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7Painkiller AnaloguesWhile most people treat headaches and muscle aches by takingaspirin, Tylenol®, Motrin®, or other over-the-counter pain relievers,chronic and severe pain requires more potent painkillers. Some ofthe most potent pain relieving drugs that have been discoveredare “narcotic analgesics,” such as morphine, codeine, Vicodin®,OxyContin®, Demerol, Dilaudid®, and others. These drugs arewidely used for the treatment of severe pain and are also usedas anesthetics for surgical procedures and childbirth. As narcoticanalgesics were originally derived from the opium poppy(Figure 7.1), they are often referred to as “opiate” or “opioid”drugs. However, pharmaceutical companies can now synthesizenarcotic analgesics in chemical laboratories and are no longerdependent on using raw opium as the primary ingredient.Most, if not all, opiate drugs are highly addictive, and it isestimated that over 2 million Americans use prescription narcoticanalgesics for nonmedical (i.e., recreational) purposes. Thispercentage tends to be greater among women. The most commonaddictive opiate drug that is sold on the street is heroin, butpatients who use prescription narcotic analgesics for pain, aswell as the doctors who prescribe them, can also become addicted.In the late 1970s and early 1980s, two commonly prescribedopiate painkillers, fentanyl and meperidine, fell into the handsof underground drug chemists who tried to synthesize illegalanalogues. These fentanyl and meperidine analogues were amongthe first “designer drugs.”72