The 10 Most Addictive Painkillers

Why These Drugs Are Often Addictive

What is the most important information I should know about painkillers?

  • Many painkillers are habit-forming and can lead to addiction even when taken exactly as prescribed by a doctor.
  • Some of the most addictive painkillers include fentanyl, OxyContin, Demerol, hydrocodone, morphine, and Percocet.

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.

The National Institute on Drug Abuse (NIDA) notes that prescription opioid painkillers can lead to dependence and addiction even when taken as prescribed by a doctor. Opiate medications are habit-forming and can quickly lead to tolerance, dependence, addiction, and withdrawal symptoms.

This article discusses why these substances are so addictive, the signs and symptoms of opioid misuse, and the painkillers with the higher potential for 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 & symptoms of opioid use

Verywell / JR Bee  

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.

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Most Addictive Painkillers

These are the top 10 most addictive pain medications currently available, according to the National Institute on Drug Abuse. 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.



Man looking at tablets

Image Source / Stockbyte / Getty Images

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.

It has also become common for fentanyl to be used in counterfeit drugs or 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.

If you believe someone has overdosed on fentanyl or another opioid painkiller, call 911 immediately and administer naloxone if it is available. Naloxone is a medication that can reverse an opioid overdose if administered quickly enough.



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.



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.



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.



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.



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.



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.



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.



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 surgery). Dilaudid can also be given as an oral solution, tablet, and suppository.



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. The pill is blue and has an octagon shape.

Treatment for Painkiller Addiction

Even when addictive pain medications are prescribed for legitimate reasons, it is important to remain aware of their addictive potential. If you are concerned about any medication that you have been prescribed, talk to your doctor or pharmacist.

If you think you might be addicted to painkillers, treatments are available that can help. The type of treatment that is best depends on the individual, their symptoms, and their needs. In many cases, treatment may involve therapy, medication, or a combination of the two.


There are many different types of therapy that can be helpful in the treatment of addiction to painkillers. Some that are often used include:

  • Cognitive behavioral therapy (CBT): This approach to therapy involves identifying and changing the underlying thought patterns that contribute to addiction.
  • Motivational enhancement therapy (MET): This approach is focused on helping people improve their motivation to change their substance use.
  • Family therapy: This approach can be helpful for families who are affected by addiction and substance use disorders. It can also help improve relationships and allow family members to play a greater role in their loved one's recovery.
  • 12-step programs: This approach involves mutual support systems that help people work through a series of steps often focused on spiritual and personal recovery. 
  • Contingency management: This approach is often utilized in situations where a person's substance use has placed them in contact with the criminal justice system. It is a type of behavioral therapy in which people are positively reinforced for making positive behavioral changes. It often involves using monetary reinforcers in exchange for negative drug tests.


Medications may also be prescribed to treat addictions to painkillers. Some of these medications include:

  • Buprenorphine: This medication blocks opioid receptors in the brain in order to prevent withdrawal symptoms.
  • Methadone: This medication reduces opioid withdrawal symptoms and cravings. It also helps block the effects of opioids.
  • Naltrexone: This medication blocks opioid receptors and reduces the pleasurable aspects of opioid use. 

If you or a loved one are struggling with substance misuse or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. 

For more mental health resources, see our National Helpline Database.

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Additional Reading

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.