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What Is the Strongest Opiate?

Opiate and opioids are two terms used interchangeably. Opiates and opioids are part of a single class of drugs which include prescription pain relievers and heroin. While opiates are technically naturally derived from opium, and opioids are synthetically made, both affect the brain in the same way. Opiates and opioids bind to the opioid receptors in the central nervous system. In doing so, they change how the user senses pain. In addition to pain relief, opiates and opioids can also create feelings of euphoria, known as a high. These drugs trigger reward and emotion responses in the brain, which can lead to addiction.

While all opiates and opioids are similar in how they behave in the brain, they’re not all the same regarding strength. For example, there are some opiates considered relatively mild, while others are so potent they can cause an almost instantaneous overdose in people who aren’t opioid-tolerant. The use of opioids has led to an epidemic in the U.S., with more than two million people reportedly addicted to these drugs. So, which are the strongest opiates and opioids?

Carfentanil

Carfentanil has become one of the most worrisome opioids in the U.S. This synthetic opioid is an analog of fentanyl, and it’s 100 times as potent. It’s 5,000 times as potent as heroin, and 10,000 times stronger than morphine. There has been a surge in drugs like heroin being laced with carfentanil, and this drug almost always leads to overdoses and deaths. Carfentanil is often brought into the U.S. after being manufactured in China. Frequently, people have no idea they’re taking carfentanil. This synthetic opioid is so strong that international governments are worried it could be used as a weapon of mass destruction.

Fentanyl

Fentanyl is behind only carfentanil as the strongest opioid. It’s synthetic and believed to be anywhere from 30 to 50 times more potent than heroin. This prescription drug is intended to treat severe pain following surgery as well as in opioid-dependent people with chronic pain. This schedule II drug is so powerful that only ¼ of a milligram can cause death. The majority of opioid overdose deaths are related to fentanyl.

Heroin

While other strong opioids are prescription medications, heroin is an illegal drug in the U.S. This semi-synthetic opioid has no medicinal purposes, and it’s the only schedule I opioid. This means that the DEA believes heroin is extremely addictive and has a high potential for being misused. Heroin enters the bloodstream very quickly and creates a rapid high, particularly when it’s injected or snorted. The instantaneous effects of heroin make it very powerful.

Hydromorphone and Oxymorphone

Hydromorphone and oxymorphone are among the strongest opioids. They are several times stronger than morphine, and as with other opiates and opioids, they have a high potential for abuse. Hydromorphone is available as the brand name prescription drug Dilaudid. Oxymorphone is sold under the brand name Opana.

Following the above strong opiates and opioids, they then go down in strength from there. Oxycodone isn’t as strong as the above drugs, but it is still very addictive. Oxycodone is found in brand-name drugs like Percocet and Oxycontin. Morphine is a natural opiate used in medicine, and it’s as powerful as oxycodone. Hydrocodone is almost the same strength as morphine and is brand-name drugs like Vicodin and Lortab. Codeine is one of the weakest opioids and is usually given in cough medicines or to alleviate pain ranging from mild to moderate. Some formulations with codeine are schedule II or V, meaning the risk of abuse is relatively low.

While the strength of opiates and opioids may vary, it’s important to realize they are all addictive and can cause physical dependence. If you or a loved one struggles with opiate or opioid misuse, please reach out to our team of addiction and recovery specialists at The Recovery Village.

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