Opiates are a classification of medications that are derived, either naturally or synthetically (man-made) from the opium plant. These medications are very effective pain relievers because they attach to the opiate receptors in the peripheral nervous system to modify the transmission of pain signals. They also attach to receptors in the brain to modify the incoming pain signals and trigger feelings of euphoria. There are many different types of opiate pain relievers, some to relieve severe pain and others for moderate or mild pain.
Severe Pain
Morphine, the main active ingredient of opium, is the standard against which other opiate medications are measured. It acts upon the central nervous system very effectively and is able to relieve severe pain. Morphine is also highly addictive, induces tolerance (meaning as the body gets used to it more is needed to induce the effects), and is prone to both physical and emotional dependence.
Methadone is a synthetic opiate that was produced to provide effective pain relief without the addictive side effects. Methadone has a chemical structure different from morphine, but its effect of the opiate receptors is very similar. Methadone is often used to treat chronic severe pain as well as to help treat narcotic addiction.
Fentanyl, a synthetic opiate medication, is about 100 times more potent as a pain reliever than morphine, according to the U.S Department of Justice Drug Enforcement Administration. Fentanyl is commonly prescribed as a patch for severe chronic pain relief.
Moderate to Severe Pain
Hydrocodone, the most frequently prescribed opiate in the United States according to the Drug Enforcement Administration, is a semi-synthetic (meaning partially man-made) opiate used to treat moderate to severe pain. It is similar in structure to codeine and similar in effects to morphine.
Oxycodone, another semi-synthetic opiate, is derived from thebaine, which is part of opium. Oxycodone is very similar to morphine in its effects, its addictiveness and dependence. There are prescription medications available for pain relief that are a mixture of oxycodone and either aspirin or acetaminophen.
Codeine is a naturally occurring part of the opium plant; however, most used for pharmaceutical reasons is produced synthetically. Codeine differs from morphine because it can be administered orally without losing the drug through the gastrointestinal system or liver.
Mild to Moderate Pain
Propoxyphene, also called dextropropoxyphene, closely resembles methadone. Its pain relieving effects, according to Drug Free Workplace, is only about one-half to one-third that of codeine. It is therefore used to treat only mild to moderate pain. Propoxyphene napsylate is a form of the medication that is often prescribed. The napsylate salt makes the formulation less prone to abuse because it cannot be dissolved in water and therefore cannot be injected.
