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The Most Commonly Abused Opiates

Opioids have medical uses but are regularly abused because, in addition to pain relief, they can produce a pleasant sense of relaxation and improved well-being. They include drugs available by prescription as well as street drugs.1 Opioids are a major contributor to the spike in drug overdose deaths over the past few decades.2

Read on to learn more about 5 of the most commonly abused opioids in the United States.

What are Opioids?

Opioids are a class of drugs that relieve physical pain and are sometimes used to treat other conditions such as coughing and diarrhea.3 This group of substances includes prescription painkillers and heroin, a highly addictive illicit drug.1

The ways in which opioids are manufactured depend upon the particular drug.

  • Several opiate alkaloid substances (such as codeine, morphine, and thebaine) derive directly from the opium poppy plant and serve as the building blocks for several semi-synthetic opioid drugs.
  • Semi-synthetic opioids, like heroin, OxyContin, and Vicodin are created from these naturally occurring opiate precursors.
  • Synthetic opioids, like fentanyl, are produced exclusively in labs.1

Opioid users are at high risk for physical and psychological dependence, addiction, and overdose. In 2016, over 11.5 million Americans ages 12 and over had misused prescription painkillers in the past year.4 Heroin and prescription opioids were responsible for nearly 36,000 deaths in 2015, and the number of opioid overdose deaths nearly tripled between 2002 and 2015.2

Prevalence of Vicodin Misuse

Vicodin is a semi-synthetic opioid painkiller. It is a combination of hydrocodone and acetaminophen.5

Similar to other prescription painkillers, Vicodin abuse may occur when people intentionally disregard prescription guidelines, such as taking a larger-than-prescribed dose with the intention to get high or using illegally acquired pills without a prescription altogether.3 The drug is available as a tablet and is typically abused orally, often with alcohol.5

In 2016, over 6.9 million Americans ages 12 and over, or 2.6% of this population, had misused hydrocodone products such as Vicodin within the past year.4

Risks of Abusing OxyContin

Sometimes called “Hillbilly Heroin,” OxyContin is a semi-synthetic opioid that is prescribed to treat severe pain.1

OxyContin can be abused by misusing a prescription or taking it without a prescription. The drug is available as an extended-release tablet that is intended to be taken orally.6 However, the drug can also be abused by snorting, smoking, or injecting it.

OxyContin is a time-release medication—designed to meter out its active ingredients over time. When people crush the tablets prior to snorting or injecting it, they receive all of the medication at once and can place themselves at extreme risk of overdose.7

In 2016, more than 1.4 million Americans ages 12 and over, or 0.5% of this population, reported misusing OxyContin within the past year.4

Dangers of Heroin

Heroin is a semi-synthetic opioid that is illegally sold as a white or brown powder or sticky black substance.1,8 It is a Schedule I drug, which means that it has a high potential for abuse and no accepted medical use in the United States.1

One of the most dangerous drugs in the world, heroin claims countless lives each year. Smoking, snorting, and injecting are the 3 most common methods of using heroin.1 Individuals who share dirty needles with other users after injection are at a high risk for contracting HIV/AIDS or hepatitis.8

Some people become addicted to heroin after first abusing prescription painkillers. They may transition to heroin because it produces a similar high at a lower cost and is easier to obtain.3

In 2016, approximately 948,000 Americans ages 12 and over, or 0.4% of this population, reported using heroin within the past year.4 That same year, almost 13,000 Americans died from heroin overdoses.2

Consequences of Fentanyl Use

Fentanyl is a synthetic opioid used as an anesthetic and to treat severe pain. It is considered 50 times more potent than heroin and 100 times more potent than morphine.1

Fentanyl is available as an oral lozenge, tablet, nasal spray, patch, injectable solution, and sublingual spray and tablet. Powder and tablet forms of the drug are also produced in illegal labs.1

Fentanyl may be taken orally or snorted, smoked, injected, or spiked onto blotter paper. Some users may remove the gel from fentanyl patches to inject or ingest it. Illegally manufactured fentanyl is often combined with heroin, cocaine, and other drugs and then sold on the streets—often without the user’s knowledge.1

In 2016, roughly 228,000 Americans ages 12 and over, or 0.1% of this population, reported misusing fentanyl in the past year.4

Synthetic opioids like fentanyl are responsible for the most overdose deaths of any drug in the United States. In 2016, fentanyl was involved in 19,413 overdose deaths. Fentanyl was also implicated in 40.3% of cocaine overdoses and 31% of benzodiazepine overdoses.9

What is Morphine?

Morphine is an opiate alkaloid substance used in the synthesis of pharmaceutical morphine sulfate—the prototypical opioid painkiller. It is available as an oral solution, injectable solution, and immediate and extended-release tablets and capsules.1

The drug may be consumed orally or injected. Many people who abuse morphine prefer to inject the drug because it causes a more rapid high.1

In 2016, approximately 536,000 Americans ages 12 and older, or 0.2% of this population, reported misusing morphine within the past year.4

Helping Those With an Opiate Addiction

Finding drug rehab help for an individual living with an opioid addiction is one of the most important things a person can do for their friend or loved one. Through detox, counseling, and aftercare, opiate drug rehab helps the individual stop using drugs and gives them the tools to stay clean.

You can search for rehabilitation programs on this site using our directory.


  1. Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide.
  2. National Institute on Drug Abuse. (2017). Overdose death rates.
  3. National Institute on Drug Abuse. (2018). Drug facts: Prescription opioids.
  4. Substance Abuse and Mental Health Services Administration. (2017). Results from the 2016 National Survey on Drug Use and Health: Detailed tables.
  5. Drug Enforcement Administration. (2014). Hydrocodone.
  6. S. National Library of Medicine. (2018). Oxycodone.
  7. Lofwall, M. R., Moody, D. E., Fang, W. B., Nuzzo, P. A., & Walsh, S. L. (2012). Pharmacokinetics of intranasal crushed OxyContin and intravenous oxycodone in nondependent prescription opioid abusersThe Journal of Clinical Pharmacology52(4), 600-606.
  8. National Institute on Drug Abuse. (2018). Drug facts: Heroin.
  9. National Institute on Drug Abuse. (2018). Nearly half of opioid-related overdose deaths involve fentanyl.

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