Fact Checked and Peer Reviewed
August 29, 2018
What are opioids?
Opioids are a class of medication that work on the body’s opioid receptors. Opioids have many uses, including as cough suppressants, sedatives for surgery and as addiction treatment. All opioids also have painkiller properties.
With many opioids on the market, it can be confusing to know the difference between drugs. When comparing opioids it is important to consider strength, time for release (extended versus immediate) and any additional ingredients. Let’s look at some of the most popular opioid painkillers and compare.
Opioids Vary In Strength
The strength of pain relief you feel after taking an opioid depends on many factors unique to you such as weight, tolerance, and metabolism. However, there is a handy tool called a equianalgesic chart that can help compare opioid strengths. This chart compares the strength and dose equivalents of painkillers to 10 mg of morphine taken by mouth. For example, aspirin (which is not an opioid) is 0.28% as strong as 10mg of oral morphine and it would take 3600 mg of aspirin to have the same pain-killing effect.
On the other extreme, carfentanil is 10,000 times as strong as 10mg of oral morphine. Healthcare professionals use the equianalgesic chart as a handy tool to manage pain.
What are the differences between popular opioid medications?
Codeine is 10-15% as strong as morphine. Common brand names include Tylenol with Codeine #3 and #4. Both these medications contain acetaminophen as well as codeine. Acetaminophen can cause liver damage and failure if you take too much, so be sure to never take more than your provider prescribes.
Tramadol is 10% as strong as morphine. Common brand names include Ultram and Zytram.
Hydrocodone is as strong as morphine. Common brand names include Vicodin and Norco. Both these medications contain acetaminophen as well as hydrocodone. Acetaminophen can cause liver damage and failure if you take too much so be sure to never take more than your provider prescribes.
Oxycodone is 1.5 times stronger than morphine. Common brand names include Percocet and OxyContin. Percocet contains acetaminophen as well as oxycodone. Extended and immediate release formulas of oxycodone are available.
Methadone is 3-5 times stronger than morphine. While it is most well-known as a treatment for opioid use disorder, it is also used for pain.
Hydromorphone is 4 times stronger than morphine. Common brand names include Dilaudid and Hydromorph Contin.
Oxymorphone is 3-7 times stronger than morphine. Common brand names include Numorphan, Numorphone and Opana. Oxymorphone is highly addictive and last year Opana extended-release was removed from the US market.
Buprenorphine is 40 times stronger than morphine, but works differently in the brain to reduce the risk of addiction and lower cravings. Common brand names include Suboxone, Zubsolv, Subutex and Sublocade. Like methadone, buprenorphine is used to treat opioid use disorder as well as pain.
Opioids and Addiction
All opioids carry the risk for addiction and are considered Controlled Substances by the US federal government. If you are worried about addiction and are taking opioids, Workit Health can help you kick risky behaviors before they get out of control.
Ali Safawi is a Workit Associate and former Intern. He is an alumni of the University of Michigan School of Public Health and is pursuing his masters degree at George Washington University in our nation’s capitol. He is passionate about fighting the opioid epidemic and creating a more equitable health system for all Americans.