Narcotics

Opioid Analgesics

• Strong pain-relief medication

• Work by attaching to opioid receptors in the brain + spinal cord, which blocks pain signals

• Used for moderate to severe pain

• Must be used carefully and exactly as prescribed because they can cause dependence, drowsiness, and slowed breathing

Tramadol

Trade Name: Vitram, Vitracet; Classification: Opioid analgesic (synthetic), SNRI-like activity; Indication: Moderate Pain; Notes: Schedule IV, low risk for dependence and misuse

Codeine

Trade Name: Codeine; Classification: Opioid analgesic; Indication: Mild to Moderate Pain; Notes: Schedule II, schedule III-IV in combination. For pain as a cough suppressant. Found in combination with acetaminophen. Less potent than both hydrocodone + oxycodone.

Hydrocodone

Trade Name: Vicodin, Norco; Classification: Opioid analgesic; Indication: Moderate to Severe Pain; Notes: Schedule II. Found in combination with acetaminophen. Slightly less potent than oxycodone. High risk for dependence + abuse.

Oxycodone

Trade Name: Oxycontin, Percocet; Classification: Opioid analgesic; Indication: Moderate to Severe Pain; Notes: Schedule II. Found in combination with acetaminophen. Oxycontin is long-acting. High risk for dependence + abuse.

Meperidine

Trade Name: Demerol; Classification: Opioid analgesic; Indication: Moderate to Severe Pain; Notes: Schedule II. Less common due to potential for toxic metabolite accumulation which can cause seizures.

Oxymorphone

Trade Name: Opana; Classification: Opioid analgesic; Indication: Moderate to Severe Pain; Notes: Schedule II. High potency. High risk for dependence + abuse.

Morphine

Trade Name: Morphine; Classification: Opioid analgesic; Indication: Severe Pain; Notes: Schedule II. Available in many forms (oral, IV). High risk for dependence.

Fentanyl

Trade Name: Duragesic, Sublimaze; Classification: Opioid analgesic, Semi-Synthetic; Indication: Severe Pain; Notes: Schedule II. Often used in transdermal patches or IV. High risk of overdose and dependence. Extremely potent; even small variations in dose can be fatal.

Hydromorphone

Trade Name: Dilaudid; Classification: Opioid analgesic; Indication: Severe Pain; Notes: Schedule I. Very potent. High risk of dependence and abuse.

Methadone

Trade Name: Methadone, Dolophine; Classification: Opioid analgesic; Indication: Chronic Pain; Notes: Schedule I. Long Acting, used for chronic pain opioid dependence. Methadone has a very long half-life, requires specialized titration, careful monitoring.

Tylenol with Codeine; Tylenol #3, #4 (Combination Medication)

Acetaminophen-codeine

Lorcet, Lortab, Norco, Vicodin (Combination Medication)

Hydrocodone-acetaminophen

Endocet, Percocet (Combination Medication)

Oxycodone-acetaminophen

Endodan, Percodan (Combination Medication)

Oxycodone-aspirin

Cambunox (Combination Medication)

Oxycodone-ibuprofen

Talwin NX (Combination Medication)

Pentazocine-naloxone