Although many narcotic drugs and medications have similar effects or characteristics, each substance is unique. Here are some common examples.

From codeine to heroin, there are many narcotic substances. Some have medical uses and are available by prescription, while others do not.

The term “narcotic” originally referred to any substance that relieved pain and dulled the senses. Some people use the term to refer to all drugs — particularly illegal drugs — but it technically refers to opioids only.

Today, “opioid” is the preferred term, in part due to the connotations the term narcotic has.

Opiates are naturally occurring compounds. Opioids include naturally occurring compounds as well as semi-synthetic and synthetic compounds. Opiates are a subcategory of opioids.

Clinicians often prescribe opioid and opiate medications:

Opioid and opiate medications can cause many side effects, including:

The higher the dose, the more potent the medication.

Some of the most common opioid and opiate medications include:

  • Codeine: One of the most commonly used drugs worldwide, codeine is used to treat chronic pain. Doctors often prescribe it to people living with cancer and people with back pain, fibromyalgia, osteoarthritis, and headache.
  • Oxycodone: This medication may be used for acute or chronic pain.
  • Hydrocodone: This semi-synthetic opioid is typically used to treat severe pain and, in some cases, coughs.
  • Oxymorphone: A highly potent opioid, oxymorphone is used to help manage severe pain.
  • Morphine: This medication is used to manage pain in people with moderate or severe acute or chronic pain, particularly in cancer treatment and palliative care.
  • Fentanyl: A synthetic opioid, fentanyl is approximately 100 times more potent than morphine and 50 times more potent than heroin.
  • Hydromorphone: This medication is used to help manage moderate to severe acute pain and severe chronic pain. It’s very potent and has a high potential for misuse, so it’s usually only prescribed when other treatments have been unsuccessful.
  • Tramadol: This medication is used to treat moderate to severe pain, but it has a high potential for misuse. Doctors usually only prescribe it to manage pain when other treatments have been unsuccessful.
  • Methadone: A synthetic opioid, methadone is often used to treat substance use disorders.

What to do if your clinician prescribes a controlled substance

Your doctor or other healthcare professional may recommend a controlled substance to help treat an underlying health condition, like anxiety or insomnia.

They’ll work with you to determine the appropriate dose for your needs and advise you on any side effects or risks associated with use.

Different regions have different laws around prescription medication and other controlled substances. Familiarize yourself with the laws in your area to ensure you’re properly storing your medication.

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Some opioid and opiate substances aren’t prescribed by clinicians. They’re typically used for their pleasurable effects and have a high potential for dependence and misuse.

Common examples include:

  • Opium: This naturally occurring substance is derived from the opium poppy. It creates many different opioids, including heroin, codeine, and morphine. It’s a Schedule II controlled substance in the United States.
  • Heroin: Made from morphine, heroin often takes the form of white or brown powder or a sticky black substance. It’s a Schedule I controlled substance in the United States.
  • Lean: This is a liquid mixture of cough syrup containing codeine and soda. It’s also known as “purple drank” or “sizzurp.”
  • Carfentanil: Veterinarians use this medication to tranquilize large animals, like elephants and rhinoceroses. It’s a Schedule II controlled substance in the United States.

With substances like opioids, there’s always the potential for tolerance, dependence, and addiction. Although these terms are often used interchangeably, they’re not the same.

When you develop a tolerance to a substance, it becomes less effective. In time, you’ll need a higher dose to get the same effects.

When you develop a dependence, your body begins to rely on the substance to function. It’s not related to the dosage needed to feel the substance’s effects.

Caffeine, for example, can cause physical dependence. Some people develop a headache, have difficulty concentrating, or experience fatigue if they go more than a day or so without coffee or other sources of caffeine.

Addiction, in contrast, is a chronic dysfunction of the brain system involving memory, motivation, and reward. When it’s related to drugs, it’s sometimes referred to as a substance use disorder. It can be managed with treatment.

You can develop an addiction to a wide range of things, from over-the-counter substances — including caffeine, nicotine, and alcohol — to controlled substances.

Different substances have different thresholds for tolerance, dependence, and addiction.

Heroin, for example, has a high potential for addiction. People who use the substance often develop a tolerance, requiring a higher dose or more frequent use to produce the same effect.

Harm reduction and safer substance use

Harm reduction refers to various strategies implemented to reduce the negative consequences associated with drug use. Safer substance use refers to using substances in a way that minimizes harm.

This might include not using a substance while alone or having a trusted friend or loved one check in on you.

Understanding the effects of different substances, using only one substance at a time, and staying hydrated can also reduce your risk of harm.

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If you’d like to learn more, many organizations can help. And likewise, if you’re looking for support for yourself or somebody else, there are places you can go.

The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and treatment referrals. You can call the 24/7 helpline at 800-662-HELP (4357) to learn more.

The National Institute on Drug Abuse provides information and research on substances and substance use, including opioids.

The National Institute on Drug Abuse for Teenagers provides information and research for teenagers and young adults about substance use disorders.

The Centers for Disease Control and Prevention (CDC) offers information and support around opioid use.

Narcotics Anonymous (NA) offers support and meetings for people who experience substance misuse.

Adam England lives in the United Kingdom, and his work has appeared in a number of national and international publications. When he’s not working, he’s probably listening to live music.