Author: Ruben Bermea, LPC

Narcotic pain meds like oxycodone and hydrocodone are typically prescribed to manage moderate to severe pain. However, many people misuse them for their euphoric and relaxing effects. Narcotic painkillers are also commonly referred to as prescription opioids—contrary to what some may think, there is no difference between narcotic and opioid drugs.

Effects of Narcotic Painkillers

Opioids activate pain receptors throughout your body and central nervous system. By binding to opioid receptors in these different parts of your body, narcotic painkillers can relieve sensations of pain as well as increase feelings of well-being.

This rewarding experience can cause you to want to continue using these potent medications, even when you do not have a medical need for doing so. However, narcotic painkiller use can lead to serious side effects, including overdose and death.

Other effects of narcotic pain meds may include:

• Nausea, constipation
• Extreme sleepiness
• Confusion
• Increased sensitivity to pain
• Dry mouth
• Dizziness and drowsiness
• Depression
• Low levels of testosterone, which can result in reduced energy, strength and sex drive
• Itching
• Sweating
• Respiratory depression

Narcotic Pain Medications

Some narcotic pain meds are made from the opium poppy plant and others are synthetic, meaning they were made in a lab. This list includes some of the most common narcotic pain meds, or opioid painkillers

Codeine

Doctors may prescribe codeine to treat mild to moderate pain or in combination with other medications to treat a cough. Codeine manufacturers produce several codeine formulas and combinations and offer them under dozens of brand names. Codeine containing medications typically come in tablets, capsule or oral solutions. 

While codeine used to be available over the counter, it is now strictly controlled and only available by prescription.

Street names for codeine-based medications and combination narcotics include:

• Loads
• Schoolboy
• Coties
• Sizzurp
• Doors and Fours
• Purple Drank
• Captain Cody
• Lean
• Pancakes and Syrup

Fentanyl

Fentanyl, a synthetic opioid, was developed in 1959 for use in surgical anesthesia and for the treatment of severe and chronic pain. While fentanyl has an essential role in medicine, it is considered a Schedule II substance due to its potency and high likelihood for misuse, addiction and overdose risk. Though the effects of fentanyl are similar to those of other opioids included on this list, the potency (50 to 100 times stronger than morphine) of this opioid medication contributes to its unique risk for devastating health consequences.

Fentanyl formulas that the U.S. government has approved for pharmaceutical use include:

• Lozenges or “lollipops”
• Nasal sprays
• Mouth sprays
• Tablets
• Patches 
• Injectable solutions

Illicit manufacturers may sell fentanyl in powder or tablet forms, cut with drugs like cocaine, heroin, methamphetamine and MDMA with fentanyl, unbeknownst to the individual buying and using the drug. This often leads to overdoses since people don’t know they’re using fentanyl.

The methods of fentanyl misuse vary depending on the formula and include methods such as:

• Modifying patches
• Soaking blotter paper in fentanyl for oral consumption
• Snorting fentanyl
• Smoking this medication
• Injecting solutions
• Oral consumption of pills, tablets or capsules

People may sell or misuse fentanyl under street names such as:

• Lollipops
• Tango and Cash
• He-Man
• Jackpot
• Murder 8
• King Ivory
• Dance Fever
• China Town
• China Girl
• Friend
• Apache
• Great Bear
• Goodfellas

Hydrocodone

Hydrocodone is the most commonly prescribed narcotic pain medication in the United States. It is typically used to manage the symptoms of moderate to severe pain and is considered a Schedule II substance.
Some brand names for hydrocodone include:

• Norco
• Hysingla
• Vicodin
• Zohydro

Despite the government’s approval of hydrocodone use for medicinal purposes, the risk for misuse and addiction still exists, especially when people divert this medication for non-medicinal use. People may sell this medication under street names such as:

• Lorries
• Dones
• Idiot
• Droco
• 357s
• Bananas
• Pills
• Lemonade
• Veeks
• Scratch

Hydromorphone

Manufactured under the brand name Dilaudid, hydromorphone is another opioid medication that carries a high risk for misuse and addiction. When compared to morphine, hydromorphone has a significantly higher potency, risk for misuse and negative health consequences when abused.

Manufacturers have developed multiple hydromorphone formulas approved for medicinal use by the U.S. government, including:

• Rectal suppositories
• Oral solutions
• Injectable solutions
• Tablets
• Capsules

When purchased from illicit sources, hydromorphone may go by several street names, including:

• Juice
• Footballs
• Dust
• Smack
• D
• Dillies

Meperidine

Meperidine is a synthetic opioid that is used to treat short-term moderate to severe pain symptoms. Merperidine is not recommended for long-term use because of the likelihood of toxic metabolite accumulation, especially in the elderly or in individuals with kidney disease. Prescribers may offer this medication in tablet or liquid formulas.

Brand names for meperidine include:

• Demerol
• Isonipecaine
• Pethidine
• Demmies
• Pain Killer

Morphine

Morphine is used to treat pain, especially after surgery and cancer treatment and for the management of severe chronic pain. Several morphine formulas exist, including:

• Extended-release tablets
• Extended-release capsules
• Sublingual formulations
• Rectal suppositories
• Oral solutions
• Solutions for intravenous or intramuscular administration

Manufacturers market and sell this medication under several brand names, including:

• Oramorph SR
• RMS
• MSIR
• MS-Contin
• Roxanne
• Duramorph

The names for morphine sold on illicit or illegal markets can vary and may include:

• Unkie
• Emsel
• God’s Drug
• Morpho
• Mister Blue
• White Stuff
• Monkey
• First Line
• Dreamer
• Joy Juice

Oxycodone

Oxycodone is a semi-synthetic opioid medication that is used to treat severe acute pain, post-operative pain and chronic pain. Although it plays an important role in pain management strategies, it is considered a Schedule II drug and carries with it a very high potential for misuse. Manufacturers produce oxycodone in several formulas, including:

• Extended-release tablets and capsules
• Immediate-release tablets and capsules
• Liquid solutions

Prescribers who offer this medication for pain management may offer it under different brand names and formulas that combine oxycodone with other non-narcotic medications such as acetaminophen or ibuprofen.  Brand names for oxycodone-based medications include:

• Roxicet
• Percodan
• OxyIR
• OxyContin
• Percodan

Street names for oxycodone include:

• Hillbilly Heroin
• Percs
• Kickers
• Roxy
• Killers
• Buttons
• Beans
• Cotton
• Blues
• Ox
• OC
• Oxy
• 512s
• 40s
• 30s

Methods of oxycodone medication misuse may include:

• Smoking
• Injection
• Snorting
• Oral consumption

Oxymorphone

Oxymorphone is a semi-synthetic opioid medication that is three times more potent than oral morphine. It is used to treat severe pain.

When manufactured and sold illegally, this medication goes by several non-pharmaceutical monikers, including:

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

How Addictive Are Narcotic Pain Meds?

Narcotic pain meds fall under varying drug schedule classifications, ranging from Schedule V to Schedule II. Schedule V substances, such as cough medications with less than 200 mg of codeine, have the lowest potential for abuse and addiction, while Schedule II drugs like hydromorphone and oxycodone have a high potential for addiction. 

The U.S. National Institute of Health describes the process of opioid addiction as complex and the result of “a combination of genetic, environmental, and lifestyle factors, some of which have not been identified.”

Other factors relating to opioid addiction include:

• A history of substance misuse
• A history of psychiatric disorders
• Ease of access to opioid substances
• Poverty or other financial challenges
• Other lifestyle factors

If you have concerns that you or someone you know misuses opioids, call 800-934-1582(Sponsored) to find out about the range of treatment options in substance use recovery.

Resources

1. 1. U.S. National Library of Medicine. (2025). Codeine.
   2. U.S. National Library of Medicine (2025) Hydrocodone
   3. National Institute on Drug Abuse (2025, June) Fentanyl
   4. National Institute on Drug Abuse. (2025, April 10). Commonly used drug charts. 
   5. U.S. National Library of Medicine. (2025, October 15). Meperidine.
   6. U.S. National Library of Medicine. (2025, Septemer 15). Morphine.
   7. U.S. National Library of Medicine. (2025, September 15). Oxymorphone.
   8. Drug Enforcement Administration. (n.d.). Drug Scheduling.

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