What are the most common narcotic drugs? An Overview of Opioids

October 12, 2025 •

4 min read

In the United States, provisional data for 2024 shows an estimated 80,391 drug overdose deaths, with opioids accounting for almost 68% of these fatalities [1.4.2]. So, what are the most common narcotic drugs driving this crisis? This article breaks them down.

Quick Summary

An overview of common narcotic drugs, also known as opioids. It details widely used prescription medications like oxycodone and fentanyl, as well as illicit drugs such as heroin, and examines their risks.

Key Points

Definition: The term 'narcotic' is now commonly used to refer to opioids, which include prescription painkillers and illicit drugs like heroin [1.9.2].
Common Prescriptions: Frequently prescribed narcotic drugs include hydrocodone, oxycodone, morphine, and fentanyl, all of which carry a high risk for addiction [1.2.1].
Fentanyl's Potency: Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine, making it a major driver of overdose deaths [1.6.5].
Illicit Drugs: Heroin is an illegal opioid made from morphine, while illicitly manufactured fentanyl is often mixed with other drugs, increasing danger [1.5.1, 1.2.2].
Health Risks: Long-term use of narcotics can lead to physical dependence, organ damage, a weakened immune system, and an increased sensitivity to pain [1.11.2].
Overdose Statistics: In 2024, opioids were involved in nearly 68% of the estimated 80,391 drug overdose fatalities in the U.S. [1.4.2].
Treatment Options: Effective treatments for opioid use disorder include medications like methadone and buprenorphine, combined with behavioral therapy [1.7.1, 1.7.2].

Understanding Narcotic Drugs (Opioids)

The term "narcotic" originally referred to substances that dulled the senses [1.8.1]. Today, it is used more specifically to refer to opioids, a class of drugs that includes prescription pain relievers and the illicit drug heroin [1.9.2, 1.9.3]. Opioids can be derived from the opium poppy plant (natural), synthesized from natural opium products (semi-synthetic), or created entirely in a lab (synthetic) [1.8.1]. They work by binding to opioid receptors in the brain and spinal cord, reducing pain signals and producing feelings of euphoria [1.5.4, 1.11.1]. While medically effective for moderate to severe pain, their use carries a significant risk of addiction and overdose [1.2.1, 1.5.1].

Common Prescription Narcotic Drugs

Many narcotics are prescribed legally for pain management. However, these are often diverted and misused [1.2.2].

Oxycodone (OxyContin®, Percocet®)

Oxycodone is a powerful semi-synthetic opioid prescribed to treat moderate to severe pain [1.2.1, 1.2.2]. It is a Schedule II controlled substance, indicating a high potential for abuse and dependence [1.2.2]. It is available in various forms, including immediate and extended-release tablets [1.2.2]. Misuse can involve crushing tablets to snort or inject, which rapidly increases the risk of overdose [1.8.4].

Hydrocodone (Vicodin®, Norco®)

According to the Drug Enforcement Administration (DEA), hydrocodone is one of the most frequently prescribed and diverted opioid drugs [1.2.2]. It is often combined with other non-opioid pain relievers like acetaminophen. In 2014, it was reclassified as a Schedule II controlled substance to tighten regulation [1.2.2]. Besides pain relief, it also has cough suppressant properties [1.2.2].

Fentanyl

Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine [1.2.1, 1.6.5]. Medically, it is prescribed for severe pain, often for advanced cancer patients or post-surgery [1.2.1, 1.6.5]. However, illicitly manufactured fentanyl is a major contributor to the opioid crisis. It is often mixed with other drugs like heroin or cocaine, or pressed into counterfeit pills, with or without the user's knowledge, dramatically increasing the risk of fatal overdose [1.2.2, 1.6.5].

Morphine

Morphine is a natural opioid derived directly from the opium poppy plant and is a cornerstone of pain management in hospital settings [1.2.2]. It is used for both acute and chronic pain [1.2.2]. Many other semi-synthetic opioids, including heroin, are derived from morphine [1.2.2, 1.8.1]. Dependence can develop rapidly, and it carries a high potential for abuse [1.2.2].

Common Illicit Narcotic Drugs

Heroin

Heroin is an illegal, highly addictive semi-synthetic opioid processed from morphine [1.5.1, 1.8.1]. It is typically sold as a white or brownish powder, or a black, sticky substance known as "black tar heroin" [1.8.1]. Heroin is most commonly injected, which carries additional risks such as contracting HIV and hepatitis [1.5.1]. Its potency is often unknown, and it is frequently cut with other substances, including the powerful opioid fentanyl [1.5.1].

Comparison of Common Narcotic Drugs


Drug	Type	Medical Use	Common Brands	Relative Potency
Morphine	Natural Opiate	Severe pain relief	MS Contin®, Kadian®	Baseline standard [1.2.2]
Hydrocodone	Semi-Synthetic	Moderate to severe pain, cough	Vicodin®, Norco®	Similar to morphine [1.6.3]
Oxycodone	Semi-Synthetic	Moderate to severe pain	OxyContin®, Percocet®	Stronger than morphine [1.6.3]
Fentanyl	Synthetic	Severe pain, often post-surgery	Duragesic®, Actiq®	50-100x stronger than morphine [1.6.5]
Heroin	Semi-Synthetic	None (Illegal in U.S.)	N/A (Street Names: Smack, Junk)	2-5x stronger than morphine

Risks and Long-Term Effects

Opioid use, even when prescribed, comes with significant risks. Short-term side effects include drowsiness, confusion, nausea, constipation, and slowed breathing [1.5.4]. Slowed breathing, or respiratory depression, can lead to overdose and death [1.5.5].

Long-term use can lead to severe health consequences [1.11.2]:

Physical Dependence and Addiction: The body adapts to the drug, leading to withdrawal symptoms when it's stopped, and compulsive drug-seeking behavior [1.5.1].
Organ Damage: Chronic use, especially of combination products with acetaminophen, can cause liver damage. Kidney damage is also a risk [1.11.2].
Weakened Immune System: Users become more susceptible to infections [1.11.2].
Hormonal Disruption: Opioids can lower sex hormones, leading to issues like reduced libido and infertility [1.5.2].
Increased Pain Sensitivity: A condition called hyperalgesia can develop, where a person becomes more sensitive to pain [1.5.1].

Treatment for Opioid Use Disorder

Recovery from opioid use disorder (OUD) is possible and often involves a combination of medication and therapy [1.7.1]. Medications for Opioid Use Disorder (MOUD) include [1.7.2, 1.7.3]:

Methadone: A long-acting full opioid agonist that reduces cravings and withdrawal. It is dispensed through certified opioid treatment programs [1.7.4].
Buprenorphine: A partial opioid agonist that also reduces cravings and withdrawal symptoms. It can be prescribed in a doctor's office [1.7.1].
Naltrexone: An opioid antagonist that blocks the euphoric effects of opioids, helping to prevent relapse. A person must be opioid-free for 7-10 days before starting it [1.7.2].

Behavioral therapies like Cognitive-Behavioral Therapy (CBT) and counseling are crucial for addressing the behavioral aspects of addiction and developing coping skills [1.7.2]. Naloxone (Narcan®) is a life-saving medication that can rapidly reverse an opioid overdose [1.3.2].

Conclusion

The most common narcotic drugs are opioids, a class that includes vital prescription painkillers like morphine, oxycodone, and fentanyl, as well as the illicit drug heroin [1.9.2]. While effective for pain, their potential for addiction and overdose is extremely high [1.2.1]. The rise of potent synthetic opioids like illicitly made fentanyl has intensified the public health crisis [1.4.4]. Understanding these substances, their risks, and the available treatments is essential for addressing the widespread impact of opioid use and misuse.

Authoritative Link: Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline

Frequently Asked Questions

Today, the terms are often used interchangeably. 'Narcotic' is an older term that now primarily refers to opioids, a class of drugs that relieve pain and include prescription medications like morphine and fentanyl, as well as the illegal drug heroin [1.9.2].

Fentanyl is a synthetic opioid that is considered exceptionally potent, estimated to be 50 to 100 times stronger than morphine [1.2.1, 1.6.5].

Yes, tramadol is a synthetic opioid and is considered a narcotic used to treat pain [1.2.2, 1.2.3].

Common side effects include drowsiness, constipation, mental fog or confusion, nausea, and slowed breathing. Long-term use can lead to dependence, addiction, and organ damage [1.5.1, 1.5.2].

Yes, anyone who takes prescription opioids can become addicted. Even when taken as directed by a doctor, there is a risk of developing physical dependence and addiction [1.3.2, 1.5.4].

Both are powerful semi-synthetic opioids used for pain. Oxycodone is generally considered stronger than hydrocodone [1.6.3]. Hydrocodone is frequently combined with acetaminophen and is one of the most prescribed opioids in the U.S. [1.2.2].

Naloxone is a life-saving medication that can rapidly reverse the effects of an opioid overdose. It is an opioid antagonist and is available in forms like a nasal spray, which can be purchased over-the-counter [1.3.2, 1.7.1].