Oxycodone vs Morphine Opioids for Severe or Acute Pain Relief

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Oxycodone and morphine are both opioids commonly prescribed to treat acute or chronic moderate-to-severe pain. When used as directed by a doctor, these medications can be safe and effective for their intended purposes. However, both drugs have a high potential for misuse, which can lead to many adverse health consequences, dependence, and addiction.

If you or a loved one is struggling with opioid misuse, you are urged to seek comprehensive treatment to help you develop the skills you need to overcome addiction, prevent relapse, and foster a healthier, more fulfilling life. Contact Guardian Recovery to learn more about our integrated, evidence-based programs and multiple levels of care.

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What Is Oxycodone?

Oxycodone (OxyContin) is a semi-synthetic opioid derived from thebaine, an alkaloid found in the opium poppy plant. (1) Oxycodone can reduce a person’s perception of pain by binding to opioid receptors in the brain and spinal cord.

German chemists first developed oxycodone in 1916 in an effort to develop a less potent and addictive alternative to morphine, which was the most widely used painkiller at the time. Initially, oxycodone was more often used as a cough suppressant than a pain reliever. However, in the 1960s, it became increasingly popular for its pain-relieving properties and was approved for use in the U.S. in 1976.

Since that time, oxycodone has become one of the most commonly prescribed opioids in the world and is used to manage a wide range of pain conditions. OxyContin is the most well-known brand name for oxycodone, developed by Purdue Pharma in 1995. (2) Unfortunately, its potent effects have been blamed for the massive number of overdose fatalities that have occurred since that time due to prescription painkillers and illicit drugs, such as heroin and fentanyl.

What Is Morphine?

Morphine is an opiate alkaloid with painkilling properties that occurs naturally in the opium poppy, in addition to codeine, thebaine, and others. Morphine has a long history of use in the U.S., beginning in 1903 when a German pharmacist extracted it from opium. It rapidly became popular as a pain reliever and was commonly used during the American Civil War to treat pain in wounded soldiers.

However, as the use of morphine increased, so did concerns about its addictive potential. By the late 19th century, morphine use had become a major social issue, with many people becoming addicted. In response, the federal government passed the 2017 Harrison Narcotics Tax Act, requiring any party who manufactured, distributed, or prescribed opioids to pay a tax and register with the government. (3) Despite these efforts, morphine use continued and was widely prescribed for pain relief throughout much of the 20th century until the use of synthetic opioids such as oxycodone became more popular.

How Are Oxycodone & Morphine Similar & Different?

In addition to how oxycodone and morphine act in the central nervous system (CNS), they have both been associated with euphoric effects that can contribute to misuse and dependence. They can also cause side effects, such as drowsiness, constipation, nausea, and respiratory depression, particularly if used in high doses or for a prolonged period. Furthermore, they can be hazardous if combined with other substances that slow activity in the CNS, such as alcohol, benzodiazepines, and other opioids.

Both drugs are classified as Schedule II controlled substances by the Drug Enforcement Administration (DEA), meaning that although they have a legitimate medical purpose, they also have a high potential for misuse and dependence. (4) It’s important to stress, however, that despite these drugs sharing many similarities, they are not the same substances.

Shared Medical Uses Include:

  • Pain Management—Treatment of moderate to severe pain associated with conditions, such as cancer, surgery, and injury.
  • Palliative Care—Pain relief provided in hospice and palliative care settings for terminally ill patients.
  • Chronic Pain—Treatment for ongoing pain that does not respond to other medications.
  • Shortness of Breath—Relief for shortness of breath associated with end-stage lung disease.
  • Sedation—Used during medical procedures or to help people on ventilators tolerate equipment.

Differences Include:

  • Chemical Structure—Oxycodone is synthesized in a laboratory as a derivative of thebaine, whereas morphine occurs naturally.
  • Potency—Oxycodone is considered to be about twice as strong as morphine, meaning that it may induce more powerful effects, including more intense pain relief and euphoria. (5)
  • Onset and Duration of Effects—Oxycodone has a more rapid onset of action versus morphine, but morphine provides pain relief for a longer period of time.
  • Side Effects—Both medications can cause similar side effects, but oxycodone may be more likely to cause itching and sweating than morphine.
  • Formulations—Unlike morphine, oxycodone can be found in combination with other medications, such as acetaminophen or aspirin, for added pain relief.

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Doses & Administration

Dosage and administration of oxycodone and morphine vary depending on each person’s medical history, individual factors, and the type and severity of pain treated. Both drugs are available in immediate-release (IR) and extended-release (ER) tablets to be taken with water and with or without food.

General Guidelines for Oxycodone Dosing & Administration Include:

  • Dosage—The typical adult dose of IR oxycodone for pain relief is 5–15 mg every 4-6 hours, as needed. (6) For the ER version, this is 10–80 mg once or twice daily depending on patient needs, not to exceed 288 mg per day.
  • Administration—Oxycodone should be taken orally with water and with or without food, but using it with food may help reduce stomach upset. It’s important not to crush, break, or chew either IR or ER tablets, as this can cause too much medication to be released at once, leading to severe side effects or overdose.

General Guidelines for Morphine Dosing & Administration Include:

  • Dosage—The typical adult dose of IR morphine for pain relief is 10–20 mg every 4 hours, as needed. (7) This can be between 15-200 mg once daily for the ER formulation, depending on individual needs.
  • Administration—Morphine can be administered by mouth, injection, or suppository. The method used depends on the individual’s medical history and the type and severity of pain being treated.

Oxycodone & Morphine Price Comparison & Availability

The cost of oxycodone varies depending on the formulation (IR vs. ER), as well as dosage, quantity, and pharmacy prices. In the U.S., without insurance, the average cash price of a 30-day supply of immediate-release (IR) oxycodone tablets ranges from $30 to $300, depending on dose and quantity. Conversely, the average cash price of a 30-day supply of IR morphine tablets, ranges from $20 to $200, also based on dose and quantity.

It’s important to note that insurance coverage and discounts or coupons can dramatically decrease the cost of both oxycodone and morphine in many cases. (8) (9)

Oxycodone & Morphine Warnings & Drug Interactions

Both oxycodone and morphine can cause respiratory depression, which can be life-threatening. This risk is increased when these medications are taken with other drugs that also depress the CNS, such as benzodiazepines, barbiturates, or other opioids. They also cause sedation and impair cognitive and motor function.

Both oxycodone and morphine can interact with other substances in various ways, including many prescription drugs, over-the-counter medications, and herbal supplements. (10) It’s important for patients to inform their healthcare provider of all the medications they’re taking to avoid experiencing harmful drug interactions.

Risks of Addiction & Dependence

Drug dependence is a serious medical condition that can have a wide range of negative physical, psychological, and social consequences.

Risks of Opioid Dependence & Addiction Include:

  • Tolerance—This condition requires users to take more of a drug to experience the desired effects.
  • Physical Health Problems—These include respiratory issues, heart disease, liver damage, and infection.
  • Mental Health Issues—These include emerging or worsening depression, anxiety, and suicidal ideations.
  • Adverse Social Consequences—Job loss, poor academic performance, financial distress, legal issues, and relationship strain are all commonly associated with drug addiction.

Life-Threatening Overdose—This can occur when drugs are used in high doses or combined with other substances.

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Oxycodone and morphine should only be used as prescribed and shouldn’t be taken without a prescription or in ways not directed by a health provider. Because these and other opioids can be addictive, it’s important not to use them excessively to avoid health problems and physical dependence.

Guardian Recovery provides individuals with a full range of therapeutic services, including medical detox, residential treatment, outpatient programs, behavioral therapies, and aftercare planning. Contact us today to speak to an experienced Treatment Advisor and receive a free, no-obligation assessment and health insurance benefits check. Learn more about our straightforward admissions process and how we can help you overcome addiction and sustain long-lasting sobriety and wellness.

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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.

  1. https://medlineplus.gov/druginfo/meds/a682132.html
  2. https://www.statnews.com/2019/12/03/oxycontin-history-told-through-purdue-pharma-documents/
  3. https://www.ojp.gov/ncjrs/virtual-library/abstracts/drug-laws-and-drug-law-enforcement-review-and-evaluation-based-111
  4. https://www.deadiversion.usdoj.gov/schedules/
  5. https://bpac.org.nz/bpj/2014/july/oxycodone.aspx
  6. https://www.mayoclinic.org/drugs-supplements/oxycodone-oral-route/proper-use/drg-20074193
  7. https://www.mayoclinic.org/drugs-supplements/morphine-oral-route/proper-use/drg-20074216
  8. https://www.goodrx.com/oxycodone
  9. https://www.goodrx.com/morphine-er
  10. https://www.fda.gov/media/99761/download

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

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:

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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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