Opioids are highly addictive and deadly drugs. Although many opioids are used in the medical field to help manage pain, many people abuse prescription or illicit opioids for their own pleasure. In fact, opioids are at the center of the drug epidemic in the United States and responsible for taking hundreds of lives each and every week. However, not all opioids are the same.
Some opioids are stronger and more potent than others, and some are very weak. Whether you are someone who uses drugs recreationally or you know someone who does, it is important to be educated on the dangers of opioid abuse and the different types of opioids. Here is a list of opioids, strongest to weakest.
Carfentanil
Carfentanil is a synthetic opioid that is gaining popularity as it is being found in counterfeit pills or added to other substances to increase the potency and decrease the cost. According to the U.S. Justice Department, carfentanil is nearly 10,000 times more potent than morphine and 100 times more potent than fentanyl, making it the strongest opioid on this list.
Carfentanil is used as a tranquilizing agent for elephants and other large animals. It was never intended for human use. As such a strong drug, people can overdose by ingesting as little as 2 milligrams.[1]
Fentanyl
After carfentanil, the next strongest opioid is fentanyl. Fentanyl is thought to be 50 times more potent than heroin and 80-100 times more powerful than morphine. Even though it was originally created for pain management, particularly in cancer patients or others who are chronically ill, it is also diverted for abuse.[2]
As a highly potent and cheap substance, it is often added to other illicit drugs to drive the price down and make them feel more potent. Fentanyl may also be manufactured in clandestine and illegal laboratories in Mexico or China.
Heroin
Next on the list of opioids from strongest to weakest is heroin. Heroin is derived from the opium poppy plant and, unlike other opioids on this list, has no medical use. As a result, all heroin use is illegal. Even though heroin is weaker than fentanyl or carfentanil in its pure form, much of the heroin on the streets of America today is cut with more powerful substances, making the risk for overdose extremely high.
Dilaudid (Hydromorphone)
Dilaudid is the brand name formulation of hydromorphone, an opioid that is prescribed to treat severe pain. It is one of the strongest opioids patients may be prescribed in the emergency room (ER) and it produces feelings of sedation and relaxation.
Dilaudid produces effects that are similar to those of heroin, only weaker. According to the U.S. Drug Enforcement Administration (DEA), is thought to be between two and eight times more powerful than morphine.[3]
Opana (Oxymorphone)
Opana, the brand name for oxymorphone, is used to treat moderate to severe pain. When taken in tablet form, it is 3 times stronger than morphine. However, when injected, Opana can be stronger than Dilaudid. Even though it may be used to treat moderate pain, individuals should never underestimate how powerful oxymorphone can be. It is highly addictive and can lead to an overdose if abused.
Methadone
Methadone, sometimes sold under the names Dolophine or Methadose, is a medication that is approved by the FDA to treat opioid addiction. However, if abused, it can be habit-forming and addictive just like any other opioid. Similar to Opana, methadone is thought to be 3 times stronger than morphine.[4]
OxyContin, Percocet (Oxycodone)
Oxycodone, the active ingredient found in Oxycontin, Percocet, and Roxicodone, is one of the most commonly abused opioids on this list. It is often prescribed to treat moderate to severe pain in people who go to the emergency room for an injury or accident. Since it is prescribed so often, it is also responsible for many people’s opioid addictions.
Morphine
Morphine is next on the list of opioids from strongest to weakest. It is a naturally occurring opioid that is derived from the poppy plant. Morphine is similar in potency to oxycodone and may be prescribed to treat moderate to severe pain.
Vicodin, Lortab (Hydrocodone)
After Oxycodone, Hydrocodone is another commonly abused and prescribed opioid. Hydrocodone is the active ingredient in the brand-name drugs Vicodin and Lortab. In 2017 alone, there were nearly 84 million prescriptions filled for hydrocodone products.[5] With such a high prescribing rate, there are also high rates of hydrocodone abuse and addiction on the streets. Even though it is one of the weaker opioids on this list, abusing it is still dangerous, addictive, and potentially deadly.
Codeine
Codeine is an opioid that is often found in prescription cough syrup because it can help reduce coughing. However, codeine may also be prescribed by itself to treat mild to moderate pain. While it is weaker than many other opioids that are abused, it still has the potential for addiction, overdose, and other harmful side effects.
Demerol (Meperidine)
Meperidine, better known as Demerol, was one of the first synthetic opioids used to treat mild to moderate pain. Even though it is weaker than most of the strongest opioids on this list, people can develop a dependence and tolerance to Demerol rapidly. As a result, it is highly addictive and thought to be just as dangerous as stronger opioids.
Ultram (Tramadol)
Finally, the last opioid on the list from strongest to weakest is Ultram, better known as Tramadol. As a very weak opioid, Tramadol is often given to people who cannot take opioids and need treatment for mild pain. In terms of potency, it is about 10% as potent as morphine. It is similar in potency to Demerol, however, it is less addictive and habit-forming.
Find Help For Opioid Addiction
No matter how a person starts taking opioids, continuing to take them against medical advice is a recipe for disaster. Whether someone is taking a weak or a strong opioid, they are all habit-forming and destructive to the lives of those who abuse them.
If you or a loved one are struggling with opioid addiction, our team at Mandala Healing Center can help. Call today to learn about your treatment options.
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