According to the Centers for Disease Control and Prevention (CDC), drug overdose deaths have increased significantly throughout the opioid epidemic. Most drug overdose deaths, about 68% in 2017, involve an opioid.
Most opioids have a high potential for abuse and physical dependence, even if they are prescribed by a doctor. However, some opioids are much more powerful and dangerous than others. Carfentanil is the most potent opioid and about 10,000 times stronger than morphine.
A list of opioids strongest to weakest includes:
Carfentanil is a highly potent tranquilizer used on large animals and is not approved by the FDA for human use. Carfentanil is about 100 times stronger than fentanyl and 50 times stronger than heroin.
It is the strongest opioid in the United States and belongs to a class of fentanyl analogs. Fentanyl analogs, also known as designer drugs, are produced to mimic the side effects of fentanyl.
Fentanyl has caused a significant increase in opioid overdose deaths and is sometimes found in illicit drugs like cocaine and heroin. Fentanyl is up to 100 times more powerful than morphine.
Heroin is an illegal street drug with no accepted medical purpose. Heroin use has been prevalent since the beginning of the opioid crisis and is responsible for at least 130,000 deaths.
Buprenorphine is a prescription opioid primarily used to treat opioid use disorder (OUD) as part of a medication-assisted treatment (MAT) program. Depending on the dose, buprenorphine is between 80-100 times stronger than morphine.
However, it is a partial agonist drug, which means it does not fully activate opioid receptors. Although it is a more potent drug, it does not produce the same powerful effects as other opioids.
Methadone is used to treat opioid use disorder and prevent opioid withdrawal symptoms. Depending on the dose, methadone can be 4-12 times stronger than morphine.
Although it is possible to abuse methadone, it does not produce the same intense euphoric effects that are associated with other opioids.
Hydromorphone is a prescription opioid analgesic (painkiller) sold under the brand name Dilaudid. It is 2-8 times more powerful than morphine and is sometimes abused because it produces effects similar to heroin.
Oxymorphone, which was sold under the brand name Opana until 2017, is a prescription drug used to treat severe pain. It is three times stronger than morphine and has a high risk of abuse. It is currently only available in its generic form.
Oxycodone is the active ingredient in several prescription pain medications, including Oxycontin, Percocet, and Roxicodone.
Oxycodone is one of the most common opioid medications and has a high risk of abuse. It is about 1.5 times stronger than morphine and produces potent painkiller and euphoric effects.
Morphine is an opiate, which is a natural opioid that comes from opium poppy plants. It is used for severe or chronic pain and sold under the brand name MS Contin.
Like other opioids, morphine binds to opioids in the central nervous system. Along with pain relief, morphine can cause euphoria, sedation, and respiratory depression.
Hydrocodone is one of the most commonly prescribed opioids and has about the same potency as morphine. It is found in a variety of combination drugs that contain acetaminophen (Tylenol), including Lortab, Norco, and Vicodin.
Codeine is an opiate made from morphine and is available in tablet form (with acetaminophen) and in prescription cough syrups. It is used as a cough suppressant or to treat moderate pain. Codeine is about 10% less potent than morphine.
Meperidine, sold under the brand name Demerol, is an opioid painkiller used for moderate to severe pain. Although Demerol was considered to be less addictive than other opioids, it has an increased risk of severe health effects, including serotonin syndrome.
Tramadol, also known as the brand name Ultram, is the weakest opioid available in the United States. It is a controlled substance but has the lower risk of drug abuse compared to all other opioids.
Opioid Addiction Treatment
If you struggle with substance abuse and are ready to reach out for help, a provider can work with you to develop a personalized treatment plan. Opioid addiction treatment is likely to start with detox, where medical professionals will help you safely manage withdrawal symptoms.
Depending on the severity of addiction, treatment may also involve an intensive inpatient program or a more flexible outpatient program. If you or a loved one would like to learn more about opioid addiction treatment options, please reach out to us today.
- Centers For Disease Control And Prevention (CDC) — Calculating Total Daily Dose Of Opioids For Safer Dosage
- Centers For Disease Control And Prevention (CDC) — CDC’s Response To The Opioid Overdose Epidemic
- Centers For Disease Control And Prevention (CDC) — Heroin
- Minnesota Department Of Health — Fentanyl And Fentanyl Analogs
- World Health Organization — WHO Guidelines For The Pharmacological And Radiotherapeutic Management Of Cancer Pain In Adults And Adolescents