There are several narcotic prescription drugs (pain killers) that usually can provide stronger pain relief than aspirin. These include the four broad classes of opioids: endogenous opioid peptides, produced in the body; opium alkaloids, such as morphine (the prototypical opioid) and codeine; semi-synthetic opioids such as heroin and oxycodone; and fully synthetic opioids such as pethidine and methadone that have structures unrelated to the opium alkaloids. Common pain killers are: Codeine, Morphine, Hydrocodone, Lorcet, Lortab, Zydone, Hydrocet, Oxycontin (Oxycodone), Percodan (Percocet), Darvon (Darvocet), and Vicodin (Vicoprofen).

Opioid pain killers can be administered in a variety of ways. Some are taken orally, transdermally (skin patches) or injected. They are also available in suppositories.

About Narcotic Pain Killers:

1. Narcotics

The United States legal definition of narcotics refers to opium, opium derivatives, and their synthetic substitutes. Some illegal drugs that are classified as "narcotics" in the U.S. Controlled Substances Act (CSA), are technically not narcotics. The term is often used inaccurately outside of medical contexts. Typically the more precise term opioid is used for all medicines that behave pharmacologically like morphine, the primary chemical in opium.

The effects of narcotic use may include drowsiness, itching, insomnia, constricted pupils, constipation, nausea, vomiting and possible respiratory depression. The effects become more pronounced with an increased dose. Usually there is no loss of motor skills or slurred speech that is commonly associated with many depressants.

All narcotic drugs have some potential for abuse and may have unpleasant and even harmful side effects, as reported in the FDA (Federal Drug Administration) Findings on Narcotic Analgesics. In combination with other medications or alcohol, some can be dangerous. Used wisely, however, they are important recruits in the chemical fight against pain.

1. Hyperalgesia, Prostaglandins, and Asprin

When you complain of headache or low back pain and the doctor says take two aspirins every 4 hours and stay in bed, you may think your pain is being dismissed lightly. Not at all. Aspirin, one of the most universally used medications is an excellent pain manager. Scientists still cannot explain all the ways aspirin works, but they do know that it interferes with pain signals where they usually originate, at the nerve endings outside the brain and spinal cord: peripheral nerves. Aspirin also inhibits the production of chemicals called prostaglandins that are manufactured in the blood to promote blood clotting and wound healing. Unfortunately, prostaglandins, released from cells at the site of injury, are pain-causing substances. They actually sensitize nerve endings, making them-and you-feel more pain. Along with increasing the blood supply to the area, these chemicals contribute to inflammation-the pain, heat, redness, and swelling of tissue damage.

Some investigators now think that the continued release of pain-causing substances in chronic pain conditions may lead to long-term nervous system changes in some patients, making them hypersensitive to pain. People suffering such hyperalgesia can cry out in pain at the gentlest touch, or even when a soft breeze blows over the affected area. In addition to the prostaglandins, blister fluid and certain insect and snake venoms also contain pain-causing substances. Presumably these chemicals alert you to the need for care-a fine reaction in an emergency, but not in chronic pain.

In the search for effective pain killers, physicians have discovered pain-relieving benefits from drugs not normally prescribed for pain. Certain antidepressants are used to treat several particularly severe pain conditions, notably the riveting pain of facial neuralgias like trigeminal neuralgia and the excruciating pain that can follow an attack of shingles.

Interestingly, pain patients who benefit from antidepressants report pain relief before any uplift in mood. Pain specialists think that the antidepressant works because it increases the supply of a naturally produced neurotransmitter, serotonin. (Doctors have long associated decreased amounts of serotonin with severe depression.) But now scientists have evidence that cells using serotonin are also an integral part of a pain-controlling pathway that starts with endorphin-rich nerve cells high up in the brain and ends with inhibition of pain-conducting nerve cells lower in the brain or spinal cord.

2. Opioids and morphine-like synthetics.

Narcotic analgesics (opioids) are safe and effective when used appropriately, with relatively little risk of addiction. Sometimes a gradual reduction of the dose is required to avoid withdrawal symptoms. Morphine and morphine-like substances (oxycodone, hydrocodone) all exert a similar influence on the brain's opioid system. Dosing may be limited by toxicity to the drug (confusion, jerkiness and pinpoint pupils), but there is no dose ceiling in patients who can tolerate this.

Opioid pain killers, while very effective analgesics, may have some unpleasant side-effects. Many patients begining morphine experience nausea and vomiting. Sometimes itching may require switching to a different opioid. Constipation occurs frequently, and laxatives are usually co-prescribed.

Vicodin
Generic ingredients: Hydrocodone bitartrate, Acetaminophen. Vicodin combines a narcotic analgesic (painkiller) and cough reliever with a non-narcotic analgesic for the relief of moderate to moderately severe pain. Back to Top

Oxycontin
Generic ingredients: Oxycodone. OxyContin is an agonist opioid. Opioid agonists are some of the most effective pain relievers available. Unlike other analgesics, opioid agonists have an increasing analgesic effect with increased doses. Meaning that the more you take, the better you feel. Other analgesics, like aspirin or acetaminophen, have a threshold to their effectiveness. Back to Top

Hydrocodone (and Acetaminophen)
Brand Names: Lorcet 10/650, Lorcet HD, Lorcet Plus, Lortab, Lortab 10, Lortab 5/500, Lortab 7.5/500, Lortab Elixir, Vicodin, Vicodin ES, Vicodin HP, Zydone. Hydrocodone is a cough-suppressant and narcotic analgesic for pain management. 5mg of it taken orally is the same as 30mg of codeine. Typically hydrocodone is combined with acetaminophen (Vicodin, Lortab), but sometimes it is combined with aspirin (Lortab ASA), ibuprofen (Vicoprofen), and antihistamines (Hycomine) or in liquid form (Tussionex) as well. Back to Top

Lortab
Lortab is a combination of Hydrocodone and Acetaminophen. Hydrocodone relieves pain. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone. Together, Lortab is most commonly used to relieve moderate-to-severe pain. Lortab may also be used for purposes other than those listed here. Back to Top

Codeine
Codeine can be found in many pharmaceutical products all around the world, it's found in many forms including tablets, capsules, syrups, etc. Codeine in most countries is a scheduled (controlled) substance not available as a sole product. Codeine is usually given orally as an ingredient in syrups to relieve non-productive cough. It is also combined with non-narcotic analgesics (eg paracetamol, aspirin, ibuprofen, and others) and is used orally to relieve pain. Back to Top

Hydrocet
Hydrocet contains a narcotic analgesic (Hydrocodone) and acetaminophen to relieve pain. A narcotic analgesic and acetaminophen used together may provide better pain relief than either medicine used alone. In some cases, relief of pain may come at lower doses of each medicine.
Back to Top

Percodan
Percodan is a combination of aspirin and oxycodone, it is used to treat moderate-to-severe pain. Oxycodone (related to codeine) is in a class of drugs called narcotic analgesics. Aspirin is a less potent pain reliever, as well as an anti-inflammatory and a fever reducer. Aspirin increases the effects of oxycodone. Back to Top

Lorcet
Lorcet is a combination of Hydrocodone and Acetaminophen. Hydrocodone relieves pain. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone. Together, Lorcet is most commonly used to relieve moderate-to-severe pain. Lorcet may also be used for purposes other than those listed here. Back to Top

Vicoprofen
Vicoprofen is a mix of hydrocodone, a narcotic (opiate) pain medication (analgesic), and ibuprofen (a non-steroidal anti-inflammatory, or NSAID), which relieves pain better than either medication taken alone. Hydrocodone acts on the central nervous system and smooth muscle tissue, slowing the central nervous system. It is not clear exactly how ibuprofen works to ease pain. Back to Top

Zydone
Zydone is a combination of Hydrocodone and Acetaminophen. Hydrocodone relieves pain. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone. Together, Zydone is most commonly used to relieve moderate-to-severe pain. Zydone may also be used for purposes other than those listed here. Back to Top

Darvocet
Darvocet is a combination of acetaminophen and propoxyphene (a see tah MIH no fen/proe POX ih feen). Darvocet may be habit forming. Physical and/or psychological dependence can occur, and withdrawal effects are possible if the medication is stopped suddenly after prolonged or high-dose treatment. Back to Top

More Information on Narcotic Pain Killers:

MedlinePlus: Narcotic Analgesics and Acetaminophen
DEA (Drug Enforcement Agency): Controlled Substances Act (CSA)
Wikipedia: Narcotic
Wikipedia: Analgesic