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Oxycodone vs Fentanyl for Acute and Chronic Pain Relief

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Oxycodone and fentanyl are potent painkillers in a class of drugs known as opioids, which also include a wide variety of prescription medications and illicit drugs such as heroin. All substances in this category have similar effects intended for acute and chronic pain relief, but they vary widely in intensity and are more or less risky to use depending on their potency and other factors.

Fentanyl is a much more powerful drug than oxycodone and less likely to be found outside clinical settings due to its high potential for overdose. Illicit fentanyl, on the other hand, is a common street drug typically made in illegal labs for non-medical use. Its popularity over the last few years has skyrocketed, and it can frequently be found as an adulterant in other illicit substances, having already led to an untold number of deaths in the last few years alone. More than 932,000 people have died since 1999 from a drug overdose, and synthetic opioids such as fentanyl are the primary impetus for these deaths, being involved in 82% of cases. (1)

If you or a loved one have been misusing oxycodone or fentanyl, you are urged to seek professional treatment to prevent your condition from worsening or leading to death. Guardian Recovery is a specialized addiction treatment center committed to helping individuals struggling with substance misuse break free and develop the tools they need to maintain long-lasting sobriety. Contact us to learn more and begin your recovery journey today.

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What Is Oxycodone?

Oxycodone is a potent prescription opioid medication indicated to provide pain relief resulting from injury, surgery, or chronic conditions. Like all opioids, oxycodone works by attaching to certain receptors in the central nervous system (CNS) and lessening the individual’s perception of pain. Appropriate medical use of oxycodone is relatively safe, but unfortunately, oxycodone can be extremely addictive and has a high potential for misuse and dependence. For this reason, the Drug Enforcement Administration (DEA) classifies oxycodone as a Schedule II substance. (2) As such, it is subject to stringent regulations and penalties, and unless licensed, its manufacture, distribution, and possession are unlawful.

What Is Fentanyl?

Fentanyl is a fully synthetic opioid often found in clinical environments and used for specific medical applications such as anesthesia and severe pain. For these purposes, fentanyl is used in very small amounts due to its potency, which is estimated to be 100 times stronger than morphine. It is occasionally prescribed for at-home use in the form of transdermal patches (e.g., Duragesic) or lozenges. (3) Most fentanyl on the street, however, is not diverted from legitimate sources and is instead produced in illegal laboratories overseas, outside of government control or regulation.

Like oxycodone, fentanyl and its analogs are classified by the DEA as Schedule II substances that are illegal to make, distribute, or possess without a doctor’s prescription.

Similarities & Differences Between Oxycodone & Fentanyl

Oxycodone and fentanyl are similar in many ways, as they both work in the CNS by binding to receptors to reduce pain. However, there are also some important distinctions between them.

Shared Similarities Include:

  • Potent painkilling properties and intense feelings of well-being.
  • Affinity for opioid receptors that can block pain signals.
    Classification as Schedule II controlled substances in the United States.
  • Used to treat severe pain, such as that related to cancer, injury, or after surgery.
    Wide range of common side effects, including drowsiness, dizziness, nausea, constipation, and potentially life-threatening respiratory depression.
  • High potential for tolerance, dependence, and addiction
  • Interactions with other medications, such as other opioids and CNS depressants like benzodiazepines and alcohol.
  • High risk of overdose and death when used in excessive amounts or with other CNS depressants.

Differences Include:

  • Fentanyl is substantially more potent and dangerous to use than oxycodone.
  • Fentanyl is typically used for more severe pain in clinical settings, palliative care, or in extremely slow-acting forms, such as transdermal patches.
  • Oxycodone is often prescribed in tablet form and is safer than fentanyl for extended use.
  • Oxycodone is a semi-synthetic opioid derived from thebaine, an alkaloid in the opium poppy, whereas fentanyl is fully synthesized in a lab and derived from a chemical structure known as phenylpiperidine. (4)

Furthermore, oxycodone and fentanyl can both be obtained illicitly in various forms. However, oxycodone is commonly found in its prescription tablet or capsule form, versus fentanyl, which typically comes in a powder and is frequently laced into other street drugs, such as heroin, cocaine, and meth. Fentanyl can also be found in counterfeit pills marked as oxycodone, hydrocodone, or other prescription drugs.

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Is Oxycodone Stronger Than Fentanyl for Pain Management?

Fentanyl is far stronger in terms of its effects on the brain and body than oxycodone. As such, it may more effectively manage more severe pain in more instances and for a longer period. The major drawback to this is that fentanyl comes with an extremely high risk of overdose, and even small amounts, including exposure through the skin, can be lethal. A fentanyl overdose may also be more difficult to treat, requiring multiple doses of naloxone and extended medical intervention for a patient to fully recover.

Dosage, Administration, & Duration of Action

Oxycodone is available in various forms, including immediate-release (IR) and extended-release (ER) tablets and capsules for oral use.

Oxycodone IR tablets and capsules are available in 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg dosages. (5) Oral use typically results in a 20–30 minute onset of action and 4-6 hours of pain relief.

Oxycodone ER tablets and capsules are available in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, and 120 mg dosages. Oral use typically results in effects within an hour, with a duration of action of up to 12 hours.

Price Comparison

The price of oxycodone varies depending on the formulation, dosage, quantity, and pharmacy. In the U.S., without insurance, the average cash price of a 30-day supply of IR oxycodone tablets ranges from $30 to $300, depending on dose and quantity.

Conversely, the average cash price of fentanyl transdermal patches is approximately $173.93 for two cartons of five patches with a 72-hour duration of action. (6)

It’s important to note that insurance coverage and discounts or coupons can dramatically decrease the cost of both oxycodone and fentanyl in many cases. (7)(8) Both oxycodone and fentanyl products, such as Duragesic, are widely available at most pharmacies in various formulations and doses.

Oxycodone & Fentanyl Addiction, Dependence, & Overdose Risks

Oxycodone and fentanyl both come with the risk of dependence and addiction. Due to fentanyl’s dramatically higher potency and intensity of effects, however, users face greater health hazards than those who take oxycodone. Dependence occurs when a person’s body has become accustomed to the presence of a substance. As a result, attempts to quit result in unpleasant withdrawal symptoms and strong drug cravings.

These effects can make the leap into recovery particularly challenging for many individuals, especially those who’ve developed a full-blown addiction marked by compulsive drug-seeking despite incurring serious consequences, including adverse health issues, damaged relationships, financial or legal troubles, or one or more overdoses.

Symptoms of Opioid Overdose Include:

  • Slow, shallow, or labored breathing.
  • Blue or purple lips and nails (cyanosis).
  • Cold, clammy skin.
  • Pinpoint pupils.
  • Loss of consciousness or unresponsiveness.
  • Slow heartbeat.
  • Extreme sleepiness or fatigue.
  • Confusion or disorientation.
  • Nausea and vomiting.
  • Seizures or convulsions.

If you suspect someone is experiencing an opioid overdose, it is vital they urgently receive medical attention to improve their chances of surviving and making a full recovery. Immediately call 911 or your local emergency services.

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Opioid misuse is risky regardless of which drugs are being taken, although these risks increase with the use of more potent drugs, excessive amounts, or the combined use of interacting substances. If you suspect you or a loved one have an opioid use disorder, Guardian Recovery provides professional treatment and support and can provide you with a free, no-obligation assessment and health benefits check today.

Contact us to learn more about our straightforward admissions process, medical detox services, variety of evidence-based therapies, and more. We can help you begin your recovery journey and provide you with the tools you need to overcome addiction and foster a healthier, more fulfilling life.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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