Pain Medication List Strongest to Weakest, Risks & Effects

Read more about the pain medication list strongest to weakest and learn about its risks, effects, and treatment options for you or your loved ones struggling with pain medication addiction.

Pain Medication List Strongest to Weakest, Risks & Effects

As the opioid epidemic in the United States continues to increase in severity, with over 2 million people suffering from opioid addiction and 90 Americans dying each day from an opioid overdose, being able to understand and identify the strongest pain medications has become more important than ever.

Opioids are powerful drugs that relieve pain and produce feelings of euphoria and should only be taken for short periods of time for acute pain, such as following surgery or injury. Regardless of strength, all opioids are potentially addictive and can result in an overdose if abused. However, different opioids can induce different risks and effects depending on their frequency of use and method of administration.

Abuse and diversion of these medications is a growing problem as the availability of these medications increases. Common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. Opioids can cause life-threatening breathing problems, including slow, shallow, unusual or no breathing — even when used as recommended. These problems can occur at any time during use,

The following pain medication list includes commonly abused opioids and opiates from strongest to weakest in potency. Opioids and opiates are controlled substances with a high potential for abuse, dependence, and tolerance. Not surprisingly, an estimated 1.7 million Americans were addicted to pain relievers and two million had an opioid use disorder in 2018.

Opioid Pain Medication List: Strongest to Weakest

What is the strongest pain medication? The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of addiction. Here are some of the most common prescription opioid pain relievers, from strongest to weakest.

1. Carfentanilpain medication list strongest to weakest

Carfentanil is strongest pain medication. Carfentanil or carfentanyl (Wildnil) is an analog of the prevalent synthetic opioid analgesic fentanyl and is one of the most potent opioids known.  In fact, it is also the most potent opioid used commercially. [1]

It has a quantitative potency of approximately 10,000 times that of morphine and 100 times that of fentanyl, with activity in humans starting at about one microgram.  It is marketed under the trade name Wildnil as a general anesthetic agent for large animals.  Basically, Carfentanil is intended for large-animal use only as its extreme potency makes it inappropriate for use in humans.

Carfentanil has been linked to a significant number of overdose deaths all over the country and continues to be a serious danger to public safety. Occasionally it is found on the black market and has surfaced in communities all over the U.S.

2. Fentanylpain medication list strongest to weakest

Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.

Fentanyl ranks second in the strongest pain medication. Fentanyl works by acting on the brain’s opioid receptors to alter how the brain experiences pain and reacts to it. Additionally, fentanyl is used specifically for opioid-tolerant people, meaning they need relief for serious pain but have developed a tolerance to other opioids, rendering them ineffective.

Fentanyl is not intended to be used for pain that’s short-term and will go away in a few days or on an as-needed basis. Some studies warn against using fentanyl to treat surgical pain, but it is still sometimes used for such pain management. When fentanyl is used for surgical applications, it’s normally part of the anesthesia administered to patients to manage pain following the surgery.

Anyone who uses drugs that may contain fentanyl, even occasionally, is at risk of a fentanyl overdose. A fentanyl overdose can overwhelm the central nervous system, disrupting the pathways that control heart function and breathing. Many people who overdose on fentanyl will fall asleep and never wake up. 

3. Heroinpain medication list strongest to weakest

Heroin (diacetylmorphine) is a very addictive drug made from morphine; a psychoactive (mind-altering) drug taken from the resin of the seed pod of the opium poppy plant. Heroin’s color and look depending on how it is made and what else it may be mixed with. It can be white or brown powder, or a black, sticky substance called “black tar heroin.”

Heroin ranks third as the strongest pain medication. Heroin has a very strong potential for abuse, especially when injected. It can also be consumed, however, by snorting or smoking, and is often found as a whitish powder, or a black sticky substance (black tar heroin). When injected, heroin enters the bloodstream and the brain much faster than other opioids, creating immediate intense feelings of euphoria.

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Pain Medications Statistics

Pain relievers or painkillers are drugs designed to diminish or eliminate pain. Opioids fall under this umbrella term, as well as oxycodone, morphine, and fentanyl. Opioids are the most abused drug type, with addiction and overdose rates climbing annually.

100 million

Chronic pain affects an estimated 100 million Americans, or one third of the U.S. population, and it is the primary reason Americans are on disability.

Source: NIDA [1]

9.7 million

9.7 million people over 12 misuse painkillers, 16.5% for the first time, making it the most-abused type of prescription drug.

Source: NIDA [2]


70% of prescription drug addicts are addicted to painkillers.

Source: NIDA [3]

Opioids Drug Fact Sheet

What is it?

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. 

Prescription Opioids

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness.

How do people misuse prescription opioids?

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by a doctor, but they can be misused. People misuse prescription opioids by:

  • taking the medicine in a way or dose other than prescribed
  • taking someone else’s prescription medicine
  • taking the medicine for the effect it causes-to get high

How do prescription opioids affect the brain?

Opioids bind to and activate opioid receptors on cells located in many areas of the brain, spinal cord, and other organs in the body, especially those involved in feelings of pain and pleasure. When opioids attach to these receptors, they block pain signals sent from the brain to the body and release large amounts of dopamine throughout the body. This release can strongly reinforce the act of taking the drug, making the user want to repeat the experience.

What are some possible effects of prescription opioids on the brain and body?

In the short term, opioids can relieve pain and make people feel relaxed and happy. However, opioids can also have harmful effects, including:

  • drowsiness
  • confusion
  • nausea
  • constipation
  • euphoria
  • slowed breathing

4. Hydromorphone (Dilaudid)pain medication list strongest to weakest

Dilaudid is an opioid analgesic pain prescription drug synthesized from morphine to create a potent hydromorphone drug. We know it by the brand name Dilaudid. It helps people who suffer from severe pain but also puts them at risk for abusing the medication [3].

Dilaudid is sold in immediate-release tablets, oral solutions, and intravenous injections. The Drug Enforcement Administration (DEA) [2] lists hydromorphone as a Schedule II controlled substance, meaning it has a high potential for abuse and a high chance of causing dependency.

This prescription drug ranks fourth on the list as the strongest pain medication. Dilaudid addiction means that the person physically and psychologically needs the drug longer than they feel the pain from their injury. This dependency affects all aspects of their life, including family, school, work, and community life.

According to the National Institutes of Health, certain drugs can change the structure and inner workings of the brain. Repeated use affects a person’s self-control and interferes with the ability to resist the urge to take the drug. For instance, being unable to stop taking Dilaudid even though you know the side effects of Dilaudid abuse is the hallmark of addiction. [4]

5. Oxymorphone (Opana)pain medication list strongest to weakest

Oxymorphone is a powerful prescription opioid pain reliever used to treat moderate to severe pain. It is a Schedule II drug and, much like others in its class, is highly addictive and can produce strong feelings of euphoria and relaxation. People who abuse oxymorphone often do so by consuming large doses orally, snorting it, or dissolving it and injecting it.

A person who uses oxymorphone can develop an addiction to it in as little as two weeks or less. With opioid use, a person experiences an initial rush of euphoria followed by a prolonged period of feelings of well-being and altered perceptions of pain, a “high.”

The brand name drug Opana has been discontinued. However, generic, extended-release versions of oxymorphone are still available by prescription in the U.S. This long-acting version can be taken every 12 hours.  Before prescribing oxymorphone, doctors are advised to go over their patient’s medical history and history of substance use.

Let's take a look at some of the strongest pain medications.
Let’s take a look at some of the strongest pain medications.
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6. Methadonepain medication list strongest to weakest

Methadone is used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. It is also used to prevent withdrawal symptoms in individuals addicted to opiate drugs and are enrolled in treatment programs to stop taking or continue not taking the drugs.

Methadone is in a class of medications called opiate (narcotic) analgesics. Methadone works to treat pain by changing how the brain and nervous system respond to pain. In addition, it works to treat people who were addicted to opiate drugs by producing similar effects and preventing withdrawal symptoms in people who have stopped using these drugs.

When abused, methadone consumption can result in chemical and psychological dependence. Whether taken orally as a tablet or injected as a liquid, methadone abuse can result in adverse health effects if not administered under qualified medical supervision.

As a powerful Opioid, Methadone can cause an overdose. An overdose occurs when someone takes too much of the medication, often without a prescription or beyond medical limits. An overdose is a dangerous situation that requires medical attention, so it’s important to recognize the signs.

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7. Oxycodonepain medication list strongest to weakest

Oxycodone is an opioid agonist prescription medication. A doctor will prescribe these drugs if there are no alternative treatment options that will work to treat moderate to severe pain. Oxycodone is marketed alone as OxyContin in 10, 20, 40, and 80 mg extended-release tablets and other immediate-release capsules like 5 mg OxyIR. It is often used in combination with other drugs (Acetaminophen) such as Percocet and Roxicet. Common street names include Hillbilly Heroin, Kicker, OC, Ox, Roxy, Perc, and Oxy.

Oxycodone is abused orally or intravenously. The tablets are crushed and sniffed or dissolved in water and injected. Others heat a tablet that has been placed on a piece of foil and then inhale the vapors. Oxycodone products are in Schedule II of the Controlled Substances Act, meaning they had medical use and a high potential for addiction. Euphoria and feelings of relaxation are the most common effects of oxycodone on the brain, which explains its high potential for abuse.

The pain medication list strongest to weakest provided in this article will guide you and warn you on the risks of abusing pain meds.
The pain medication list strongest to weakest provided in this article will guide you and warn you on the risks of abusing pain meds.

8. Morphinepain medication list strongest to weakest

Morphine is an opiate alkaloid secluded from the plant Papaver somniferum and produced synthetically.  This drug is a DEA controlled drug and a DEA Schedule II controlled substance.  Substances in the DEA Schedule II have a high potential for abuse, leading to severe psychological or physical drug dependence.  Therefore, the DEA classifies Morphine as a Narcotics (Opioids) drug.

Morphine can potentially be a lethal medication when not used correctly because it causes a host of symptoms related to depression of the CNS.  Severe respiratory depression is the most worrying complication of Morphine in cases of overdose.  Therefore, urgent injection of naloxone is needed to reverse the effects of Morphine.

9. Hydrocodonepain medication list strongest to weakest

Hydrocodone is almost as potent as morphine and is prescribed to treat moderate pain. Brand names for hydrocodone include Vicodin, Lortab, and Norco. More potent than codeine, hydrocodone is currently the most commonly prescribed opioid in the U.S.

Hydrocodone is commonly abused with alcohol. You hear people popping a Vicodin and sipping a beer like it’s no big deal. Mixing Hydrocodone and alcohol is dangerous. Because alcohol and hydrocodone have comparable effects on the brain, their mixed intoxication can make someone feel euphoric or inebriated. Mixing these drugs greatly increases the risk of overdose and death.

10. Codeinepain medication list strongest to weakest

Codeine is a less potent opioid drug that is used to treat mild to moderate pain. It is also an ingredient in some prescription Tylenol medications that are used to treat coughing. It comes in tablet form and is the main ingredient in prescription-grade cough suppressants. Tylenol 3, a popular Painkiller, is Codeine combined with Acetaminophen. Patients who are prescribed Codeine by their doctors may soon find they’ve developed a Codeine addiction.

Codeine use often starts out innocently, with a prescription for a Codeine-based cough syrup. Because Codeine is less regulated than some Opiates considered to be more dangerous (such as Morphine and OxyContin), calling and using it is relatively easy. This is despite the fact that Codeine is very similar chemically to drugs such as Morphine and Hydrocodone. Though less rugged, Codeine provides results similar to Morphine.

Alcohol and codeine can be dangerous when taken together. In fact, mixing the two can lead to a life-threatening reaction. The combined effects of alcohol and codeine can also cause problems with memory, coordination, and judgment. Alcohol and codeine are both highly addictive drugs. They have a powerful effect on the body, which can be fatal if taken in large amounts or mixed with other substances. The effects of alcohol and codeine on the body can be dangerous if you drink enough of either substance or don’t have any other health conditions that could be affected by either drug.

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11. Meperidine (Demerol)pain medication list strongest to weakest

Meperidine, also known by brand name Demerol, was the first synthetic opioid ever developed. Meperidine is used to ease moderate to severe pain.  It works by altering the way the brain and nervous system respond to pain.   Meperidine (Rx) Brand and other names are Demerol, Pethidine, Isonipecaine. Moreover, it is also called meperidine hydrochloride. Unfortunately, meperidine may be habit-forming, especially with prolonged use. 

Demerol can cause physical dependence. This means that a person relies on the drug to prevent withdrawal symptoms. Over time, more of the drug is needed for the same effect. This is called drug tolerance. Taking it more often than needed or in higher doses than prescribed may lead to addiction requiring Demerol detox.

Learn about the pain medication list strongest to weakest.
Learn about the pain medication list strongest to weakest.

12. Tramadolpain medication list strongest to weakest

In 2012, more than 3 million people reported having used Tramadol for recreational or nonmedical purposes. Although Tramadol is the least potent opioid on the list, it is still often misused and can lead to addiction. Tramadol is an opioid pain reliever to treat moderate to fairly severe pain. It is marketed under the trade names Ultram and others. The beginning of pain alleviation when ingested in an immediate-release formulation often starts within an hour. Additionally, it can be injected. Tramadol and Alcohol can be dangerous if you take them both simultaneously.

Tramadol abuse does occur, though, often by those who have never been prescribed the medication in the first place or those who started taking more of the drug to combat their building tolerances. This type of behavior can lead to several severe effects, especially as the result of tramadol abuse as opposed to the abuse of other opioids. This drug, in particular, can cause severe withdrawal syndrome in certain individuals, which makes it potentially more dangerous than other drugs in its class.

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Strongest Pain Medication Addiction Treatment

If you think a loved one is abusing drugs or alcohol, you should research the substances and their associated addiction to understand better what your loved one needs. Next, you must plan an intervention to provide your loved ones with options to battle the effects of drug addiction in a safe and supportive environment. During this intervention, offer compassion and support instead of judgment. Lastly, show your support throughout the entire treatment process.

In addition, prolonged drug use can have severe physical and psychological effects on you, so it is essential to seek treatment as soon as possible. To have a better idea on the strongest pain medication addiction treatment, it is essential to get medical assistance when needed. Inpatient drug rehab offers intensive care that can help you promptly get through the early stages of drug withdrawal. 

Strongest Pain Medication Detox

Medical detox is often considered the first stage of treatment. It will help you navigate the complicated drug detox withdrawal but doesn’t address patterns of thought and behavior contributing to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete the drug detox.

Cravings are very common during drug detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can give medication and medical expertise to lessen cravings and withdrawal symptoms.

Inpatient Drug Addiction Rehab

There isn’t one treatment approach or style that will suit everyone. Treatment should speak to the needs of the individual. Inpatient rehab and addiction treatment aren’t just about drug use. the goal is to help the patient stop using drugs and other substances, but drug rehab should also focus on the whole person’s needs.

Addiction is a complex but treatable disease that affects brain function and behavior. When someone or their family is considering different treatment facilities, they should account for the complexity of addiction and the needs of the individual. The objective of attending an inpatient rehab center for addiction treatment is to stop using the drug and re-learn how to live a productive life without it.

Following a full medical detox, most people benefit from inpatient rehab. Inpatient drug rehab can last anywhere from a few weeks to several months. Patients stay overnight in the rehab facility and participate in intensive treatment programs and therapy. Once someone completes rehab, their addiction treatment team will create an aftercare plan, which may include continuing therapy and participation in a 12-step program like Narcotics Anonymous.


Many rehab programs will also have early morning classes or programs. Group sessions occur during inpatient rehab, as do individual therapy sessions. Family therapy may be part of inpatient rehab when it’s feasible. Alternative forms of therapy may be introduced during inpatient rehab, like a holistic therapy program, yoga for addiction recovery, or an addiction treatment massage therapy.

Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves changing both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Solution-focused therapy is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. Traumatic experiences can often result in mental health disorders and substance abuse. Dual-diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. This strategy treats both the substance abuse problem and the mental disorder simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend mainly on the treatment for both diseases done by the same team or provider.

The list of pain medication list strongest to weakest is only a guide for you understand the effects and risks of abusing these drugs.
The pain medication list strongest to weakest is only a guide for you understand the effects and risks of abusing these drugs.

Medication Assisted Treatments (MAT)

Medication-Assisted Treatments (MAT) for substance use and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Please, do not try to detox on your own. The detox process can be painful and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We Level Up provide proper care with round-the-clock medical staff to assist your recovery through our drug addiction treatment program medically. So, reclaim your life, and call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

Strongest Pain Medication Rehab Near Me

Drug addiction is a condition that can cause significant health problems, such as an overdose. We Level Up NJ rehab treatment & detox center can provide you, or someone you love, the tools to recover from this with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition and clarify issues like drug withdrawal symptoms. Our specialists know what you are going through. Please understand that each call is private and confidential.

8 Most Common Strongest Pain Medication Addiction FAQs

  1. What is the strongest pain medication?

    Opioids more powerful than morphine include hydromorphone (Dilaudid) and oxymorphone (Opana). But the strongest opioid in community use is fentanyl which, in its intravenous form, is 70 to 100 times more potent than morphine.

  2. What is the strongest over the counter pain medication?

    Naproxen (Aleve) is the most powerful anti-inflammatory pain reliever available without a prescription. It is especially effective for sprains, sunburns and arthritis and other conditions. Similar doses of Naproxen tend to last longer than other non-prescription pain relievers.

  3. What is strongest over the counter pain medication for toothache?

    Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, and generic) and naproxen (Aleve and generic), work particularly well against dental pain because they block the enzyme that causes your gums to become red and swollen

  4. What is the strongest over the counter back pain medication?

    The Best Otc Pain Reliever For: Backache If your back hurts after heavy lifting or other physical exertion, consider naproxen. This NSAID differs from pain relievers like ibuprofen and aspirin in that it takes longer to work, but its pain-relieving effect lasts longer, making it the better choice for deeper aches and pains

  5. What is the strongest opioid pain medications?

    Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in the U.S. There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl.

  6. Strongest pain medication for humans?

    Dsuvia is the most powerful opioid painkiller approved for human use. It is up to 10 times stronger than fentanyl and 1000 times more potent than morphine. Dsuvia was approved by the FDA in 2018 and was developed for acute pain management in a hospital setting.

  7. What is the strongest arthritis pain medication?

    There is no “one size fits all” pain remedy to treat arthritis. Effective pain relief can vary depending on the type of arthritis you have the severity. Opioids Opioids are powerful painkillers (analgesics) that block pain signals to the brain. Corticosteroids Corticosteroids, or steroids, are a type of drug used to treat inflammation. NSAIDs Nonsteroidal anti-inflammatory pain medications (NSAIDs) are the most commonly prescribed drugs to treat inflammation and pain from arthritis,

  8. What is the strongest nerve pain medication?

    Tramadol. Tramadol is a powerful painkiller related to morphine that can be used to treat neuropathic pain that does not respond to other treatments a GP can prescribe. Like all opioids, tramadol can be addictive if it’s taken for a long time.

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