Even though comparing fentanyl vs. oxycodone may primarily draw our attention to the differences between them, there’s one major thing these two opioids have in common: both of them are widely considered the largest contributors to the opioid epidemic.
The first wave of the opioid epidemic, which started back in the 1990s, is closely linked to the overprescription of OxyContin®, a brand-name version of oxycodone. While this opioid still takes thousands of lives every year, today we’re facing the third—and deadliest—wave of the opioid epidemic, ushered in by fentanyl.
So, what makes fentanyl different from oxycodone?
Keep reading to find out—this article will compare the two in terms of effectiveness, addictiveness, side effects, and more.
What Is Fentanyl, and How Does It Work?
Fentanyl is an extremely potent synthetic opioid typically prescribed to manage severe pain, such as that experienced post-surgery. Although it is approved for medical use, it has a high potential for abuse, dependence, and addiction.
Fentanyl comes in many different forms, including:
- Injectable solution
- Transdermal patches
- Oral transmucosal lozenges
- Sublingual tablets and sublingual spray
Some of the most common names it is marketed under include Actiq®, Sublimaze®, Abstral®, and Duragesic®.
In recent years, fentanyl has become a very popular street drug, with TNT, Murder 8, Goodfellas, and Dance Fever being some of its most common street names. It is also often used to lace other illicit drugs, including oxycodone, which increases the risk of an overdose.
Fentanyl relieves pain by binding to the opioid receptors in the central nervous system (CNS) and stopping pain signals from reaching the brain. It can also induce intense feelings of euphoria, relaxation, and sedation.
What Is Oxycodone, and How Does It Work?
Oxycodone is a semi-synthetic opioid used to ease moderate-to-severe pain that cannot be managed with non-opioid pain medications.
With over 11.5 million prescriptions issued in 2021, oxycodone is the most commonly prescribed opioid after acetaminophen/hydrocodone (Vicodin®). It can also be combined with other medications, including acetaminophen (Percocet®).
By itself, oxycodone is sold under its generic name and several brand names, such as OxyContin® and Roxicodone®. It is available in the form of oral solutions, immediate- or extended-release capsules, and tablets. Oxy, Hillbilly Heroin, and OC are some common street names for oxycodone.
Since they both belong to the opioid family, oxycodone works in the same way as fentanyl: it interacts with opioid receptors to soothe pain but also causes euphoria and deep relaxation.
Key Differences Between Fentanyl vs. Oxycodone
Now, let’s see the key differences between fentanyl vs. oxycodone in terms of effectiveness, chemical composition, addictive potential, and cost.
Fentanyl vs. Oxycodone Effectiveness
Both fentanyl and oxycodone are highly effective pain medications. Even though fentanyl is the most potent opioid, several studies comparing the effectiveness of fentanyl vs. oxycodone injections suggest that oxycodone provides better pain relief than fentanyl post-surgery.
A randomized controlled trial of 46 patients who underwent hip replacement surgery showed that a single, large dose of oxycodone administered intravenously is more effective than that of fentanyl.
Similarly, another study found that oxycodone is more effective in relieving pain after a gastric laparotomy than fentanyl.
Fentanyl vs. Oxycodone Chemical Composition
While both are opioids, fentanyl is synthetic, whereas oxycodone is semi-synthetic. This means that while fentanyl is fully human-made and devoid of natural opioids, oxycodone is synthesized from thebaine, an alkaloid that naturally occurs in the opium poppy.
Moreover, oxycodone is a phenanthrene derivative and thus structurally resembles morphine. Meanwhile, fentanyl isn’t structurally related to morphine, as it belongs to the chemical class of phenylpiperidines.
Nonetheless, both are classified as full opioid agonists and thus activate opioid receptors fully, producing intense effects.
Fentanyl vs. Oxycodone Addictiveness
Both fentanyl and oxycodone are highly addictive, which is why they are classified as Schedule II controlled substances and can only be legally obtained by prescription.
Taking them as prescribed can reduce the risk of addiction, but it doesn’t eliminate it. Since opioids alter the brain chemistry, anyone taking them risks becoming dependent.
However, fentanyl has a very rapid onset of action—you may start feeling its effects within minutes after taking it. This, coupled with its exceptional potency, means that fentanyl might lead to abuse, dependence, and addiction even quicker than oxycodone.
Fentanyl vs. Oxycodone Cost
The cost of fentanyl and oxycodone largely depends on the drug’s formulation, the strength of your prescription, and similar factors. Generic prescription opioids are always cheaper than their brand-name versions. Some insurance plans also offer coverage for them.
For comparison, a single generic tablet containing 5mg of oxycodone costs around $0.19–$0.64. However, you might have to pay as much as $24 for one generic 80 mg extended-release oxycodone tablet.
Meanwhile, one unit of generic intravenous fentanyl solution (50 mcg/ml) costs around $0.53, whereas a single generic buccal tablet of 100 mcg fentanyl might cost you just under $50.
Now that you’re more familiar with both of these painkillers, let’s compare fentanyl vs. oxycodone in terms of side effects.
Fentanyl vs. Oxycodone Side Effects
Fentanyl and oxycodone can cause many of the same side effects, including:
- Nausea
- Vomiting
- Drowsiness
- Constipation
- Dry mouth
- Headache
- Lightheadedness
- Confusion
- Itching
While their side effects tend to be similar, the above-mentioned study comparing the efficacy of oxycodone vs. fentanyl after gastric laparotomy found that oxycodone is slightly more likely to cause nausea and vomiting than fentanyl. Meanwhile, fentanyl is significantly more likely to lead to sedation than oxycodone.
Moreover, taking fentanyl or oxycodone for a prolonged period of time and/or in higher doses than prescribed also increases the risk of:
- Tolerance
- Opioid dependence
- Opioid addiction
- Sleep problems
- Respiratory depression
- Organ (liver, kidney, etc.) damage
- Opioid overdose
- Death
Mixing opioids with other drugs can also increase the risk of severe side effects.
On that note, let’s discuss fentanyl and oxy interactions with other substances in greater depth.
Fentanyl and Oxycodone Drug Interactions
Like all medications, fentanyl and oxycodone can interact with other drugs and even herbal supplements. Never combine them with any other substance before consulting your doctor. This can lead to serious and potentially life-threatening adverse events, such as respiratory depression and opioid overdose.
In particular, fentanyl and oxycodone may interact with:
- Alcohol
- Sleep medications
- Benzodiazepines
- Muscle relaxants
- Antihistamines
- Other opioids
- Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs)
Both fentanyl and oxycodone may also interact with certain foods. For example, grapefruit juice impairs the metabolism of both of these drugs. This can lead to higher concentrations of fentanyl and oxycodone in the blood, enhancing the risk of respiratory depression.
Other Risk Factors of Fentanyl and Oxycodone
Before taking fentanyl or oxycodone, inform your doctor about any medical conditions you have to reduce the risk of severe side effects.
These medications may not be suitable for you if you:
- Are pregnant
- Have low blood pressure
- Are allergic to fentanyl or oxycodone
- Suffer from lung, kidney, liver, or heart problems
- Have experienced a stroke, a head injury, or another condition that elevated the pressure in your skull
Also, you should never take fentanyl if you have little to no tolerance to opioids. Given how potent this drug is, even a small amount can dangerously suppress your breathing or lead to a fentanyl overdose.
Physical Dependence and Addiction to Opioids
Opioids like fentanyl and oxycodone can lead to dependence and addiction, even when taken as prescribed. Over time, the body becomes so accustomed to opioids that the usual dose loses its effectiveness. This is known as tolerance, and it signifies a dependence on opioids.
Once you become dependent on fentanyl or oxycodone, your body needs them to maintain normal function. If you stop taking them, you’ll experience uncomfortable withdrawal symptoms.
While dependence and addiction often co-occur, they aren’t the same. Unlike dependence, opioid addiction is marked by a loss of control over opioid use; those addicted to opioids cannot stop taking them despite the toll these drugs take on their lives.
Signs and Symptoms of Opioid Addiction
Some of the most common signs and symptoms that indicate you or a loved one might be suffering from opioid addiction include:
- Continuing to take opioids even when they’re no longer medically needed
- Taking opioids in other ways than prescribed to enhance their effects
- Increasing the dosage or frequency of opioid use without a doctor’s approval
- Showing less interest in previously enjoyed activities
- Becoming more isolated or secretive
- Spending a lot of time trying to obtain opioids or using them
- Lying about opioid use or to get opioids (e.g., exaggerating or faking pain to get a prescription)
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is a life-changing opioid dependence treatment that can help you conquer fentanyl or oxycodone dependence in a matter of days.
ANR is the only treatment that treats the root cause of opioid dependence. By re-regulating the endorphin-receptor system to its normal state, the ANR treatment restores the brain to its pre-addiction state, eradicating the risk of ongoing withdrawal symptoms and relapse.
While effectiveness is the greatest advantage of the ANR treatment by far, this treatment also stands out due to its safety and speed. The average hospital stay for ANR patients lasts just 36 hours on average.
Furthermore, ANR is carried out in an ICU setting of an accredited hospital by board-certified medical professionals. This, coupled with the fact that the treatment is tailored to each patient individually, enhances its safety and makes it suitable even for those with complex health conditions.
Looking to leave oxycodone or fentanyl dependence behind? Contact us today for a free consultation!
Key Takeaways
Lastly, let’s wrap up this fentanyl vs. oxycodone comparison by highlighting the key differences between them:
- Fentanyl is used to relieve severe pain, whereas oxycodone is prescribed for moderate-to-severe pain relief.
- Even though oxycodone is weaker than fentanyl, it can be more effective in certain cases, such as postoperative pain management.
- Fentanyl and oxycodone cause similar side effects, but fentanyl has a more substantial sedating effect.
Fentanyl vs. Oxycodone FAQ
Opioids are the strongest painkillers, and fentanyl is the strongest of them. It is as many as 100 times more potent than morphine. For comparison, oxycodone is about 1.5 times as potent as morphine.
Fentanyl can be consumed orally (in the form of tablets, lozenges, or a spray), injected, or administered in the form of a transdermal patch or a nasal spray. Your doctor will indicate the method of consumption in your prescription. Taking it in other ways than prescribed constitutes fentanyl abuse and can increase the risk of dependence and addiction.
While taking fentanyl as prescribed reduces the risks associated with it, it doesn’t make it safe. Anyone taking it is exposed to the risk of dependence and addiction, especially if they take it for a prolonged time. You can fall victim to fentanyl addiction even if you carefully follow your doctor’s recommendations.
The difference between morphine, oxycodone, and fentanyl lies in their origin and potency. Morphine is a natural opioid (opiate); meanwhile, oxycodone is a semi-synthetic opioid, whereas fentanyl is entirely synthetic. While morphine is the weakest of the three, fentanyl is the most potent.
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