While some people use the word narcotic to refer to any addictive drug, they are likely referring to opioids. Opioids include:

  • Natural opioids that come from the opium poppy, such as morphine and codeine. These are also known as opiates.
  • Semi-synthetic opioids, such as heroin, oxycodone, and hydrocodone, which are chemically altered opiates.
  • Fully synthetic opioids, such as fentanyl and methadone

Narcotics are a hot topic right now because some have useful medical benefits but their unchecked use generated the opioid epidemic. Lawmakers, medical professionals, and families are struggling to find a balance between the important medical uses for these drugs and their disquieting potential for harm.

Where Do Narcotics Come From?

Narcotics originate from the opium poppy (Papaver somniferum). The word narcotic comes from the ancient Greek word “narkōtikos,” which means making stiff or numb. Opiates are derived directly from the opium poppy, but semi-synthetic opioids are a combination of organic and inorganic substances.

What Are Narcotics Used For?

Narcotics have some valid medical uses, including:

  • Pain management
  • Anesthesia
  • Reduction of respiratory distress for the dying
  • Sedation
  • Anti-diarrheal
  • Antitussives (cough suppressant)
  • Treatment of withdrawal and cravings in opioid-dependent individuals
  • Lowering blood pressure and reducing fluid flow through the heart during an acute heart attack

Narcotics are abused for their euphoric effects.

What Is An Illegal Narcotic?

In the United States, narcotics are classified into one of five schedules depending on their medical uses and abuse potential:

  • Schedule I: Drugs with no medical use and a high potential for abuse. Examples include heroin, LSD, marijuana and ecstasy
  • Schedule II: A medically useful drug but has a high potential for abuse. Examples include oxycodone, fentanyl, cocaine, Ritalin and methadone
  • Schedule III: Medically useful drugs with low to moderate potential for abuse. Examples include Tylenol 3s, ketamine and anabolic steroids
  • Schedule IV: Medically useful drugs with a lower risk of abuse. Examples include Darvon, most benzodiazepines, Ambien and tramadol
  • Schedule V: Medically useful drugs that contain some narcotic but have a low potential for abuse. Examples include cough medicines and antidiarrheals

Illegal narcotics are those that are listed as Schedule I drugs. They have no approved medical use and high abuse potential. However, other narcotics can be illegal. Possession or use of prescribed narcotics by someone other than the person they were prescribed for is illegal, even though the drugs are legal.

The same narcotic can have different legal statuses depending on how it is formulated and the amount present in the formulation. For example, codeine is a Schedule II substance, but when formulated with Tylenol it becomes a Schedule III substance; When in cough syrup, it becomes a Schedule V substance.

The production of a narcotic outside of FDA control makes that narcotic illegal. Consider fentanyl, which is a legally produced Schedule II pharmaceutical that is also widely synthesized illegally. Illicit production or possession of such narcotics is illegal.

How Do Narcotics Work?

Narcotics work by binding to opioid “receptors” in the brain. These receptors are on the surface of brain cells, and they are activated when a specific chemical binds to them. When activated, they give instructions to the brain cells.

Different types of receptors give different instructions when they are activated. When opioid receptors are activated, one of the things they do is to tell the nerves to slow down the transmission of pain signals. That function is what makes narcotics useful for addressing pain.

Unfortunately, when narcotics activate opioid receptors they also have other, unwanted side effects. One of those side effects is the activation of the brain’s reward system, which is the basis of the addictive properties of narcotics.

Most Common Narcotics

Narcotics themselves are common:

  • In 2017, 58.7 opioid prescriptions per 100 people were issued in the United States.
  • In 16% of American counties, enough narcotic prescriptions were issued for every man, woman, and child to have one
  • Two out of three drug overdose deaths involve a narcotic
  • 36% of narcotic overdose deaths involve narcotics obtained by prescription
  • More than 130 Americans die every day from a drug overdose, 46 of which are from prescription narcotics

The most widely prescribed narcotic in America is hydrocodone. Americans consume 99.7% of the world’s hydrocodone production. The second most-prevalent opioid in America is oxycodone, followed by prescription fentanyl.

List of Narcotic Drugs

There are three opiate drugs (opioids that are naturally produced by the opium poppy): morphine, codeine, and thebaine. Semi-synthetic opioids include:

  • Heroin
  • Hydrocodone
  • Hydromorphone
  • Oxycodone
  • Oxymorphone

New, fully synthetic opioids are developed all the time, especially derivatives of fentanyl. Synthetic opioids include:

  • Meperidine
  • Fentanyl
  • Sufentanil
  • Alfentanil
  • Carfentanil
  • Methadone
  • Propoxyphene

Are Narcotics Addictive?

Narcotics are highly addictive. Besides their intended effects of attenuating pain, they also cause some abnormal chemical changes in the brain that activate the brain’s reward system.

The brain has a system for rewarding people for positive behaviors, such as when we get a good meal when we are hungry or achieve something else necessary for survival. To encourage such necessary behaviors, the brain releases “feel-good” chemicals (neurotransmitters) that make us feel good when we achieve them.

Narcotics release huge amounts of neurotransmitters — about ten times that released by sex — which is why people who use the drugs feel high. Addiction occurs because this reward system has its intended effect: it gets the individual to repeat the behavior that resulted in the reward, in this case, the drug use.

As individuals are driven to use the narcotics repeatedly, tolerance develops. This is where it takes increasing amounts of the narcotics to get the same effect. Tolerance is a major feature of addiction and the main cause of the escalating drug use that is typical of addiction.

Another feature of addiction is withdrawal. When drug use stops, uncomfortable symptoms and cravings result. As tolerance develops, people who are addicted to narcotics get very little high from their drug use. Their continued use is largely to avoid withdrawal symptoms.

Commonly Abused Narcotic Drugs

Many people who are addicted to narcotics started with prescription opioids. Many people automatically think of heroin when they think of opioid abuse. However, data from the 2017 U.S. National Survey on Drug Use and Health shed some light on which narcotics are most commonly abused:

  • 97.2% of people who abuse narcotics use prescription opioids, versus 7.8% who use heroin (there is some overlap, so the numbers do not add up to 100)
  • 5.7% of people who abuse prescription narcotics got them from a dealer, the rest got them from prescriptions (either their own or someone else’s)

The most commonly abused prescription narcotics in the United States are:

  • Buprenorphine (31.7% of the total)
  • Methadone (19.7%)
  • Oxycodone (14.0%)
  • Fentanyl and hydrocodone (tied at 12.0%)
  • Codeine (10.5%)
  • Tramadol (9.5%)
  • Morphine (8.0%)

The most commonly abused illegal or illegally produced narcotics are heroin and fentanyl. The odd thing about fentanyl abuse is that most people who use fentanyl aren’t even aware of it. Fentanyl is widely used by dealers to increase their profits and increase the addictiveness of their products by making fake narcotics, including fake prescription pills.

One study found that 73% of people who tested positive for fentanyl were not even aware that they had been using the drug.

If you or a loved one struggle with addiction, contact The Recovery Village Palm Beach at Baptist Health today to speak with a representative about how professional treatment can help. Take the first step toward a healthier future, call today.

Medical Disclaimer: The Recovery Village Palm Beach at Baptist Health 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.