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Understand the Differences Between Fentanyl and Oxycodone

While both fentanyl and oxycodone are used for medical and recreational reasons, there are major differences between the two drugs.

What Is Fentanyl?


Fentanyl is a synthetic opioid drug that has medical purposes. It has also been playing a significant role in the current opioid overdose epidemic.

Medically, fentanyl is used to treat severe pain, such as following an accident, after surgery, cancer pain. Recreationally, however, fentanyl has increasingly become a dangerous drug of abuse.

Fifty to 100 times more potent than morphine, fentanyl is a powerful pain reliever. Because of this strength, however, it is also widely misused. Many people experiment with fentanyl recreationally because of the strong high that it can induce, while many other people take the drug unknowingly and suffer serious consequences.

Illicit manufacturers of fentanyl and other synthetic opioids commonly mix fentanyl into other products because it is so strong, and only a small amount is needed to create a product that produces an effective high that is similar to heroin. Illegally made fentanyl, however, is extremely dangerous and linked to most of the recent cases related to synthetic overdose and death.

From 2012 to 2015, the United States saw a 264 percent increase in the number of deaths caused by synthetic opioids across the country. In 2017, over 28,000 people died from overdoses caused by synthetic opioids.

The rates of fentanyl prescriptions have decreased over the past few years, yet fentanyl-related overdoses continue to rise, suggesting an increase of illicit fentanyl production.

What Is Oxycodone?


Oxycodone is a synthetic opioid like fentanyl, though it is not nearly as strong. Medically, it is used for the treatment of moderate to moderately severe pain, and it is widely prescribed throughout the U.S. According to the Drug Enforcement Administration (DEA), almost 59 million prescriptions for oxycodone were filled in 2013.

Oxycodone has played a significant role in the country’s opioid epidemic from the very beginning. Since the early 1960s, oxycodone abuse has been a problem, reports the DEA. It has similar pain-relieving effects as morphine and is relatively accessible, making it a prime candidate for abuse.

Widespread abuse of prescription opioids, like oxycodone, began in the 1990s when doctors began prescribing them in large amounts without awareness of their highly addictive potential. According to the National Survey on Drug Use and Health (NSDUH), over 16 million people reported using oxycodone for nonmedical purposes in 2012. Between 1999 and 2017, prescription opioid misuse caused nearly 218,000 deaths, a number that increased fivefold since 1999.

The Primary Similarities

Oxycodone and fentanyl are both synthetic opioids that provide significant pain relief. They both have their place in the medical world, and they are both misused recreationally.

Due to the addictive nature of both substances, the DEA has classified both drugs as Schedule II controlled substances. This classification is meant to serve as warning to users about the high risk of abuse and dependence that the drugs pose.

Since they are both opioids, oxycodone and fentanyl cause similar side effects. Common side effects of opioids include the following:

  • Nausea and vomiting
  • Constipation
  • Headache
  • Dizziness
  • Lightheadedness
  • Sleepiness
  • Weakness and lack of energy
  • Severe itching
  • Dry mouth
  • Sweating
  • Insomnia
  • Slowed breathing
  • Fainting
  • Confusion
  • Low blood pressure
  • Seizures

The above symptoms range in severity. While most are expected to clear up on their own as your body gets used to the medication, some symptoms indicate a serious reaction to the drugs. In the cases of severe breathing problems, very low blood pressure, seizures, or fainting, you’ll want to get medical help right away.

An additional risk and common side effect of using both oxycodone and fentanyl is the likelihood of developing a dependence on either substance. Dependence does not necessarily mean an addiction is present, though increased use of either substance for an extended period of time will also increase your chances of developing an opioid use disorder.

drug addiction

The Primary Differences

The greatest difference between oxycodone and fentanyl is the potency of each drug. Both drugs provide similar effects but to much different degrees. While fentanyl is as much as 100 times stronger than morphine, morphine is 1.5 times stronger than oxycodone.

When taking fentanyl or oxycodone, it is vital to be aware of your dosage levels even when prescribed by a doctor. The Centers for Disease Control and Prevention (CDC) explains that higher dosages of opioids are directly associated with an increased risk of overdose and death. Because of this risk, especially in regard to fentanyl, it is highly recommended to use the lowest possible dosage of any prescription opioid you are using.

Because fentanyl is so potent, its is associated with many more overdose deaths than oxycodone is. The National Institute on Drug Abuse (NIDA) reports that more than 29,000 deaths were due to synthetic opioid abuse in 2017, most of which involved fentanyl. The same year, nearly 15,000 deaths were attributed to semi-synthetic opioids like oxycodone.

Additional differences between fentanyl and oxycodone include how they are administered and how long the effects of each can be felt. Medically, fentanyl is available as an injection, nasal spray, lozenge, and transdermal patch. Oxycodone, on the other hand, is primarily available as pill to be taken orally.

Unless you are using the transdermal patch version of fentanyl, which can release medicine for up to four days, the effects of oxycodone are typically felt for longer durations. Oxycodone pills provide pain relief for 3 to 12 hours, depending on whether you are using the immediate- or extended-release version. Fentanyl injections, sprays, and lozenges typically last for 1 to 2 hours.

Signs of Fentanyl and Oxycodone Misuse

If you are using fentanyl or oxycodone, it is important to be aware of signs of opioid misuse so you can get help before it is too late. When someone begins to exhibit problematic behaviors or psychological changes that can’t be explained by any other current events in their life, there is a good chance that opioid misuse is to blame.

Signs of opioid intoxication include the following:

  • Drastic mood changes
  • Anxiety
  • Uncontrollable movements of the hands or tongue
  • Pacing
  • Impaired cognition
  • Lessened coordination
  • Constricted or dilated pupils
  • Drowsiness
  • Slurred speech
  • Reduced attention and memory
  • Cravings to use opioids
  • Inability to function without opioids
  • Loss of control over drug use

woman on bed suffering from xanax hangover

When someone continues to use their drug of choice despite facing health, financial, work, and relationship problems, they are likely battling with a substance use disorder. Misuse of opioids like oxycodone and fentanyl may have started through a doctor’s prescription, but even when taking opioids as directed by a doctor, many people develop habits of misuse. Opioids are extremely habit-forming medications that must be taken with caution.

Using Fentanyl and Oxycodone Safely

Although there are many risks associated with using fentanyl and oxycodone, they serve important medical purposes and can be taken safely. The U.S. National Library of Medicine’s MedlinePlus explains that when taken for short periods of time exactly as prescribed by your doctor, prescription opioids are generally considered to be safe.

It is important, however, not to mix prescription opioids with any other substances, including alcohol. Only take them for as long as medically necessary, and do not experiment with them for recreational reasons or for the sole purpose of getting high.  


Calculating Total Daily Dose of Opioids for Safer Dosage. U.S. Department of Health and Human Services.

Drug Scheduling. United States Drug Enforcement Administration.

Fentanyl Transdermal (Rx). Medscape.

Opioids. (February 2018). Psychology Today.

Opioid Overdose: Fentanyl. (December 2018). Centers for Disease Control and Prevention.

Overdose Death Rates. (January 2019). National Institute on Drug Abuse.

Oxycodone, Oral Tablet. (October 2018). Healthline.

Oxycodone (Rx). Medscape.

Prescription Opioid Data. (December 2018). Centers for Disease Control and Prevention.

Safe Opioid Use. (August 2018). U.S. National Library of Medicine: Medline Plus.

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