How is fentanyl different from oxycodone and other opioids?

Both drugs are similar since they are both opioids; however, there are some major differences.

  • The most salient difference between the two drugs is their potency. Fentanyl is the most potent of all opioid drugs; it is 50 to 100 times more potent than morphine, and morphine is 1.5 times more potent than oxycodone. Both are easy to overdose on if taken inappropriately, but this makes fentanyl especially dangerous in illicit markets.
  • According to provisional counts for 2017, over 29,400 overdose deaths involved synthetics opioids (not including methadone), and most of these involved fentanyl. Over 14,900 involved natural and semi-synthetic opioids, which would include oxycodone.
  • While fentanyl is available as a transdermal patch, nasal spray, lozenge, sublingual tablet, buccal tablet, and solution for intramuscular or intravenous use, oxycodone is typically only available in tablet or capsule form to be taken orally.
  • The drugs have different duration of actions (the amount of time the drug is effective for). This also depends on the formulation of the drug. Examples of typical durations include:
  • Similarly, the drugs also have different onset of actions, depending on formulation. Onset of action is the amount of time after the drug is administered before a person begins feeling its intended effects. Examples of typical times until onset include:
  • One study found that fentanyl and oxycodone provided comparable postop pain relief, but that oxycodone was less sedating than fentanyl. However, they found there were more side effects in patients who took oxycodone, although this difference was not statistically significant.

Both drugs can cause users to become dependent on opioids, even when not being misused. These individuals may need medical detox, possibly including medication-assisted treatment (MAT), to safely detox from opioids. Addiction to these drugs is also very common, but there are effective treatments for opioid use disorders. Treatment may include medications, individual therapy, group therapy, and other adjunctive treatments.

Conclusions

doctor reviewing medical detox options for fentanyl addiction

Fentanyl and oxycodone are drugs that belong to the same general class of drugs: opioid medications. Both drugs are used to treat significant pain.

However, both drugs are also highly prone to being drugs of abuse. Regular use of these drugs can result in the development of tolerance and physical dependence. Fentanyl is far more potent than oxycodone, and it is involved in more overdose deaths in the US.

There is help available for individuals who are dependent on opioids, including inpatient detox and outpatient detox. Medications can be used to lessen or eliminate withdrawal symptoms, and alternative methods of pain management can be used for those who need them. Addiction treatment programs can help those who struggle with opioid use disorders, whether they involve fentanyl, oxycodone, or other opioids.

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