With the ongoing opioid epidemic in the United States, it can be helpful to know which drugs are opioids, which opioids are weakest and which are strongest, and to know the names of all opioids.
Identifying opioids, and knowing the dangers which can come with abuse of these drugs, is important to fighting the opioid health crisis.
This list comprises a guide of opioids from strongest to weakest and includes both prescription and illicit opioid drugs.
How Opioid Strength Is Determined
When it comes to opioid drugs, their strength is often determined by how they compare to the opioid morphine.
The strength of an opioid may be affected by several factors, such as:
- a person’s tolerance level: whether the person has an opioid addiction or physical dependence, how long and how often they abuse opioids, and which opioid they abuse
- a person’s metabolism, or how well their body breaks down opioids
- method of administration: if a person injects an opioid, for example, this will make the drug take effect more quickly than smoking, snorting, or swallowing the drug
Morphine is a medium-strength opioid prescription typically used to relieve moderate to severe pain. The liquid solution and long-acting tablet forms of morphine are often used for moderate pain, while extended-release capsules treat severe, round-the-clock pain.
This same method of prescription is often applied to more potent drugs. However, the strongest opioids are usually used for surgery (such as fentanyl), while weaker opioids, like morphine and oxycodone, treat chronic or terminal pain (such as in cancer patients).
When discussing the strength of opioids, they are typically described in terms of “3 times more powerful than morphine” (heroin), or “50 times stronger than morphine” (fentanyl).
While legally produced opioid prescriptions have a guaranteed strength, any opioids produced illicitly (on the streets) do not have a guaranteed strength or purity. Heroin, for example, may be cut with other drugs or substances, meaning its strength and purity vary from dose to dose.
A List Of Opioids From Strongest To Weakest
This list shows opioid medications and drugs in order from strongest to weakest. For prescriptions, generic names are listed with their common brand names.
- fentanyl (Duragesic, Sublimaze)
- buprenorphine (Suboxone, Subutex)
- oxymorphone (Opana)
- U-47700 (street opioid)
- hydromorphone (Dilaudid)
- methadone (Methadose)
- oxycodone (Percocet, Oxycontin)
- hydrocodone (Vicodin, Norco)
- morphine (Duramorph, Oramorph, MS Contin)
- tapentadol (Nucynta)
- tramadol (Ultram, Ultram ER)
- meperidine (Demerol)
- codeine (Tuzistra XR)
- laudanum (opium tincture)
List of opioids by strength compared to morphine
- carfentanil = 10,000 times > morphine
- fentanyl = 50 to 100 times > morphine
- buprenorphine = 40 times > morphine
- oxymorphone = 10 times > morphine
- U-47700 = 10 times > morphine
- Heroin = 2 to 5 times > morphine
- hydromorphone = 5 to 10 times > morphine
- methadone = 3 times > morphine
- oxycodone = 50 percent (1.5 times) > morphine
- hydrocodone = equal in strength to morphine
- tapentadol = 2 to 3 times < morphine
- tramadol = 10 percent as strong as morphine
- meperidine = 7 to 10 times < morphine
- codeine = 7 to 14 times < morphine
- laudanum = 1 percent as strong as morphine
Dangers Of Opioid Abuse
Opioids are never to be prescribed for longer than short-term use, such as more than 10 days up to two weeks at a time, as they can be highly addictive, even when used as prescribed.
In general, opioids can cause respiratory depression, or breathing at a rate that is dangerously slowed to nonexistent. Increasing a dose, taking a powerful opioid when a person has no tolerance to opioids, or taking an opioid which may be cut with other, more potent substances can present high risks.
Many drugs sold on the street are now cut with other substances, including fentanyl-laced heroin. For those who do not have a high opioid tolerance, obtaining and taking a powerful opioid such as this drug could lead to fatal overdose.
If a person does not experience an opioid overdose, opioid withdrawal symptoms can be highly painful and make it difficult to quit use of an opioid without treatment. Withdrawal is often what keeps a person using opioids long after they recognize abuse.
When To Get Help For Opioid Abuse
Opioids are some of the most powerful drugs on the market. Highly addictive, they pose real threats to health even if abused for only a short time.
If someone you know is abusing opioids, even a weaker opioid, it is important to seek help right away. Abuse of weaker opioids can lead to tolerance. After a person becomes tolerant to their opioid’s strength, they may seek stronger opioids, putting themselves at further risk for danger.
Seeking help for opioid addiction or dependence can aid a person in entering addiction recovery before it’s too late. To learn more about rehab programs for opioid abuse and addiction, contact a treatment specialist today.
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- The Washington Post — See how deadly street opioids like ‘elephant tranquilizer’ have become
- U.S. National Library of Medicine — Morphine