Opioid Medication Strength: A Comparison
When prescription painkillers were marketed to the public, they were deemed safe and powerful to help those with both acute and chronic pain. Doctors and pharmaceutical companies didn’t anticipate the impending opioid epidemic that would ensue once the use of these medications became more mainstream, and prescriptions were being written and filled at an alarming rate. The result of the overprescribing of these opioid pain killers was a devastating number of people who became dependent on these medications, leading millions to addiction, and even overdose death.
This list shows the most commonly prescribed opioid medications ranked from weakest to strongest:
Codeine: A fairly short-acting opiate that treats moderate pain that is commonly prescribed with aspirin or acetaminophen. It comes in tablet, capsule, and liquid form and is frequently sold illegally on the black market.
Demerol®: Also known as Meperidine, is a brand name opioid is used to treat moderate to severe pain. It’s about ten times less potent than morphine but is sometimes used as anesthesia due to its strength. It comes as an injectable solution, tablet, or oral liquid.
Tramadol: With about a tenth of the potency of morphine, the drug, sometimes called Ultram®, is often used to relieve moderate to moderately severe pain and is legally marked as a Schedule IV substance.
Morphine: Brand names include MS Contin® and Duramorph®, is used as pain-management for those with cancer or terminal illness, and is available in tablets, capsules, suppositories, and injectable liquid.
Hydrocodone: It’s prescribed under many brand names such as Vicodin®, Norco®, and others, and is commonly prescribed for pain management after surgery, injury, or chronic pain sufferers. It comes in pill or syrup form and is about the same strength as morphine, and is often combined with other pain relievers like ibuprofen or acetaminophen.
Percocet®: A drug that is a combination of oxycodone and acetaminophen in tablet, liquid oral solution, and capsule form and is prescribed to people after surgery or for acute severe pain.
OxyContin®: The brand name for the drug Oxycodone and is available in an extended-release form of opioid. It’s used to treat moderate to severe pain and is about 50% stronger than morphine. It is the leading cause of overdose deaths among those with opioid use disorder.
Methadone: A FDA-approved medication used to treat opioid addiction through medication-assisted treatment (MAT), is about three times stronger than morphine. It’s helpful in the long-term maintenance for people with opioid use disorder and is dispensed under medical supervision.
Heroin: This is an illicit opiate drug classified as a Schedule I substance with a very high potential for dependency; it is not used medically or prescribed. It’s about two to five times stronger than morphine on average and can be mixed with extremely potent substances like fentanyl or carfentanil. Heroin is responsible for nearly 15,000 overdose deaths in 2018.
Hydromorphone: Used to treat moderate to severe pain while being up to eight times stronger than morphine, available as an injection, tablet, liquid, or suppository.
Oxymorphone®: An extended-release opioid medication that is often sold on the black-market though it is prescribed to treat moderate to severe pain in patients who no longer respond to the effects of other pain medications. It is about ten times stronger than morphine when injected.
Buprenorphine: An FDA-approved medication for the treatment of opioid addiction that is about 25 to 100 times stronger than morphine but does not provide a euphoric high like other opioids. It’s commonly used to relieve and control withdrawal symptoms.
Fentanyl: About 50 to 100 times stronger than morphine, this opioid is the cause of many newer overdose deaths as it’s being sold illicitly on the street and mixed with heroin, cocaine, and methamphetamine in fatal doses.
Carfentanil: Extremely potent and dangerous, this opioid is about 10,000 times stronger than morphine and 100 times more potent than fentanyl. It’s used to tranquilize large mammals and is not intended for human use. It can sometimes be found in illicit street drugs and has proven to be fatal even in tiny amounts.
Those who feel they may be dependent or addicted to any of these opioid substances, whether they were prescribed or obtained illicitly, are strongly advised to seek medical treatment at a local recovery services clinic.