Opioids

Opioid List And Potency


If you are switching meds, say from 30 milligrams of Morphine taken orally to Oxymorphone taken orally, looking at the info below will tell you that 30 milligrams of oral Morphine is roughly equal to 10 to 15 milligrams of oral Oxymorphone.

Instead of taking a 15 milligram dose of Oxymorphone right away, consider taking a 5 to 10 milligram dose, and see if it provides the necessary analgesic action required. If not, raise the dose slowly on subsequent attempts.

Starting off at too high of a dose when switching pain relief medications could lead to overdose, which could cause serious consequences including fatalities. Start slow at a low dose and slowly work your way up to a higher dose.

Oral Opioid List
--- oral tramadol (ultram)
--- oral codeine (codeine)
--- oral tapentadol (nucynta)
--- oral hydrocodone (vicodin)
--- oral morphine (morphine)
--- oral oxycodone (oxycontin)
--- oral oxymorphone (opana)
--- oral methadone (dolophine)
--- oral hydromorphone (dilaudid)
Notes On Opioids
Image Credits


Oral Opioid List - Common Opioids

The following opioids are listed with the least potent, by weight when taken orally, at the top of the list and the most potent, by weight when taken orally, at the bottom.

When taken by other means than orally, for example with inhalation or injection, the relative potency of many opioids changes when compared to when they are consumed orally.

Do not assume that because a certain drug is 2-3 times stronger than a similar size dose of morphine, when taken orally, that it will be 2-3 times stronger than a similar size dose of morphine, when injected or taken via other routes.


Tramadoli) Tramadol is a generic name for a synthetic opioid drug.

You can buy generic tramadol and find it marketed under brand names like: Ultram.

When taken orally, immediate release Tramadol is about 1/10 to 1/12 as strong as immediate release Morphine taken orally. When taken orally, 10-12 milligrams of Tramadol are equal to about 1 mg Morphine.

It would take about 300 to 360 milligrams of immediate release Tramadol taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

Note that the maximum recommended dose is 100 mg for immediate release, and 75 mg for slow release Tramadol. The total daily maximum is about 300 mg for instant release and 400 mg for slow release formulations.

Immediate release Tramadol taken orally starts working in about 30-60 minutes, and takes about 60-90 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Tramadol pills are available in various dose sizes including: 50 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 25 to 50 milligrams.


Codeineii) Codeine is a generic name for a natural occuring opioid drug found in the latex obtained from opium poppies, botanical name Papaver somniferum.

You can buy generic codeine and find it marketed under various brand names. In addition to being found in stand alone preparations, codeine is often combined with products like acetaminophen, aspirin, caffeine, doxylamine, as well as other compounds.

When taken orally, immediate release Codeine is about 1/5 as strong as immediate release Morphine taken orally. When taken orally, 5 milligrams of Codeine are equal to about 1 mg Morphine.

It would take about 150 milligrams of immediate release Codeine taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

Note that the maximum recommended dose of immediate release codeine is about 60 milligrams. The total daily recommended maximum intake of instant release is 240 mg. Daily intake above 240 mg does not usually increase analgesia but may increase negative side effects.

Immediate release Codeine taken orally starts working in about 20-60 minutes, and takes about 45-90 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Codeine pills are available in various dose sizes including: 15, 30, 60 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 15 milligrams.


Tapentadoliii) Tapentadol is a generic name for a synthetic opioid drug.

You can buy generic tapentadol and find it marketed under brand names like: Nucynta, Palexia, Tapal.

When taken orally, immediate release Tapentadol is about 1/3 as strong as immediate release Morphine taken orally. When taken orally, 3 milligrams of Tapentadol are equal to about 1 mg Morphine.

It would take about 100 milligrams of immediate release Tapentadol taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

Immediate release Tapentadol taken orally starts working in about 20-60 minutes, and takes about 60-90 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Tapentadol pills are available in various dose sizes including: 50, 75, 100 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 25 milligrams.


Hydrocodoneiv) Hydrocodone is a generic name for a semi-synthetic opioid drug.

You can buy generic hydrocodone and find it marketed under various brand names. Mixed with acetaminophen, it has been sold as Lortab, Norco, Vicodin. Mixed with ibuprofen, it has been sold as Vicoprofen. Zohydro is an extended release formulation of pure hydrocodone.

When taken orally, Hydrocodone is about as strong as an equal size dose of Morphine taken orally. When taken orally, 1 milligram Hydrocodone is equal to about 1 mg Morphine.

It would take about 30 milligrams of Hydrocodone taken orally to produce the same analgesic effect as 30 milligrams of Morphine taken orally.

Hydrocodone pills taken orally will start working in about 20-45 minutes, and take about 45-120 minutes to work fully. The primary effects last about 2-6 hours, or longer.

Hydrocodone pills are available in various dose sizes including: 2.5, 5.0, 7.5, 10 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 2.5 to 5.0 milligrams.

Hydrocodone is most commonly available in continuous, extended, slow release formulations so it can take longer to work fully. It is rarely, if ever, commercially produced in immediate release formulations.


Morphinev) Morphine is a generic name for a natural occuring opioid drug found in large concentrations in the latex obtained from opium poppies, botanical name Papaver somniferum.

You can buy generic morphine and find it marketed under brand names like: Kadian, Morphabond, Roxanol. MS Contin is a continuous release formulation.

Immediate release Morphine taken orally starts working in about 15-30 minutes, and takes about 30-60 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Morphine pills are available in various dose sizes including: 5, 10, 20, 30 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 2.5 to 5.0 milligrams.


Oxycodonevi) Oxycodone is a generic name for a semi-synthetic opioid drug.

You can buy immediate release generic oxycodone and find it marketed under brand names like: Roxicodone, Xolox. When mixed with aspirin: Percodan. When mixed with acetaminophen: Endocet, Oxycet, Percocet, Primlev, Roxicet, Roxilox, Tylox. A continuous release formulation of pure oxycodone is available as OxyContin.

When taken orally, immediate release Oxycodone is about 1.5 to 2.0 times stronger than immediate release Morphine taken orally. When taken orally, 1 milligram Oxycodone is equal to about 1.5 to 2.0 mg Morphine.

It would take about 15 to 20 milligrams of immediate release Oxycodone taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

Immediate release Oxycodone taken orally starts working in about 10-20 minutes, and can take 30-60 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Oxycodone pills are available in various dose sizes including: 2.5, 5, 10, 15, 20, 30 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 2.5 to 5.0 milligrams.


Oxymorphonevii) Oxymorphone is a generic name for a semi-synthetic opioid drug.

You can buy generic oxymorphone and find it marketed under brand names like: Numorphan, Numorphone, O-Morphon, Opana.

When taken orally, immediate release Oxymorphone is about 2 to 3 times stronger than immediate release Morphine taken orally. When taken orally, 1 milligram Oxymorphone is equal to about 2 to 3 mg Morphine.

It would take about 10 to 15 milligrams of immediate release Oxymorphone taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

Immediate release Oxymorphone taken orally starts working in about 10-15 minutes, and takes about 30-60 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Oxymorphone pills are available in various dose sizes including: 5, 10 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 2.5 milligrams.


Methadoneviii) Methadone is a generic name for a synthetic opioid drug.

You can buy generic methadone and find it marketed under brand names like: Dolophine, Methadose.

When taken orally, immediate release Methadone is about 2 to 5 times stronger than immediate release Morphine taken orally. When taken orally, 1 milligram Methadone is equal to about 2 to 5 mg Morphine.

It would take about 6 to 15 milligrams of immediate release Methadone taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

The potency of Methadone can vary widely depending on the individual. It can also change when ingested on a regular basis. Start with small dose sizes, and decrease the dose if you find it getting more potent after repeated use.

Immediate release Methadone taken orally starts working in about 15-30 minutes, and takes about 30-60 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Methadone pills are available in various dose sizes including: 5, 10, 40 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 2.5 milligrams.


Hydromorphoneix) Hydromorphone is a generic name for a semi-synthetic opioid drug.

You can buy generic hydromorphone and find it marketed under brand names like: Dilaudid, Dimorphone, Hydal, Hydromorfan, Hydromorphan, Hydromorph Contin, Hydrostat, Hymorphan, Laudicon, Opidol.

When taken orally, immediate release Hydromorphone is about 4 to 6 times stronger than immediate release Morphine taken orally. When taken orally, 1 milligram Hydromorphone is equal to about 4 to 6 mg Morphine.

It would take about 5.0 to 7.5 milligrams of immediate release Hydromorphone taken orally to produce the same analgesic effect as 30 milligrams of immediate release Morphine taken orally.

Immediate release Hydromorphone taken orally starts working in about 10-15 minutes, and takes about 30-60 minutes to work fully. The primary effects last about 2-6 hours for immediate release formulations.

Immediate release Hydromorphone pills are available in various dose sizes including: 1, 2, 3, 4, 8 milligrams. It is also sold as an oral liquid. Recommended initial oral dose size for pain or recreation, either pill or liquid, for those with no opioid tolerance is 1 milligram.


Notes On Opioids

1 --- The effects of continuous release, extended release, slow release, or other non-immediate release formulations are not as strong as a similar sized dose of an immediate release product, but the effects last longer.

2 --- The first time you try an opioid drug for any reason, try the mildest drug (closest to the top of the list on this page) in as small a dose size as possible.

If the results were not effective enough, you can increase the dose size in small increments on subsequent attempts, until you find a dose size that you feel you are comfortable taking.

Stick with the least potent opioid in the smallest dose possible. Years down the road, if your pain gets worse or the need to increase the effects of the medicine occurs, you can switch to a more potent opioid.

3 --- Check out opioid potentiating instructions like this guide. It discusses different ways to increase the effects and duration of opioid pain relief medicine. This can result in having to consume smaller amounts of opioids.

4 --- Regardless of what anyone tells you, do not take a dose if you don't think it is necessary. For instance don't take one pill every 8 hours just because the pill bottle says so. Keep it to a minimum all the time.

5 --- Alternating drugs is a good idea when possible. There are differences in the chemical structure of each opioid drug that make them unique. Don't take the same drug all the time and you will reduce the chances of quickly building up a tolerance to a specific drug.

6 --- When given the choice between synthetic, semi-synthetic, or natural drugs. A natural opioid like morphine or codeine might be the best choice. Being naturally occuring compounds, they may be the best option for some people.

7 --- Pills can be split with a pill splitter, a pill splitter is available at most pharmacies. However, when splitting pills there is no guarantee the active ingredient is evenly distributed in the pill.

So one half of the split pill might contain more medication than the other. If possible when you want a certain dose, 5 mg for example, get a 5 mg pill rather than splitting a 10 mg pill in half.

8 --- Tramadol inhibits the reuptake of serotonin. So depending on the individual, it may prove an effective antidepressant. Both Tramadol and Tapentadol inhibit the reuptake of noradrenaline.

They will have more of a stimulating effect on a majority of patients when compared with other opioids. This can make them better suited to those taking pain medications in order to work or remain physically active.

9 --- If you were an opioid user and had gradually increased the dose size then quit for several months or longer, if you resume taking opioids again, do not go back to the same size dose you were taking before you stopped.

Over the course of months and years after stopping, your tolerance will probably decrease. Taking a dose the same size as when you stopped can cause a person to overdose, which could possibly be fatal.

10 --- For some people, alcohol will increase the potency of opioids. Many people who don't drink often find that alcohol reduces, rather than increases, the effects. Like the alcohol is fighting the opioid, making it less potent.

People who are regular drinkers usually like the combination. But, opioids and alcohol both decrease respiration. Opioid overdose, including heroin, often occurs because opioids were mixed alcohol and/or benzodiazepines. Death comes from not breathing.

11 --- Even if you don't develop a physical addiction to opioids, you may still develop a psychological addiction that causes mental distress if you don't get the drug at the time you are used to.

Psychological addiction is a person's need to use the drug for the way it makes them feel mentally, rather than to relieve physical withdrawal symptoms. It is not limited to drugs, even things like gambling, sex, eating, can be psychologically addicting.

12 --- To minimize the addictive and tolerance potential, limiting intake to once a week or less often and keeping the dose size to a minimum will help.

So for people taking opioids for spiritual, recreational, or other reasons, keeping the frequency and dose of medication intake to a minimum is a good way to pursue a healthy relationship with these substances.

For chronic pain management where more frequent pain relief is needed, ingesting opium based pain medication only once a week, or less often than that, will probably not be a practical solution for most individuals.

13 --- Besides working well on their own, they can be taken in combination with many of the other medications, like cannabis and benzodiazepines.

Combining opioids with other substances to treat pain can reduce the amount of medication that has to be consumed, and provide more pain relief, than if either medication were used by itself.

Unfortunately for sufferers of chronic pain, getting a doctor to write a prescription for opioids may be a hard thing to accomplish. You may be forced to find a source on your own.

14 --- The word opioid is applied, on this website, to include naturally occuring, synthetic, or semi-synthetic substances that produce effects on the central nervous system that are similar to opium.

Opiate is technically defined as the naturally occuring substances produced by the plant known by the botanical name Papaver somniferum, commonly called the opium poppy.

By definition, opiates include: codeine, morphine, thebaine, opium. Some definitions do not classify opium itself as an opiate. This site does include opium in the opiate category.

On this site, opiates are included in the opioid category. By some definitions, only synthetic or semi-synthetic compounds are classified as opioids and naturally occuring opiates are not.


Image Credits

Chemical structure of tramadol by Vaccinationist.
Chemical structure of codeine by NEUROtiker.
Chemical structure of tapentadol by Fvasconcellos.
Chemical structure of hydrocodone by Edgar181.
Chemical structure of morphine by NEUROtiker.
Chemical structure of oxycodone by Fvasconcellos.
Chemical structure of oxymorphone by Fuse809.
Chemical structure of methadone by Calvero.
Chemical structure of hydromorphone by Yikrazuul.