Types Of Opiates: The 6 Most Common Addictive Painkillers

Opioids are potent painkillers that deliver where other options simply can't offer enough relief — in cases of life-limiting chronic pain, cancer, and to get you through the acute pain you may suffer from after undergoing surgery. They also belong to the same family as heroin, and besides the fact that they can induce a high, they've got a wicked addictive potential.

With time, users or abusers — who may have a medical prescription or could have gotten their opioid fix off the street — need more and more to achieve the same effect. Because long-term opioid use alters brain functioning so that you basically function "as normal" while on the drug and not while you're off it, withdrawal can be brutal. 

An ABC of opioid painkillers

Some of the most common opioid painkillers on the market include:

1. Codeine may be offered to people suffering from mild to moderate pain as well as to suppress coughs. Often combined with other medications such as aspirin, acetaminophen, and Ibuprofen, it's available under many brand names, including Aspalgin, Nurofen Plus, and Panalgesic. 
2. Hydrocodone is meant for people suffering from moderate to extreme pain, as well as to relieve coughs. Again, it's often combined with other medications and around under a variety of brand names, such as Vicodin, Lortab, and Hycodan. Hydrocodone is currently the most often-prescribed opioid painkiller in the US. 
3. Oxycodone, which also goes by OxyContin, Percodan (together with aspirin), and Roxicet (together with Tylenol), can be prescribed for moderate to extreme pain. 
4. Hydromorphone can be prescribed to relieve moderate pain.
5. Morphine is, again, meant for moderate to severe — and often chronic — pain that can't be relieved by less heavy medications. 
6. Fentanyl, which is around a hundred times stronger than morphine and 50 times more powerful than heroin, is extremely serious stuff. Used mainly to treat cancer patients who have severe episodes of pain despite already being on other opioids, fentanyl should be prescribed with particular caution. 

What should you know if your doctor hands you an opioid prescription?

Over 11 million people are estimated to misuse opioids every year in the US alone. This may mean that they use more than their doctor told them to, that they exaggerate pain symptoms to get a prescription, that they take opioids prescribed to other people, or that they buy the drugs on the black market instead of getting them from the doctor. Around two million US residents suffer from an opioid use disorder — an addiction. Tens of thousands of people die from opioid overdoses every year. 

Opioid painkillers may, depending on your medical condition, be the right option for you — but if you take opioids, that addictive potential is always there. Should your doctor have put opioids on the table, have a very serious discussion with them. It should include:

• A talk about any family or personal history of substance abuse, as the presence of such a history puts you at a higher risk of becoming addicted.
• A frank discussion about the advantages vs disadvantages of opioids, for you personally. 
• A look at alternative pain management options. 
• A look at medical conditions, alcohol use, other (prescription) medications you may be taking, and whether you're pregnant, breastfeeding, or planning to become pregnant. 
• A plan for safe use, and an emergency plan on what to do if you may feel like abusing the opioid you were prescribed. 

What are the signs of an addiction to opioids?

You may be in trouble if you stop using your opioid exactly as prescribed and use it more often, start crushing or dissolving your tablets, go about obtaining the painkiller from sources other than your pharmacy, or feel like you want to talk your doctor into prescribing more than you need to manage your pain. 

Addicts often try to cut down on their use unsuccessfully, but crave the painkiller to the point they can't really control themselves. Their life starts to revolve around using, obtaining, and recovering from using their opioid painkillers. They may use even when it's dangerous — like in combination with prescription medications that should never be used together with opioids, or while operating heavy machinery. Their opioid use may be interfering with their social relationships or daily responsibilities, and they know this but they still can't stop. 

How can you safely get off opioid painkillers?

The risk of addiction increases when you have been using opioids for a long time, even under medical supervision. Short-term use of the lowest doses possible is unlikely to cause an addiction, but chronic pain patients are indeed at risk. 

When it's time to stop using — because you have suffered a non-fatal overdose, for instance — talk to your doctor about the best way to do it. This typically involves tapering off gradually, and that concretely means reducing your dosage by 10 percent a week if you've been taking opioids for a short time, and by 10 percent a month if you have been using opioid painkillers for years. 

The drug naxalone may be used to counter the effects of opioids and reduce a person's risk of overdosing, but people who have trouble getting off opioids or who have been misusing them will also need adequate social and mental support, including counseling.