What medications are opioids?

Key Points

Prescription opioids, also called narcotics or pain killers, are a large class of drugs and an important part of modern medical care. Common prescription opioids available in the U.S. include codeine, fentanyl, hydrocodone, morphine, oxycodone, and tramadol. Painkillers, as a class, are also called narcotic analgesics.

Opioids may be used short-term to ease the discomfort from conditions such as a broken bone or after surgery, or for long-term pain such as cancer. Opioids are also used in cough medications (codeine or hydrocodone), in medicines for diarrhea and even to help combat opioid addiction itself. They can also be used in combination with other medications, such as acetaminophen or ibuprofen, for added pain relief.

All opioids are chemically related and work in concert with opioid receptors on nerve cells in the body and central nervous system. Some opioids are stronger than others, but over time you can develop a tolerance to them and may need higher doses to be effective for the same level of pain.

Misuse of opiates can lead to dependence, addiction, and in some situations, overdose, which can be fatal. According to the National Institute on Drug Abuse (NIDA), over 70,000 Americans died from drug-involved overdose in 2019, including illicit drugs and prescription opioids. Because of this risk, as well as the risk of diversion, these drugs are classified as controlled substances in the U.S.

Related: Understanding Opioid (Narcotic) Pain Medications

Examples of prescription opioids

Some of the most common single agent opioids prescribed for pain in the U.S include:

• codeine sulfate
• fentanyl (Actiq, Duragesic, Fentora, Lazanda, Sublimaze, Subsys)
• hydrocodone (Hysingla ER, Zohydro ER)
• hydromorphone (Dilaudid)
• morphine (Kadian, MS Contin)
• oxycodone (Oxaydo, OxyContin, Roxicodone, Xtampza ER)
• oxymorphone
• tramadol (Conzip, Qdolo, Ultram)

Narcotic analgesic combinations contain an opioid with another class of analgesic, such as acetaminophen, ibuprofen or aspirin. They are used to treat moderate to severe pain. Common examples include:

• aspirin, butalbital, caffeine and codeine (Fiorinal with Codeine)
• acetaminophen, butalbital, caffeine and codeine (Fioricet with Codeine)
• acetaminophen and oxycodone (Oxycet, Percocet)
• hydrocodone and ibuprofen
• acetaminophen and hydrocodone (Lortab, Lorcet, Norco, Vicodin)
• acetaminophen, caffeine and dihydrocodeine (Trezix)
• acetaminophen and tramadol (Ultracet)
• naloxone and pentazocine
• aspirin and oxycodone (Percodan)
• acetaminophen and codeine
• acetaminophen, caffeine and dihydrocodeine (Trezix)

To see a full list of prescription opioids, visit these Drugs.com pages:

• Narcotic analgesics - single agents (in more detail)
• Narcotic analgesic - combination agents (in more detail)

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Are opioids safe?

Prescription opioids are usually safe when used as directed and for short periods of time as directed by your healthcare provider. Due to the risk of abuse, doctors only prescribe these drugs when other pain treatments such as non-opioid pain medicines (like acetaminophen or NSAIDs) do not adequately treat your pain or you cannot take these medications due to side effects, allergies or other problems.

Even when prescribed correctly by a doctor, some people will take them for longer than prescribed, use larger quantities, abuse them by taking with alcohol or other drugs, or sell or give them to people illegally. Opioids are frequently misused because they cause euphoria, or a “high” and relaxation, in addition to the pain relief effect.

Not all opioids are prescription drugs. Heroin is considered a highly addictive and illegal opiate drug and is classified as a Schedule I drug under the Controlled Substances Act of 1970. Heroin carries strong criminal penalties and has no accepted medical use in the United States as determined by the DEA.

Related: Heroin information on Drugs.com

If you suspect someone is having an overdose, call 911 or other emergency personnel immediately. Signs of an opioid overdose include:

• extreme drowsiness
• blue lips and fingernails
• slow or halted breathing
• pinpoint pupils
• slow heart rate
• coma
• death

In case of an opioid overdose, individuals who take opioids, or their caregivers, should always have a rescue medication called naloxone (Narcan) within reach. This medication can block the effects of opiates to help reverse an overdose (an opioid antagonist). You should still call for emergency help, and more than one dose of naloxone may need to be administered.

Effective medicines are also available that are used to treat opioid use disorders and addiction, including buprenorphine (a partial opioid agonist/antagonist), methadone (an opioid agonist), and naltrexone (an opioid antagonist).

This is not all the information you need to know about opioids or related medicines for safe and effective use, and does not take the place of talking to your doctor about your treatment. Review the full product information for your specific medication, and discuss this information and any questions you have with your doctor or other health care provider.