The word “narcotic” and the term “narcotic pain medications” are often used in the media, but what does narcotic mean? What are narcotic painkillers, how do they work, and what are the risks? Even for people who have a general understanding of narcotic pain medications, they may not fully understand how they work and how addictive they can be.
Narcotic pain medications are also called opioids. The term narcotic means that these medications have psychoactive properties and they can induce drowsiness or sleep. There are some misconceptions that the term narcotic is a blanket legal term, when in reality there are a lot of different drug classifications in the U.S. The term narcotic, while it does have negative connotations associated with it, doesn’t automatically indicate illegal drugs. For example, heroin is a narcotic that’s illegal in the U.S., but many prescription narcotics aren’t illegal.
While plenty of narcotic pain pills are technically legal, they are controlled substances. In the U.S. the DEA outlines controlled substances based on their potential to lead to abuse or addiction. There are different guidelines as to how these drugs can be prescribed and dispensed, and also different penalties for possessing them illegally. In the United States, narcotics are defined as substances derived from opium, as well as chemically synthesized substances that act similarly to opium.
There is a lot of variation in the potency of narcotic pain relievers, so they can be prescribed for different reasons. For example, a mild narcotic might be prescribed to treat acute pain from an injury or a dental procedure. More potent narcotics are reserved for chronic or end-of-life pain. One example of this would be a cancer patient who may take narcotics continually to manage pain.
During the 1990s, there was a surge in the prescribing of narcotic pills. One result of this now is that the U.S. is grappling with an opioid epidemic. In recent years, there has been a big push to further limit how and when narcotic pills are prescribed to patients. For example, some regulations have been introduced limiting how long someone can take narcotics, and how often they can be dispensed.
Narcotics for pain are classified together because they share mechanisms of action. Pain narcotics, whether naturally-derived or synthetic, are converted back to morphine when they cross the blood-brain barrier. Once they reach the brain, they bind to opioid receptors. This action triggers a release of dopamine and other brain chemicals that help change how the person senses pain. Narcotic pain pills raise the pain tolerance of the user, rather than eliminating the pain.
While that is the primary reason for use, narcotic pills can also cause a sense of euphoria in users. This is referred to as a high. For patients who take the dose prescribed and follow their physicians’ instructions, there may be no high. Unfortunately, some people experience euphoria which triggers addiction. Other people may recreationally abuse narcotic pain medicines solely to get high.
When narcotics bind to central nervous system receptors, they slow down the functions controlled by the CNS, including respiration. Shallow breathing can be a side effect of narcotic medications, as can slow heart rate and blood pressure. Other symptoms of using narcotics for pain can include nausea, vomiting, itching, confusion, and drowsiness.
Narcotic medications for most patients are only intended to be used when other options have failed. They are also meant as a short-term treatment for the majority of people because of the potential for abuse and addiction. Narcotic pain pills can be addictive because of how they affect the brain and trigger a sense of euphoria. Physical dependence is common as well. Someone who is physically dependent on narcotics isn’t necessarily addicted. However, if they stop using the drugs suddenly, they will experience symptoms of withdrawal.
Along with addiction and dependence, the potential for an overdose is one of the biggest dangers of using narcotics for pain. Fatal respiratory depression is possible, and even if someone doesn’t die from an overdose, they may be left with lasting health effects.
Narcotic painkillers are similar to heroin in many ways and heroin is classified as an opioid or a narcotic. Heroin works on the brain and the central nervous system in the same ways as prescription narcotics. It is also very addictive and can cause deadly overdoses. There has been an increasing number of instances in the past decade where people have started taking narcotic pain medicines, often for legitimate reasons, and those users then eventually became addicted to heroin. This is a big part of the opioid crisis in the U.S.
To combat the risk of addiction with narcotics, some drug makers have focused on time-release medications. These opioids are intended to release slowly into the system of the user, reducing the likelihood they’ll get high. Despite this effort, people have found ways to abuse these versions of narcotics as well, including by crushing them up and snorting them. This allows all of the potency of the medication to be released at one time.
Many prescription drugs can be identified as narcotics, but some of the most common include:
- Fentanyl (Available in brand-name drugs including Actiq and Duragesic)
- Hydrocodone (Available in brand name drugs including Zohydro ER)
- Hydrocodone/acetaminophen combinations (Available in Vicodin, Norco, and Lortab)
- Oxycodone (Available as OxyContin and Oxyado)
- Oxycodone/acetaminophen combinations (Available as the brand names Percocet and Roxicet)
Abuse of narcotic pain medications is difficult and addiction to this class of drugs is complex and challenging to overcome, but it is possible. At The Recovery Village, we work with patients who are addicted to prescription narcotics, and we understand the unique elements of this kind of addiction. If you or a loved one is struggling with narcotic pain pills, we can speak with you anytime.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.