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What to know about opioid analgesics

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Opioid analgesics are medications that relieve and manage pain. They are the strongest form of prescription pain relievers and can be addictive. Practicing caution when taking them is important.
Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP
Written by D. M. Pollock
Updated on

Analgesics are medications that treat and manage pain, but they do not treat the underlying cause. They work by either reducing inflammation at the point of pain or changing the perception of pain in your brain.

There are three main types of analgesics:

  • non-opioid analgesics
  • compound analgesics
  • opioid analgesics

A doctor will usually recommend a non-opioid analgesic first. These include nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and ibuprofen.

Compound analgesics are medications that contain both a non-opioid component and an opioid. Acetiminopen-codeine and Percocet are examples of compound analgesics.

Prescription opioids are powerful pain medications. Most opioid analgesics are available as oral tablets or intravenous (IV) injections. They come in the form of natural, synthetic, or semi-synthetic drugs that target the opioid receptors of pain signals in the body and brain.

Read on to learn more about opioid analgesics, how doctors may prescribe them, and when to exercise caution when taking them.

What are opioid analgesics used for?

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Duet Postscriptum/Stocksy United

Doctors usually prescribe opioid analgesics for managing severe pain in the short term. They do not solve the condition but help manage pain, for example, while healing from surgery. Opioids are the most effective pain relievers available, and you need a prescription for them. They include the following medications:

Prescription opioids are safe for short-term use, provided a person takes them as their doctor instructs. However, because they produce euphoria alongside pain relief, they can be addictive.

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Types of opioid analgesics

Opioids come in many different forms that vary in strength. The three main types of opioids are as follows:

Natural opioids

Opiates or natural opioids come from the seeds of certain types of the poppy flower — specifically, the seed coating of Papaver somniferum.

Semi-synthetic opioids

These opioids are substances that are half natural and half synthetic. Scientists synthesize these medications in a laboratory. They derive them from natural plant-based medications like morphine and create more potent versions of these natural medications.

Synthetic opioids

Synthetic opioids are entirely lab-made. Many opioids are much stronger than their natural or semi-synthetic precursors. According to the Centers for Disease Control and Prevention (CDC), fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine.

While this extra strength increases the effectiveness of the medication for medical use, it can increase the risk of addiction. The CDC also reports that, on average, there are 150 daily fatalities due to synthetic opioids, such as fentanyl.

Opioid examples

There are many different types of opioids. Before prescribing opioids, your doctor will consider the type of pain you’re experiencing, your medical history, and whether you have a history of substance use disorder.

During treatment, healthcare professionals will evaluate the effect of opioids to assess their benefits against their risks. They will seek to determine whether a person needs to keep taking them.

Some examples of naturally derived opioids include:

  • Codeine: Doctors recommend codeine for various conditions, ranging from mild generalized pain to chronic diseases such as osteoarthritis and fibromyalgia.
  • Morphine (Kadian): Doctors may administer morphine through IV infusion, oral tablets, or epidurals. Morphine can help manage severe and acute pain, such as musculoskeletal or chest pain.

Some examples of semi-synthetic opioids include:

  • Oxymorphone (Opana): This drug is usually for use before surgery as a sedative to assist anesthesia. A doctor may administer this medication for severe pain.
  • Hydromorphone (Dilaudid): This medication is effective for severe pain management. Its high potency and addiction risk means that doctors will not prescribe it as a first line of treatment.

Examples of synthetic opiates include:

  • Methadone (Methadose): This medication helps manage pain, where treatment is palliative. It is also useful for treating people with opioid addiction disorders.
  • Fentanyl (Actiq): When a doctor prescribes fentanyl, it may be in the form of a skin patch, injection, or lozenge. It is primarily for post-operation care and severe pain.
  • Tramadol (Conzip): Tramadol is often effective in managing moderate to severe pain and is often available as an oral tablet.

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Warnings, misuse, and taking care of yourself

Taking opioids for however long poses a risk of addiction and overdose. However, you can take steps to minimize this risk and use opioids safely. This involves communicating clearly with your doctor. Some examples are as follows:

  • Let your doctor know about any prior history of substance misuse that you may have.
  • It’s important to follow the directions on the prescription of your medication, for example, dosage.
  • Ask your doctor whether it’s best to avoid certain substances with your prescription, such as alcohol, if applicable.
  • If you have any medications that you do not finish, dispose of them at a community drug take-back program or talk with a pharmacist about how to dispose of them safely.

The longer you take opioids, the more dependent your body can get on them. So, if taking them long term, you may need a higher dosage to reach the same level of pain management.

Withdrawal symptoms can occur if you suddenly stop taking opioids. Discuss with your doctor how to safely come off these medications. They may advise slowly reducing the dosage of opioids over some time.


There are many opioid medications for pain management that a doctor may prescribe. If you follow the instructions of a medical professional, these medications can be a safe and effective relief for acute and chronic pain.

Speak with your doctor to determine which medications may be most suitable for you and any concerns you may have about dependency.

If at any point you wish to stop an opioid medication, speak with your doctor so you can plan the best way to stop treatment for you.

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