The term narcotic originally referred medically to any psychoactive compound with sleep-inducing properties, and euphoric properties as well. In the United States, it has since become associated with opiates and opioids, commonly morphine and heroin, as well as derivatives of many of the compounds found within raw opium latex. The primary three are morphine, codeine, and thebaine (while thebaine itself is only very mildly psychoactive, it is a crucial precursor in the vast majority of semi-synthetic opioids, such as oxycodone or hydrocodone).

Legally speaking, the term "narcotic" may be imprecisely defined and typically has negative connotations.When used in a legal context in the U.S., a narcotic drug is one that is totally prohibited, such as heroin, or one that is used in violation of governmental regulation.

In the medical community, the term is more precisely defined and generally does not carry the same negative connotations.

Statutory classification of a drug as a narcotic often increases the penalties for violation of drug control statutes. For example, although U.S. federal law classifies both cocaine and amphetamines as "Schedule II" drugs, the penalty for possession of cocaine is greater than the penalty for possession of amphetamines because cocaine, unlike amphetamines, is classified as a narcotic.

The term "narcotic" is believed to have been coined by the Greek physician Galen to refer to agents that numb or deaden, causing loss of feeling or paralysis. It is based on the Greek word ναρκωσις (narcosis), the term used by Hippocrates for the process of numbing or the numbed state. Galen listed mandrake root, altercus (eclata),[16][failed verification] seeds, and poppy juice (opium) as the chief examples. It originally referred to any substance that relieved pain, dulled the senses, or induced sleep. Now, the term is used in a number of ways. Some people might define narcotics as substances that bind at opioid receptors (cellular membrane proteins activated by substances like heroin or morphine), while others refer to any illicit substance as a narcotic. From a U.S. legal perspective, narcotics refer to opium, opium derivatives, and their semi-synthetic substitutes, though in U.S. law, due to its numbing properties, cocaine is also considered a narcotic.

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Journal of evolutionary medicine