Opioids are drugs that people use to treat pain and certain other complaints. Opioids can derive from natural sources, and people can make them synthetically. There are several types of opioids available, some of which are illegal.

People mainly use opioids as pain relief medications. A person can purchase cough syrup containing codeine, which is an opioid, without a prescription. However, only doctors can prescribe stronger opioids.

Misusing opioids can cause a person to become addicted to or physically dependent on them. The United States government classes many opioids as controlled substances.

Authorities class some illegal drugs, such as heroin, as opioids. Misusing legal or illegal opioids can lead to serious side effects and even death.

This article will explore what opioids are, the different types of opioids, and how to get help for addiction or overdose.

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Opioids are drugs that occur naturally in the opium poppy plant. People can also make certain opioids using the opium poppy itself. Manufacturers make synthetic opioids by using the chemical structure of the opium in the poppy.

Most people use opioids to treat pain. People can also use opioids to treat conditions such as coughing.

Opioids can trigger a large release of dopamine within the body. Dopamine is a neurotransmitter, which is a chemical messenger that transmits signals from nerve cells to other cells in the body.

Dopamine plays an important role in a person’s mood and can help a person feel happy.

Various classifications of opioids exist. Some opioids are available over the counter, while some are only available with a prescription. Opioids that the Food and Drug Administration (FDA) has not approved for medical use are illegal to possess or take.

The following sections will look at some different classifications of opioids in more detail.

Prescription

A doctor may prescribe a person opioids for pain relief.

Prescription opioids can also cause feelings of euphoria and relaxation. It is important that a person follows the doctor’s advice when taking opioids.

Schedule II

The Drug Enforcement Administration (DEA) classes drugs into five different categories, or Schedules. The Schedule classification that a drug falls into depends on its:

  • use as a medication
  • likelihood to be misused
  • likelihood to cause dependency

The lower the Schedule number, the more dangerous the drug is.

There are several types of opioids that the U.S. government classes as Schedule II drugs. Schedule II drugs have a high potential for misuse. Additionally, Schedule II drugs have the potential to cause severe psychological or physical dependence.

Many prescription opioids are classed as Schedule II drugs. If a doctor prescribes a person a Schedule II opioid, it is important that they follow the doctor’s advice when taking it.

A person should never share their prescribed medication with anyone else. Not only is this against the law, but it can also be extremely dangerous.

Illegal

Illegal opioids include those that are illegal to use in any capacity and those that are illegal without a prescription.

Illegal opioids have no medical indication. People can misuse these, placing them at increased risk of addiction. Misusing illegal opioids can lead to severe side effects, including liver disease, overdose, and death.

Each type of prescription opioid is available under a brand name. Illegal opioids usually have multiple different informal or slang names. Law enforcement officials and others sometimes call these informal names “street names.”

The following sections will look at some of these names in more detail.

Prescription

Prescription opioids can be opioid-only drugs, or they can contain additional drugs. The addition of other drugs in opioid combination products can help with pain relief or other symptoms.

There are various types of prescription opioids available, including those in the table below.

Generic nameBrand namesForms
OxycodoneOxyContin, Roxicodone, Percocet, Oxaydo, XtampzaTablet, extended-release tablet, capsule
HydrocodoneVicodin, Norco, Lortab, Zohydro ER, Hysingla ERTablet, extended-release tablet, capsule, syrup, solution, suspension
CodeinePrometh VCTablet, syrup, injection
MorphineMS Contin, Kadian, DuramorphTablet, extended-release tablet, extended-release capsule, solution, injection, rectal suppository
HydromorphoneDilaudidTablet, extended-release tablet, solution, rectal suppository
Fentanyl Actiq, Fentora, Duragesic, Subsys, Lazanda, Sublimaze Tablet that dissolves in the mouth, lozenge, mouth spray, nasal spray, patch on the skin, injection
MeperidineDemerolTablet, syrup, injection
Opium tincture (Rx only)N/ATincture
TramadolUltram, Ultracet, ConzipTablet, extended-release tablet, capsule
BuprenorphineBuprenex, Butrans, Probuphine, Belbuca, Suboxone, Zubsolv, BunavailTablet or film that dissolves in the mouth, implant, injection, patch on the skin
ButorphanolStadolNasal spray

Generally, only doctors can administer injections of Schedule II opioids.

Illegal

People cannot legally make, sell, or distribute illegal opioids. For this reason, illegal opioids do not have brand names.

However, there are some common alternative names for certain illegal opioids, including those in the table below.

Generic nameOther namesForms
HeroinDope, smack, H, junk, snow, skag, horse, China white, brown, beast, heroPowder, tar-like substance
DesomorphineKrokodilPowder
CarfentanilDrop dead, C 50, serial killerPowder
OpiumAunti, Aunti Emma, big O, black pill, chandu, Chinese molasses, dopium, dream gun, gee, fi-do-nie, guma, midnight oil, zeroLiquid, powder, solid block

Carfentanil is a drug that people use to sedate large animals, including bears and elephants. It is illegal for a human to consume carfentanil.

“Opioid” is an umbrella term that covers both synthetic and natural opioid drugs.

On the other hand, “opiate” only refers to natural drugs derived from the opium poppy. This means that all opiates are a form of opioid, but not all opioids are opiates.

Prescription opioids are generally safe to take for short periods of time. However, due to their effect on pain levels and mood, prolonged use may lead to physical dependence. When a person has a physical dependence on a drug, they cannot function normally without it.

According to 2016 information from the Centers for Disease Control and Prevention (CDC), over 11.5 million people in the U.S. reported misusing prescription opioids in the previous year.

Illegal opioids are prone to misuse, and misuse increases a person’s risk of developing an addiction. According to the 2019 National Survey on Drug Use and Health, around 745,000 people in the U.S. had used heroin during the past year.

A person who uses opioids regularly or who knows someone who does should look out for signs of addiction. Doctors call this opioid use disorder.

The sections below will look at opioid use disorder and overdose in more detail.

Opioid use disorder

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the 11 criteria for diagnosing opioid use disorder are as follows:

  • The person often takes opioids in larger doses or over a longer period of time than they may intend.
  • The person has a persistent desire to cut down or control opioid use or has experienced unsuccessful efforts to do so.
  • The person spends a great deal of time on activities necessary to obtain the opioid, use the opioid, or recover from the opioid’s effects.
  • The person has cravings for opioids. A craving is a strong desire to use something.
  • The person experiences recurring opioid use that results in not being able to fulfill major role obligations at work, school, or home.
  • The person experiences continued opioid use despite having recurrent or persistent interpersonal or social problems that are caused or made worse by the effects of opioids.
  • The person reduces or completely gives up important social, occupational, or recreational activities due to their opioid use.
  • The person experiences recurring opioid use in situations wherein opioid use poses a physical hazard.
  • The person experiences continued use despite knowing that they have a persistent or recurrent physical or psychological problem that opioids have likely caused or made worse.
  • The person has developed a tolerance, as defined by either of the following:
    • a need for markedly increased amounts of opioids to achieve intoxication or the desired effect
    • a markedly diminished effect with continued use of the same amount of an opioid
  • The person experiences withdrawal, as manifested by either of the following:
    • the characteristic opioid withdrawal syndrome
    • taking the same, or a closely related, substance to relieve or avoid withdrawal symptoms

People should watch out for the signs listed above in themselves and others, and they should speak with a doctor if they think that they or someone else may be displaying any signs of opioid use disorder.

Overdose

Overdosing can be a serious side effect of opioid misuse. According to the CDC, around 70% of drug overdose deaths in 2019 involved an opioid.

Some symptoms of opioid overdose include:

  • pinpoint pupils
  • unconsciousness or unresponsiveness
  • difficulty breathing

A person should seek immediate medical attention for someone with these symptoms. Emergency responders can use naloxone to reverse the effects of an opioid overdose.

Although opioid addiction can be difficult to overcome, help is available. The Substance Abuse and Mental Health Services Administration has a directory of opioid treatment programs by state.

Treatment for opioid addiction can include medication and behavioral therapies. Having support from family and friends can also help.

Learn more about what to do if someone has experienced an opioid overdose here.

Opioids are drugs that derive from the opium poppy. Opioids can be natural or human-made. Natural opioids are called opiates.

Although opioids are effective pain relievers, people may become dependent on them or develop an addiction. A person should always follow a doctor’s advice when taking opioids.

There are many different types of opioids available. Certain opioids are legal to use with a prescription, whereas others are illegal to use or sell.

If a person experiences symptoms of opioid addiction, they should speak with a doctor. If a person notices any symptoms of an opioid overdose in another person, they should seek medical help immediately.