List of Dangerous Drugs in Hong Kong

Under Hong Kong law, dangerous drugs are defined and regulated by the Dangerous Drugs Ordinance (Cap. 134). This law governs the control, possession, trafficking, manufacture, and import/export of certain substances. The substances considered “dangerous drugs” are listed in the First Schedule of the Ordinance.

This category includes a wide range of opioids and synthetic analgesics that are commonly prescribed for managing moderate to severe pain. However, their powerful effects on the central nervous system also make them highly addictive and susceptible to abuse. In Hong Kong, these drugs are strictly regulated due to their potential for dependence, overdose, and fatal consequences when misused.

Below is a comprehensive list of such substances, many of which are controlled internationally and have limited or no accepted medical use in Hong Kong. Several are thousands of times more potent than morphine and can cause life-threatening respiratory depression even in small doses.

Natural Opioid Alkaloids & Derivatives

Derived directly from the opium poppy or its natural alkaloids (e.g., morphine, codeine, thebaine):

• Morphine – The primary active ingredient in opium and the gold standard for pain relief.

• Codeine – A naturally occurring alkaloid in opium; milder than morphine but still addictive.

• Heroin (Diacetylmorphine) – A semi-synthetic derivative of morphine; illegal in most countries due to extreme abuse potential.

• Dihydromorphine – A hydrogenated derivative of morphine with strong analgesic effects and a high potential for addiction.

• Ethylmorphine – A codeine-like opioid used for cough suppression; carries abuse potential.

• Nicomorphine – A fast-acting morphine derivative used in some countries for severe pain relief.

• Myrophine – A semi-synthetic opioid related to morphine, formerly used in clinical settings.

• Thebacon – A codeine derivative with similar effects to morphine; rarely used today.

• Thebaine – A naturally occurring opiate that acts as a chemical precursor for many modern synthetic opioids.

• Papaveretum – A mixture of opium alkaloids (mostly morphine and codeine) formerly used for pain relief.

Semi-Synthetic Opioids

Chemically modified from natural opiates (usually morphine, codeine, or thebaine) to enhance potency or duration:

• Oxycodone – Synthesized from thebaine; widely used for moderate to severe pain.

• Hydrocodone – Also derived from codeine or thebaine; commonly found in combination pain medications.

• Metopon – A modified form of hydromorphone with reduced side effects but high dependency risk.

• Oxymorphone – A powerful opioid analgesic, much stronger than morphine, used in chronic pain management.

• Levorphanol – A long-acting opioid painkiller similar to morphine but with a longer duration.

• Normethadone – A close relative of methadone, with similar properties but used less frequently.

• Isomethadone – An isomer of methadone with similar analgesic effects, mostly used in research.

Fully Synthetic Opioids

Made entirely in laboratories; not directly derived from the opium poppy:

• Methadone – Used in pain management and opioid substitution therapy; long-acting and orally bioavailable.

• Fentanyl – A powerful opioid, 50–100x stronger than morphine; major contributor to overdose deaths.

• Alfentanil, Sufentanil, Remifentanil – Ultra-potent fentanyl analogs used mainly in surgical anesthesia. These are extremely fast-acting and dangerous outside medical settings.

• Dextromoramide – A potent and fast-acting synthetic opioid with a high risk of dependency.

• Dextropropoxyphene – A weaker opioid painkiller, withdrawn in many countries due to heart toxicity risks.

• Diampromide – A synthetic opioid with similar potency to morphine; rarely prescribed.

• Diethylthiambutene – A thiambutene-class opioid with limited therapeutic use.

• Dipipanone – A strong opioid sometimes used with anti-nausea medication to treat severe pain.

• Ethylmethylthiambutene – A little-known synthetic opioid, structurally similar to other thiambutenes.

• Piritramide – A synthetic opioid analgesic used in some European countries, especially in hospitals.

• Proheptazine – A lesser-known synthetic opioid with a similar structure to other piperazine-based drugs.

• Acetorphine – An extremely potent opioid (thousands of times stronger than morphine), used only in veterinary medicine.

• Piritramide – A synthetic opioid widely used in Europe (but not approved in the U.S. or Hong Kong) for post-surgical and cancer-related pain. Known for its fast onset and lower histamine release compared to morphine.

• Piminodine – A short-acting opioid analgesic of the piperidine class, previously used in the U.S. for pre-operative sedation and pain control. No longer commonly used.

• Phenadoxone – A synthetic opioid structurally similar to methadone. It was once used for pain relief but has largely fallen out of clinical favor due to side effects and abuse risk.

• Phenazocine – Part of the benzomorphan class of opioids, this drug was once considered an alternative to morphine but is now rarely used due to concerns over hallucinations and dysphoria.

• Phenomorphan – An extremely potent opioid, far stronger than morphine. Its high potency and overdose risk have kept it restricted mainly to laboratory research.

• Phenoperidine – A fast-acting synthetic opioid once used in anesthesia, particularly in Europe. Structurally related to pethidine (meperidine), it has been replaced by more modern agents.

• Proheptazine – A rarely used opioid analgesic with limited medical history. Structurally related to other phenazepine-class opioids.

• Properidine – A lesser-known synthetic opioid analgesic of historical interest. Has similar effects to pethidine but is no longer in clinical use.

Naturally Occurring Stimulants

These are either found in plants or derived directly from naturally occurring compounds.

• Cocaine (including "crack") – A powerful stimulant derived from the coca plant. It increases dopamine levels in the brain, causing intense euphoria and energy. “Crack” is the smokable, freebase form that delivers a rapid, intense high but is even more addictive.

• Cathinone – A naturally occurring stimulant found in the khat plant, traditionally chewed in East Africa and the Middle East. Synthetic derivatives (e.g., mephedrone) are often referred to as "bath salts."

• Ephedrine – Derived from the ephedra plant, it stimulates the nervous system and was once common in weight loss products. It’s now regulated due to potential heart risks and its use in meth production.

• Pseudoephedrine – A decongestant chemically related to ephedrine, often used in cold medications. It can be chemically converted into methamphetamine, leading to regulatory controls.

Synthetic or Semi-Synthetic Stimulants

These are man-made or modified versions of natural stimulants, often used medically but highly prone to abuse.

• Amphetamine – A synthetic stimulant used to treat ADHD and narcolepsy. It increases dopamine and norepinephrine, improving focus but also carrying high abuse potential.

• Methamphetamine ("Ice") – A much more potent derivative of amphetamine. While it has some medical uses, illicit forms (like “crystal meth”) are highly addictive and neurotoxic.

• Methylphenidate – A synthetic stimulant prescribed for ADHD and narcolepsy. It works differently from amphetamines but has similar effects on focus and alertness. Brand names include Ritalin and Concerta.

These substances distort perception, mood, and cognitive processes.

Classic Hallucinogens (Serotonergic Psychedelics)

These primarily affect serotonin receptors, especially 5-HT2A, and produce vivid hallucinations, altered time perception, and ego dissolution.

• LSD (Lysergic acid diethylamide) – A powerful synthetic hallucinogen derived from ergot fungus. Extremely potent, with long-lasting effects (8–12 hours). Causes visual distortions, synaesthesia, and profound psychological experiences.

Atypical Hallucinogens

These act through different pathways and often have very distinct effects from classic psychedelics.

• Salvinorin-A – The active compound in Salvia divinorum, a psychoactive plant. Unlike others, it acts on kappa-opioid receptors. Known for intense, short-lasting, and often disorienting hallucinations.

Dissociative Hallucinogens (NMDA Antagonists)

These cause detachment from self and environment, altered body perception, and numbness. Often used medically but prone to abuse.

• Phencyclidine (PCP) – Originally developed as an anesthetic. Now illegal, PCP causes hallucinations, delusions, and violent behaviour. Known for producing a strong feeling of detachment and "out-of-body" experiences.

• Ketamine – A dissociative anesthetic used medically for pain relief and sedation. At sub-anesthetic doses, it produces hallucinations, depersonalization, and a "k-hole" experience. Increasingly researched for treatment-resistant depression.

These substances are commonly prescribed for anxiety, insomnia, or seizure control, but many are misused for their calming or euphoric effects.

Benzodiazepines

Prescription medications that enhance the effect of GABA, a neurotransmitter that inhibits brain activity. Known for their anti-anxiety, muscle-relaxant, and sleep-inducing effects.

• Alprazolam – Commonly known as Xanax. Used to treat anxiety and panic disorders. Fast-acting and highly addictive with strong withdrawal symptoms.

• Clonazepam – Known as Klonopin. Prescribed for panic disorders and seizures. Longer-acting than alprazolam, but also habit-forming.

• Diazepam – Known as Valium. Used for anxiety, muscle spasms, and alcohol withdrawal. One of the oldest and most well-known benzodiazepines.

• Flunitrazepam – Known as Rohypnol ("roofies"). A powerful sedative banned or heavily restricted in many countries due to its use in drug-facilitated sexual assaults.

• Lorazepam – Known as Ativan. Used to treat anxiety and seizures. Strong sedative with quick onset, often used in hospitals.

• Nitrazepam – Prescribed for severe insomnia. Longer-acting than many other benzodiazepines. Risk of daytime drowsiness and dependence.

Non-Benzodiazepine Hypnotics ("Z-drugs")

Chemically distinct from benzos, but act on similar receptors. Mainly prescribed for insomnia.

• Zolpidem – Known as Ambien. Short-acting sleep aid. Less addictive than benzodiazepines but still carries risk of misuse, especially for recreational or long-term use.

Barbiturates

An older class of CNS depressants, now rarely used due to narrow safety margin and high overdose potential.

• Barbiturates (general class) – Includes drugs like amobarbital and secobarbital. Used historically for anxiety, insomnia, and seizures but now largely replaced due to overdose risk and addiction.

• Phenobarbital – One of the few barbiturates still in medical use, mainly for epilepsy. Less commonly abused but still carries risk of dependence and toxicity.

Other CNS Depressants

• GHB (Gamma-Hydroxybutyrate) – A depressant and club drug that induces euphoria, sedation, and amnesia. Sometimes used in medical settings for narcolepsy but more commonly associated with illicit use and drug-facilitated crimes.

These drugs primarily act on the endocannabinoid system, influencing mood, memory, perception, and motor control. Some are natural, others synthetic, with varying potency and risk profiles.

Natural Cannabinoids

These are derived directly from the cannabis plant and contain psychoactive or therapeutic compounds like THC and CBD.

• Cannabis (Marijuana) – Refers to the dried flowers, leaves, and stems of the Cannabis sativa or Cannabis indica plant. Typically smoked or vaporized. Contains THC (the main psychoactive compound) and CBD. Effects include euphoria, relaxation, altered perception of time, and increased appetite.

• Hashish – A concentrated form of cannabis made by compressing the plant’s resin glands (trichomes). It contains a higher concentration of THC than raw cannabis, resulting in stronger effects. Usually smoked or ingested.

• THC (Tetrahydrocannabinol) – The primary psychoactive chemical in cannabis. Responsible for the “high,” including euphoria, anxiety, impaired memory, and altered sensory perception. THC levels vary widely among different cannabis products.

Synthetic Cannabinoids

Lab-made chemicals designed to mimic THC’s effects, often sprayed on plant material and sold under names like “Spice” or “K2.”

• Synthetic Cannabinoids (e.g., Spice, K2) – These are not natural cannabis products but are made in labs to bind to the same brain receptors as THC. They can be far more potent and unpredictable, with serious health risks like seizures, psychosis, heart problems, and even death. Often marketed as a "legal high," but many have been banned due to their danger.

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