage or narrowing of your stomach or intestines
• Paralytic ileus, impaired bowel movement
• Low blood pressure
• Difficulty urinating
• Seizures
• Thyroid, gallbladder, pancreas, liver, or kidney disease
• Colon or esophageal cancer
• Heart failure or rhythm problems
• Trying to become pregnant or breastfeeding

Morphine

Morphine is also used to treat severe pain. Morphine works as an oral solution, taken every four hours; as an extended-release tablet, taken every eight or 12 hours; or as an extended-release capsule, taken every 12 or 24 hours. The drug is available under the brand name MS Contin. Other brands of morphine, like Duramorph PH and Mitigo, are available as injections.

Morphine may cause some side effects, which include the following:

• Drowsiness
• Mood changes
• Stomach cramps
• Headache
• Feeling nervous

Severe side effects that require immediate attention include blue or purple skin tone, irregular menstrual bleeding, fainting, chest pain, hives, and fever.

Some pre-existing conditions that may prevent you from taking morphine include the following:

• Allergy to morphine
• Paralytic ileus
• Blockage in your stomach or intestines
• Seizures
• Difficulty swallowing
• Urinary problems
• Low blood pressure
• Liver, kidney, pancreas, thyroid, or gallbladder disease 
• Trying to become pregnant or breastfeeding

Codeine

Codeine is used to treat mild-to-moderate pain. The drug can also reduce coughing when combined with other medicines. Codeine will help relieve symptoms but will not treat the cause of symptoms or speed recovery.

In the United States, codeine is only available as a tablet, taken every four to six hours as needed. There are also dozens of other combination products containing codeine, such as Tuzistra XR.

Codeine may cause some side effects, which include the following:

• Headache
• Stomach pain
• Difficulty urinating
• Constipation
• Nausea
• Vomiting

Some pre-existing conditions that may prevent you from taking codeine include the following:

• Allergy to codeine
• Blockage or narrowing of your stomach or intestines
• Paralytic ileus
• Recent abdominal or urinary tract surgery
• Seizures
• Mental illness
• Trouble urinating 
• Low blood pressure
• Thyroid, pancreatic, intestinal, gallbladder, liver, or kidney disease
• Trying to become pregnant or breastfeeding

Fentanyl

Fentanyl is a synthetic opioid prescribed to help with severe post-surgery pain. Healthcare providers commonly prescribe fentanyl to treat breakthrough pain in people with cancer who are at least 18. They may prescribe the drug to people with recurring pain and a tolerance to other opioids.

Fentanyl is much more addictive than other opioids. The drug is up to 50 times stronger than heroin and 100 times stronger than morphine. In the United States, fentanyl significantly contributes to fatal and nonfatal opioid overdoses.

Fentanyl may cause some side effects, which include the following:

• Depression
• Weight loss
• Unusual dreams
• Dry mouth
• Chest pain

Severe side effects that require immediate medical attention include hallucinations, hives, shallow breathing, and fainting.

Some pre-existing conditions that may prevent you from taking fentanyl include the following:

• Allergy to fentanyl
• History (or family history) of substance use disorders
• Conditions that cause high pressure inside your skull, like head injury, brain tumor, or stroke
• Seizures
• Slowed heartbeat or other heart problems
• Low blood pressure
• Mental illness, such as depression, schizophrenia, or hallucinations
• Breathing problems, such as asthma and COPD
• Kidney or liver disease
• Trying to become pregnant or breastfeeding

Illegal Opioid Drugs

In addition to prescription opioids, there are illicit opioids manufactured, sold, and used illegally for the euphoric feeling. Illegal opioids include heroin and illicitly manufactured fentanyl (IMF). 

Misusing prescription and illegal opioids—particularly when combined with other drugs like alcohol or tranquilizers or when used for pain without proper medical supervision—can lead to fatal consequences.

Heroin

Heroin is made using morphine. The illegal drug comes either as a white or brown powder or black sticky tar. Like other opioids, heroin creates a euphoric feeling that can remove pain. 

Potential side effects of heroin include the following:

• Dry mouth
• Heaviness of the arms and legs
• Nausea
• Vomiting
• Brain fog

Long-term exposure to heroin can cause insomnia, collapsed veins, stomach cramping, constipation, liver or kidney disease, and other adverse side effects.  

People take heroin by snorting, injecting, sniffing, or smoking. Those methods help heroin reach the brain quickly, causing its fast-acting and addictive nature.

Illicitly Manufactured Fentanyl (IMF)

IMF refers to versions of fentanyl made and used illegally. The illegal drug may come in different forms, including liquid and powder. 

Powdered fentanyl is commonly mixed with other illegal drugs like heroin, cocaine, and methamphetamine and made into pills that resemble other prescription opioids. In its liquid form, IMF can be found in nasal sprays, eye drops, and dropped onto paper or small candies.

Fentanyl-laced drugs are hazardous. Some illegal drugs, such as counterfeit OxyContin or Xanax, often contain an unknown amount of fentanyl, potentially fatal with one use. In September 2021, the Drug Enforcement Administration (DEA) warned of an "alarming increase" in counterfeit prescription pills laced with fentanyl.

It is nearly impossible to tell if drugs have been laced with fentanyl unless checked with fentanyl test strips. Fentanyl test strips are small strips of paper that can detect the presence of fentanyl in all different kinds of drugs. Using fentanyl test strips is a safe and simple strategy for reducing overdose deaths.

Do Opioids Interact With Other Drugs?

Due to their addictive nature, it's best to avoid opioid drugs when possible. However, some people have a greater incentive to steer clear of them. 

Opioid interactions with other medications can be risky. People who drink or use benzodiazepines, such as Xanax, should not use opioids. Combining opioids and benzodiazepines can increase the risk of overdose because both drugs can cause sedation and suppress breathing.

People with a family history of substance use disorders may also want to avoid opioids. 

"A person's genetic makeup and psychological predisposition have a huge influence on whether or not someone becomes addicted," Michael Damioli, LCSW, CSAT, clinical director at Colorado Medication Assisted Recovery, told Health.

Additionally, people with chronic pain may build a tolerance to opioids, making the same dose less effective over time. Between 40% to 60% of people who develop opioid use disorder (OUD) also have chronic pain.

Damioli cautioned against using opioids and advised sharing any concerns with a healthcare provider to see if you can instead use another, less addictive medication. And if opioids are necessary, it may help to ask about the shortest and smallest course you can take. Also, don't hesitate to get a second opinion about other options.

Damioli also recommended having a trusted loved one hold you accountable by hanging on to your medication and only giving prescribed doses to you. 

What Are the Signs of Opioid Dependence?

Whether by prescription or illegal means, it's easy to become dependent on opioids. About 21% and 29% of people misuse prescription opioids. Additionally, nearly 80% of people who try heroin have a history of using prescription opioids.

"Stronger opioids whose effects wear off quicker, such as heroin or fentanyl, are more likely to create dependency than are weaker and longer-acting opioids," explained Damioli. "Any and all opioids can become addictive depending on how much and for how long the user consumes the drug."

OUD can cause several physical, behavioral, and psychological signs and symptoms, such as:

• Developing a dependence on prescription or illegal opioid drugs
• Using opioids differently than initially prescribed, such as taking larger or more frequent doses than recommended by a healthcare provider
• Poor decision making
• Abandoning responsibilities

Additionally, signs and symptoms of opioid withdrawal may include the following:

• Abdominal and muscle pain
• Intense opioid cravings
• Feeling agitated and anxious
• Diarrhea
• Dilated pupils
• High blood pressure and heart rate
• Sweating
• Shaking 
• Goosebumps
• Trouble sleeping
  

Opioid Overdose

Opioids can cause side effects, such as drowsiness, mental fog, nausea, and constipation. The drugs may also cause slowed breathing, potentially leading to an overdose. Other signs and symptoms of an overdose include:

• Extreme sleepiness
• Inability to talk
• Blue skin color and dark-colored lips
• Snoring or gurgling sounds

Overdosing is a severe medical condition. If someone has signs of an overdose, contact 911 immediately.

In the case of an opioid overdose, individuals can take naloxone. Commonly known by the brand name Narcan, naloxone is an opioid antagonist. In other words, the medicine reverses or even stops the effect of opioids. A person overdosing can receive naloxone through an injection or nasal spray. 

The results of naloxone only work for about 30 to 90 minutes, so you should immediately seek medical attention regardless of whether a person receives the medication.

When To Reach Out to a Healthcare Provider

If you or a loved one is experiencing the signs of OUD, seeking help from a healthcare provider can help avoid potentially fatal consequences. Also, you can ask a healthcare provider for a referral to someone specializing in substance abuse.

You can also contact the Substance Abuse and Mental Health Services Administration (SAMHSA) toll-free helpline to find drug treatment near you: 1-800-662-HELP (4357). Or you can visit SAMHSA’s Behavioral Health Treatment Services Locator.

A State Agencies webpage also helps you find state agencies with special programs for you or a loved one.

A Quick Review

Opioids are medicines that help relieve pain. Opioids include prescription and illegal drugs, oxycodone, hydrocodone, codeine, morphine, fentanyl, and heroin. 

Opioids can cause many side effects, such as drowsiness, brain fog, nausea, and constipation, among others. The drugs may become addictive, leading to OUD in some people. As of December 2022, the misuse of opioids is a severe public health problem in the United States.

If you or a loved one is experiencing the signs of OUD, it may help to consult a health professional who can help avoid potentially fatal consequences.