The 10 Most Addictive Pain Killers

The New Generation of Addictive Medications

One of the most common reasons Americans visit their doctors is to get help with the relief of pain. The pain can be debilitating and cause great comfort or distress. Quite often, doctors prescribe opioid pain relievers to help their patients. However, a number of these medications also have the potential to become misused or addictive.

Addictive Pain Relievers

There are a number of different drugs that can ease chronic and short-term pain. Many of these fall into the opioid category, also known as narcotic pain relievers. These drugs include morphine and codeine, as well as many synthetic modifications of these drugs.

It is important to be cautious when taking pain relief medications. The treatment may be more dangerous than the underlying cause of the pain. You are less likely to become addicted to pain-relieving drugs when taking them as prescribed for their intended purpose. Yet, many of these medications also produce a "high" that can become addicting to some patients. 

It is this feeling of euphoria that the National Institute on Drug Abuse (NIDA) says that some people become dependent on. It is most likely to happen when someone takes a higher dose than they were prescribed or if they are improperly prescribed the medication.

Pain medication over-use (sometimes called medication abuse or narcotic abuse) has become one of the most prevalent forms of drug abuse in the United States. One of the reasons is that these medications are sometimes over-prescribed. In some cases, someone may not really need such strong pain relief and, in other cases, it's prescribed for longer than it's truly needed.

The Opioid Crisis

Prescription opioid addictions have risen substantially. What begins as a dependency may lead to finding the medication on the black market or seeking out illegal opiates such as heroin. The NIDA notes that it began 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 estimates that between 8 percent and 12 percent of patients in the U.S. who are prescribed opioids develop a use disorder. Of them, 4 percent to 6 percent eventually turn to heroin and, on average, 115 people die every day in the U.S. from an opioid overdose. Between July 2016 and September 2017, there was a 30 percent to 54 percent increase in overdoses in various parts of the country. It is an epidemic that has hit rural America as hard as the cities.

This has led to initiatives by multiple government agencies to curb the epidemic. According to the Centers for Disease Control (CDC), the first line of defense is reducing the number of opioids prescribed. This involves working with physicians and pharmacies to only use such powerful painkillers when absolutely needed.

Signs and Symptoms of Opioid Abuse

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. These include:

  • Knowing that you're using the pain medication in amounts or at times that are not consistent with your doctor's prescription. This is especially true if you are misleading your doctor or pharmacist to do so.
  • Using the medication to get high or relieve anxiety rather than to relieve pain.
  • Requiring higher doses of the medication in order to feel the same effects you used to notice at lower dosages. In worst case scenarios, turning to snorting or injecting the drug to feel its effects.
  • Exhibiting compulsive behaviors to get the drug and continue to use it in the face of negative consequences.

Most Addictive Painkillers

The following is a list of the 10 most addictive prescription opiates available on the market today according to the NIDA. Most are usually prescribed for the treatment of chronic pain, though some are intended for short-term use. It is not a complete list, and many more addictive painkillers and other prescription medications are available.

1
Fentanyl

Man looking at tablets
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More potent than morphine, fentanyl (brand names include Actiq, Duragesic, and Sublimaze) is used most often to treat patients with severe or post-surgical pain. It is also used for those who have become physically tolerant of opiates. It's available as a lozenge, injectable solution, or skin patch.

Street names for fentanyl include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, Tango and Cash, and TNT. It has also become common for fentanyl to be used in counterfeit drugs and to be cut into illegal drugs such as heroin and cocaine. This adds to the dangers of these drugs because users are often unaware of the fentanyl.

2

OxyContin is a brand name for oxycodone. It is used as an around-the-clock treatment for patients with moderate to severe pain expected to last for an extended period of time. It's available as a tablet.

On the street, OxyContin may be called O.C., Oxycet, Oxycotton, Oxy, or Hillbilly Heroin. 

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3

Demerol is a brand name for meperidine. This pain medication is often used to help put people to sleep before a surgical procedure. It is also used to treat moderate to severe pain, such as that experienced after childbirth. Demerol is available as an oral solution, injectable solution, and oral tablet.

Street names for Demerol include Demmies and Pain Killer.

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4

Hydrocodone (brand names include Vicodin, Norco, and Zohydro, among others) is used to treat moderate to severe pain resulting from a chronic condition, injury, or surgical procedure. It's available as an oral syrup and oral tablet.

When sold on the black market, it may be called Vike or Watson-387.

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5
Morphine

Morphine is a natural opiate that is sold under the brand names Duramorph and MS Contin. It is prescribed to help treat severe ongoing pain such as that related to cancer or cancer treatment. This painkiller is available as an injectable solution, capsule, tablet, and suppository.

You may hear morphine simply called M on the street, though it's also known as Miss Emma, Monkey, and White Stuff.

6

Percocet is similar to OxyContin. It contains a combination of acetaminophen and oxycodone and is available as a capsule, tablet, and oral solution.

On the street, it may also be called Hillbilly Heroin or simply as Percs.

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7
Codeine

Codeine is a natural opiate that is a commonly prescribed pain reliever. The effects only last for a few hours, so it is often prescribed along with acetaminophen or aspirin. Codeine is available as a tablet, capsule, or liquid.

Many brand names are sold and codeine has many street names, including Captain Cody, Cody, Lean, Schoolboy, Sizzurp, and Purple Drank.

8

Methadone is most often associated with people who are trying to safely quit a heroin addiction. It is, however, used as an opiate pain reliever and it can be misused as well. Brand names include Dolophine and Methadose and it comes in tablet and liquid forms.

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

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9

Dilaudid is a brand name for hydromorphone. It is mostly used in a hospital setting and administered through an IV following surgery. Dilaudid is intended for short-term pain relief and is also available as an oral solution, tablet, and suppository.

In illicit uses, Dilaudid may simply be called D or known by the names Dillies, Footballs, Juice, and Smack.

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10

Oxymorphone is sold under the brand names Opana, Numorphan, and Numorphone. It is prescribed to treat moderate to severe pain and is available in both immediate- and extended-release tablets.

This opiate is blue and has an octagon shape, so its street names reflect this: Biscuits, Blue Heaven, Blues, Mrs. O, O Bomb, Octagons, and Stop Signs.

A Word From Verywell

Even though they are prescribed medications for legitimate reasons, it is important to be aware of the addictive potential of these pain relievers. If you have a concern about any medication you're prescribed, talk to your physician or pharmacist.

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View Article Sources
  • Centers for Disease Control and Prevention. Improve Opioid Prescribing. 2017.
  • Centers for Disease Control and Prevention. Opioid Data Analysis. 2017.
  • National Institute on Drug Abuse. Commonly Abused Drug Charts. 2018.
  • National Institute on Drug Abuse. Opioid Overdose Crisis. 2018.
  • National Institute on Drug Abuse. Which Classes of Prescription Drugs Are Commonly Misused? 2018.