Oxycodone and fentanyl are both classified as opiate or narcotic medications that are developed from the poppy plant.
These drugs belong to the same class of drugs as heroin, morphine, codeine, and a number of other drugs developed from the poppy plant. They are all primarily used to control pain.
These drugs are classified as endogenous opioid agonists, meaning that they act on and facilitate the actions of specific neurotransmitters in the brain that are involved in the control of pain. The actual mechanism of action of these drugs is only partially described; however, this class of drugs is widely used in the medical field.
Both oxycodone and fentanyl are classified as Schedule II controlled substances by the United States Drug Enforcement Administration (DEA), meaning that while they do have medicinal uses, they are also drugs that have a high potential for abuse and the development of physical dependence. These drugs can only be legally obtained with a prescription from a physician, and the rates of prescriptions written for these drugs are monitored by the DEA.
Much of the following information regarding fentanyl and oxycodone is taken from the book Acute Pain Management: A Practical Guide.
Fentanyl is a synthetic opioid analgesic that has a quick onset of action and a relatively short duration. This means that the effects of fentanyl are felt relatively quickly but are also relatively brief without re-dosing.
Fentanyl is used by means of a number of different modes of administration, and fentanyl patches are commonly used for severe chronic pain; however, there are other forms of fentanyl that can be administered differently. Fentanyl has a number of different brand names that include Durogesic, Sublimaze, Actiq, Fentora, Matrifen, Haldid, and Onsolis.
The transdermal fentanyl patch is applied to the skin and can provide very potent pain relief for as long as 72 hours. Lozenges can be dissolved in the mouth and are used in the treatment of breakthrough pain for individuals taking other forms of opioid drugs for severe pain. The intravenous or injected solution of fentanyl is used as an anesthesia during surgery.
Oxycodone, the major component of the narcotic medications OxyContin and Percocet, is also a narcotic drug that is particularly potent and used to treat moderate to severe chronic pain. It is typically not used as an anesthetic like fentanyl; however, it is often used to treat postoperative pain and individuals that have a chronic pain syndrome, which is recurrent pain that is consistent over a period of weeks or even years.
OxyContin has become a major drug of abuse and is responsible for a number of overdose deaths in the United States. It is typically delivered in pill form.
Major Differences between Fentanyl and Oxycodone
Both drugs are very similar; however, there are some major differences.
- The most salient difference between the two drugs is their relative strengths. Fentanyl is the most potent of all opioid drugs; it is 100 times more potent than morphine. This also makes fentanyl very easy to overdose on if taken inappropriately.
- Because of its higher potency, it is considered to be more dangerous to mix fentanyl with other drugs compared to mixing oxycodone with other drugs of abuse. That being said, it is not advisable to mix other drugs such as alcohol with either of these drugs due to the potential for serious complications.
- Fentanyl is primarily used as a general anesthetic, and oxycodone is more likely to be used as an acute pain medication. Fentanyl patches are prescribed for chronic pain but are typically the last resort for the treatment of chronic pain as they are often used when other narcotic medications are ineffective in fully controlling pain. Oxycodone is typically taken orally; chewing fentanyl patches can result in fatal overdoses.
- The half-life of the drug is the time it takes for the system to break down a drug to half of its original potency. The half-life of oxycodone is between three and four hours unless it is given in an extended-release form. Fentanyl’s half-life depends on its mode of administration, such that:
- Transdermal patch half-lives range from 20 to 27 hours.
- Dissolvable lozenges have half-lives from 5.4 hours to 6.3 hours.
- Nasal spray half-lives are very short, typically around six minutes.
- Because fentanyl is typically administered as a patch or as a dissolvable lozenge, it has a quicker onset of action than oxycodone, which is typically administered in pill form. The effects of fentanyl are felt very quickly, almost immediately, whereas taking Percocet or OxyContin requires up to an hour before the effects are felt.
- Fentanyl tends to be less sedating and has less of a chance of causing an allergic reaction than oxycodone. However, fentanyl is more likely to cause a decrease in breathing rates than oxycodone; therefore, it is more likely to result in a fatal overdose due to respiratory suppression.
- Fentanyl may produce much more intense withdrawal symptoms due to its potency.
Treatment protocols aimed at recovery from opioid use disorders are generally quite similar and require withdrawal management programs, intensive counseling and therapy, social support, participation in other adjunctive treatments, and long-term aftercare protocols.
Fentanyl and oxycodone are drugs that belong to the same general class of drugs: opiate or narcotic medications. The primary use of both of these drugs is the treatment of acute or chronic pain, and both drugs have significant medicinal uses; however, both drugs are also highly prone to being drugs of abuse. Prolonged use of these drugs will result in the development of physical dependence on them.
Fentanyl is far more potent than oxycodone, and this results in a much stronger potential for individuals abusing fentanyl to develop serious issues with overdoses. In addition, because fentanyl is more potent than oxycodone, mixing fentanyl with other drugs leads to a higher potential for severe complications (although it is not advisable to mix other drugs with either fentanyl or oxycodone).
Drugs that have higher potencies result in more intense withdrawal symptoms, and the withdrawal process from fentanyl will most likely result in more severe withdrawal symptoms compared to withdrawal from oxycodone. There are, however, a number of other variables that can affect the withdrawal process in different individuals.