The 10 Most Addictive Pain Killers

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.

Addictive 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 not entirely free from the 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 addicting to some patients. The National Institute on Drug Abuse (NIDA) explains that some people become psychologically dependent on this feeling of euphoria. There is also the risk of physical dependence.

Dependence is most likely to happen if a person takes a higher dose of their pain medication than they were prescribed or if the medication was improperly prescribed.

Pain medication over-use (sometimes called medication abuse or narcotic abuse) is one of the most prevalent forms of drug misuse in the United States.

One of the reasons for the prevalence is that 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 dependency can lead to seeking pain medications on the black market or using illicit opiates such as heroin.

The NIDA explains that the current issue of narcotic misuse in the U.S. started in the late 1990s when "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. On average, 115 people die from an opioid overdose in the U.S. every day.

Between July 2016 and September 2017, there was a 30% to 70% increase in heroin overdoses throughout the country. 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 Centers for Disease Control and Prevention (CDC), the first line of defense is reducing the number of opioids that are prescribed. This initiative involves working with physicians and pharmacies to ensure that they only use powerful painkillers when absolutely necessary.

Signs and Symptoms of Opioid Misuse

Unfortunately, it is part of the nature of painkillers that they become less effective over time. This is partly because your body will adjust to the medication and develop a tolerance, which means your body will require higher doses of the drug to get the same effect.

There are certain signs that your therapeutic use of opioids has crossed into the territory of addiction.

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 same effects that you used to experience at lower dosages (especially if snorting or injecting the drug might be required to get the desired effect)
  • Using pain medication in amounts or at times that are not consistent with your doctor's prescription—especially if you are misleading your doctor or pharmacist to do so

If you recognize these behaviors or are concerned about your use of pain medication, it's important to talk to your healthcare provider.

Opioid Addiction Discussion Guide

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Most Addictive Painkillers

According to the NIDA, these are the top 10 most addictive pain medications that are currently available. 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.

1

Fentanyl

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, the drug might also be obtained illegally. Common street names for fentanyl include:

  • Apache
  • China Girl
  • China White
  • Dance Fever
  • Friend
  • Goodfella
  • Jackpot
  • Murder 8
  • Tango and Cash
  • TNT

It has also become common for fentanyl to be used in counterfeit drugs or be cut into illicit drugs such as heroin and cocaine. This practice adds to the dangers of these drugs because users are often unaware that they contain fentanyl.

2

OxyContin

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 of time.

OxyContin is sometimes called O.C., Oxycet, Oxycotton, Oxy, or Hillbilly Heroin when it is sold illegally on the street.

3

Demerol

Demerol is a brand name for meperidine. This pain medication is often used with anesthesia. Demerol is also used to treat moderate to severe pain (such as that which can be experienced after childbirth). It is available as an oral solution, injectable solution, and oral tablet.

Street names for Demerol include Demmies and Pain Killer.

4

Hydrocodone

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 oral tablet.

When it is sold on the black market, hydrocodone is sometimes called Vike or Watson-387.

5

Morphine

Morphine is a natural opiate that is sold under the brand names Duramorph and MS Contin. It is prescribed to treat severe and ongoing pain (such as pain related to cancer or cancer treatment). Morphine can be given in several forms, such as an injectable solution, capsule, tablet, and suppository.

Morphine is often simply called "M" on the street, though it's also known as Miss Emma, Monkey, and White Stuff.

6

Percocet

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.

On the street, it is sometimes called Hillbilly Heroin or simply "Percs."

7

Codeine

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.

Codeine is sold under many brand names and both the drug itself and its many varieties have a number of street names, including:

  • Captain Cody
  • Cody
  • Lean
  • Schoolboy
  • Sizzurp
  • Purple Drank
8

Methadone

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.

Street names for methadone include Amidone and Fizzies. When it is used with MDMA, it is known as Chocolate Chip Cookies.

9

Dilaudid

Dilaudid is a brand name for hydromorphone. It is intended for short-term pain relief and mostly used in a hospital setting where it can be administered through an IV (most often following a surgery). Dilaudid can also be given as an oral solution, tablet, and suppository.

When used illicitly, Dilaudid is often simply called "D." It is also known as Dillies, Footballs, Juice, and Smack.

10

Oxymorphone

Oxymorphone is sold under the brand names Opana, Numorphan, and Numorphone. It is prescribed to treat moderate to severe pain.

The opiate comes in both immediate- and extended-release tablets. The pill is blue and has an octagon shape. The drug's most common street names reflect its appearance:

  • Biscuits
  • Blue Heaven
  • Blues
  • Mrs. O
  • O Bomb
  • Octagons
  • Stop Signs

A Word From Verywell

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

If you or a loved one are struggling with substance use 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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Article Sources
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Additional Reading
  • National Institute on Drug Abuse. Which Classes of Prescription Drugs Are Commonly Misused?. 2018.

  • Centers for Disease Control and Prevention. Opioid Data Analysis. 2017.
  • Centers for Disease Control and Prevention. Improve Opioid Prescribing. 2017.
  • National Institute on Drug Abuse. Commonly Abused Drug Charts. 2018.
  • National Institute on Drug Abuse. Opioid Overdose Crisis. 2018.