Ranking Narcotic Pain Relievers In Strength From Strongest To Weakest.

I have been on several narcotic pain relievers and have heard of many more. I'm interested if anyone knows which is the strongest one and which is the weakest, with rankings from Strongest to Weakest. Below is one ranking I read in a forum. If possible please make your own ranking of these medicines, adding in Fenanyl Patch, Methadone, and any other Narcotic Pain relievers I may have missed. Again, if possible, please rank them from strongest to weakest. Thank you for any information you are able to provide.

1) Hydromorphone (Dilaudid)

2) Oxymorhphone (Opana)

3) Oxycodone (Oxycontin)

4) Morphine (MScontin)

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I would agree with skeye. Each person's body metabolizes a given medication differently. If you read a lot of threads here you'll see that a medication that work extremely well for one person - something that's fairly strong - has no effect for another. Plus there's the issue of side effects, and interactions with other medications a person may be taking, and other medical conditions.


PaLady

Post Edited (PAlady) : 1/8/2009 12:06:06 AM (GMT-7)

I have to agree with Chutz, PA and Skye on this one Jimmy. Pain and the medication that goes with them is very individualized. What may work for you may not work for me and vice versa. I would go to your doctor and have him or her explain the components in each one as to the different subtances in each one.

Just my opinion

Scarred and tired and hurtin

I can understand Erics need for information. Sometimes you just want to know everything about the subject because information is power. And we CPer's lose a great deal of power with our pain. The more we know, the better we feel.

So, fortunatley the methadone helps me with the long term pain issues, and I just started taking oxycodone 15 mg. for the BT pain. I have been on several pain meds that never really helped and I'd end up taking extra. That is a big NO NO... So, for right now I am on the OKAY side. In a few months that may change and I might need to try something else.

Me.

DiLane, I am sorry that you feel this way. Most of the time we try to be helpful. I'd hate to think you had a question you wanted to address & didn't because you were afraid of being treated unfairly. The only reason I didn't post was because what may or may not work for jimmy may or may not work for me...... For example: He listed MSContin, I am allergic to sulfa which is in most meds, so I can't have almost half the meds in the sulfa family that would be prescribed to me under pain killers. Next he listed OxyContin; which I do use & I think is a wonderful drug as far as ER release pain killers are concerned... I'm noticing he listed Dilaudid as well, which is a BT pain med..... it would take up a lot of time for me to go through all of the ER & BT meds that I have been on the past 5 years. A LOT of time. Diladudid is supposed to be one of THE strongest meds, but pill form did nothing for me. So I am back on oxycodone 6 times a day. Until I get a pain pump trial. I have a very high tolerance to pain meds, which is difficult since I have been on things things that put most people to sleep & its not done anything for me. And I am a 5'0 tall female. So everyone is different. Which makes it hard to answer this question thats why most of us have not replied.... sorry you feel that way DiLane, hopefully you will see its not done, at least on my behalf, to be mean. I just didn't answer because its a very hard question TO answer..... And I try to be nice to people & answer questions, its just some questions, like this one, can be viewed tough not only by the reason I gave a response to- but some people might see this as almost a "seeking" question, which makes people leary to answer it. A lot of people on here have lost good Drs due to seekers & that makes it a sore topic, I hope you can understand their side of the story as well. Either way, please don't think they are always tough, some of the tougher ones on here have the best advice. This is just a tough subject to answer.

Well I will answer with my understanding of these kind of meds, oxycontin, mscontin, kadian, fentanyl (patches and actiq and fentora), bupernorphine (Patches, suboxone, subutex, and one other one I cant think of the name), and methadone that are some of the strongest ones, but there is a bunch of new meds coming out soon so these meds are on there way out, theres a new one coming out with oxycodone and naloxone (Oxytrex) kind of med to help with abuse and tolerence and one thats gonna be mixed with morphine too. And they're working on these whole new kind of meds that they hope to take over narcotics period that is made from diffrent kinds of venoms I beleive because they kill pain and dont cause addiction. Then theres a few like diladid and fast acting oxycodone for breakthrough that work ok if you dont have a tolerence and then theirs meds like hydro and codiene and especailly darvocet (that they're thinking of removing cause it doesnt work well so people overdose on it) that I dont understand why they're even here cause they're nothing more then sugar pills and it all it does is make lots of people very ill, even before I got a tolerence they did absoutly nothng for me but made me vomit like crazy. But like stated before it all depends on your body and pain, But I'm just glad they're working like crazy to make these new pain meds to help people not get a bad tolerence or turn to an addiction, I remember hearing about one (oxycodone I believe) thats gonna be made into a gel so people cant abuse them. I just wish they'd hurry up and put these on the market so people who do abuse them cant do it anymore so hopefully doctors will feel better about prescribing things for our pain. I guess we'll know soon in the next upcoming years.

-hellokitty

Di Lane,
You sure do have a way with words. LOL.
I think some of us like to play doctor, yanno?
Some more than others. : )
We put on our white coats and become ... "The voice of reason."
We're pretty forgiving of everyone here but I sure do know what you mean.

BTW... Methadone has helped me the most
Norco ... Has helped me not at all
Oxycontin ... Didn't help either

I don't think I helped you much either drjimmy
Pamela .

Hello, wow, looks like I missed a lot while I was sick. lol. I don't want it to appear as if I was scared away by some sort of rough responses to my question. Starting on New Years Day I got either food poison or the worst stomach virus of my life. I have been in a total "out of it" state since then and haven't been able to open my eyes much, let alone go online. Thanks for the information and know that as soon as I am fully recovered, I will be back and better than ever!!  lol.

        Eric

   

Hi drjimmy,

Glad to hear you're back on your feet. I think I was the one who passed on that virus to you...lol. I was down with violent nausea and...well, you get the picture...for about 8 days, started to get better and then went for round 2. Just as a side note...if anyone out there gets a stomach virus, please get yourself to your doc, at least. Within 24 hours I was so dehydrated I needed IV fluids...3 times before it was all over. Please take care of yourself.

Now, jimmy...I think your explanation and question was a fair one now that I understand what you were asking...and why. From what I could find online the products like tramadol and vicodin are about as light weight as you can get.

Oxford University Press:
http://www.backpain-guide.com/Tables/3_NarcPain.html

Below is a very extensive site that gets into the details of all pain relievers. It's a long but good read.
http://www.theacpa.org/documents/ACPA%20Meds%202008%20Final.pdf

This page on Wikipedia is fairly good also.
http://en.wikipedia.org/wiki/Pain_medication

I hope this helps in your search and you get some needed relief.

Chutzie

as a side note~~

The moderators on this site are nothing more than people who came in as newbies and hung around long enough to want to volunteer to help out. No pay, no benefits, no gold watch....just a good feeling if we can help someone. Rarely have I met a mod who had an attitude but if you, or anyone else, ever feels a moderator is out of line then please email the moderator and/or the owner at [email protected]. Healing Well was started by a man who has health issues just like the rest of us...in fact he has Crohns and has been very sick of late. He also is no different than the rest of us...he just decided to take on the job of trying to provide a place where we can come together and help each other. He wants this to be a family friendly site and that is the reason for the rules that are posted.

DiLane, or anyone else, if you have specific cases where you think a moderator was our of line would you please email me or the admin so we can try to help make this place better? Staying silent, then slamming others in public for perceived indiscretions isn't going to solve the problem.

One thing we try to stress is that this is a 'support' forum....nothing more, nothing less. We are here to help our fellow sufferers deal with their medical situations. A forum like Chronic Pain is ripe for people who are seeking information on drugs for illicit purposes and we get many of those types of questions each week...on the Chronic Pain forum as well as others on the boards. We are not here to provide medical advice, only our own experiences. We are not here as a repository of drug information for those who are recreational users....and we get LOTS of those who come in and out quickly. We are also not here for those who are going cold turkey because they were using narcotics illegally, although we will point them in the direction of help. We ARE here for those who are in need of compassion and honest support, like drjimmy. I hope you can understand that sometimes it's not easy to walk the fine line between the two. I do hope this helps.

It depends on the person and the pain they're suffering. I've been scoped twice in my knee and have no cartelidge left. It's bone on bone and some days I can barely walk (with fentnly and oxycondone combined) and some days I have no pain at all. Winters really suck and I've had so much pain this winter I'm considering ending everything. I just moved to Alabama and when I tell docs what other docs in Texas had me on they look at me like I'm growing a ****ing third eye in the middle of my forehead. I'm pretty sick of being looked at as a "freak" because of what doc's did to me in Texas. I told them how I felt and they wrote the scripts. I didn't put a gun to their heads and say "write me narcs darnit!". I'd like to get up really early and drive over to these docs houses and wake them up by whacking their knee with a hammer and say "Welcome to my ****ing world you ******...look at me like I'm a freak now!" I garantee you if they had my pain they wouldn't be so self-righteous and condescending.

Sam

My Doctor tried me on the MSCoitin and well, I took one pill, It made me sleep, my hubby would wake me up and I'd be out again, he
got so worried he almost took me to the hospital ER as I just couldn't seem to wake up from it, so doctor took me off the MsCoitin.
I'm on Vicodin HP which helps for me, people worry of me being on it cause of the high amount of tylenol (spelled?), but I've
tried lyrica, celebrex and tramadol all which made me throw up pretty bad, but the celebrex was the worst almost ended up in ER at Hospital
with that one as I threw up every hour on the hour for over 12 hours, not a good thing..
and well I don't really know much about any other pain med except that with the Vicodin Hp helps, doen't take the pain away but
I don't really wanna try any other pain meds for now...
as I'm not a guinea pig at least last time I looked in the mirror I wasn't...lol....
Sorry I couldn't help ya out better...

Greetings to the fellowship of chronic pain support group! I am new to this site, found it by accident...delighted to have found it, as support in this often controversial,subjective,highly controlled and misunderstood yet growing and hungry for relief, population is obviously attempting to adjust to life with their chronic pain. I personally possess a litany of physical, medically ,clinically and acknowledged variants of disease or ,illness quite often the result of factors I am personally unable to control, or historically not well understood. As I have been reading over many of your stories....I literally felt as if I was not alone with my personal tale. I am 41...a mother of one girl and have a very supportive spouse. This is the stuff I try to remind myself daily...this part of life is cherished! I always believed that the human body was intended for physical labour(I'm Canadian, therefore the subtle differences in grammar, etc). When I completed my University in 1990, with a B.A. ...I truly did not know "what I wanted to do"...however, I was eager,passionate and fully positive that whatever I truly wished to "do", would happen, if I worked on this goal. In one's youth, or at least in my life, I was a advertisement for optimal health. I literally had never seen the interior of a hospital , was never really ill and did not comprehend disability, physical or mental pain, unrelenting fatique,depression,acute and chronic daily real , real pain. Life was great....so I decided that I wanted to be a Flight Attendant , a job that was not very structured, social, active, and at that time in my life, quite parallel to my personality and character...a good fit! This was still during the years when our society appeared to be slower, more courteous ,civil,sincere and polite. It was also, here in Canada, not severely deregulated, so there were a lot of comforts and true service , highly valued and professional, dedicated employees. Fast forward....this once carefree girl entered into what eventually has become a true case study on ,multitudes of Health issues, business losses worldwide, the imminent growth of our greed society ,and a "service industry" which does not comprehend the true definition of service. That being said....I have been "grounded" or quite literally....removed from what I believed to be a job I could enjoy and continue with for life, or at least get some value for my years of service and sacrifice. It has taken 1 and 1/2 years for a proper glimpse of understanding why, with an assessment of a Chairi Malformation, advanced stage OA, or as one Dr says "bones of an old lady", factets disease, at L4, brain tumor, (benign), etc. There is more. however, it is not just the unrelenting appts, Drs with the poor ability to relate to their patients with true care, or to, often minimize my complaints, due to my gender, clinical depression,an organic result of a brain tumor....I do indeed comprehend the variants among pain, depression, tolerance to pain or personal threshold when I would often wonder if I will ever have a "happy" moment ,free of pain,tears,lack of sleep due to pain, inability to engage in even moderate activity without the fear of tomorrows pain. When I mention happy, I suppose I want a day like I had in my early 20's when all of this new, difficult to navigate,handle and treat "lifestyle", was never felt, yet I firmly believed, that if I treated my body well, I probably would have some aches here and there when I was in my 6th or 7 th decade of life, but not during the 3rd and 4th decade of life. I suppose some inquiry I have is to try and assismillate what forms of pain mang. perhaps various forms can help. I have been on 20 mgs/Oxycontin for a long time now, and even though they assist with pain, I find myself becoming very sleepy now, initially I did not feel sedated and drowsy. My sleep cycle appears to have been affected, I wonder if others have had this issue and if I miss a dose, I have horrible restless leg sydrome when I attempt to sleep. Any suggestions? Advice, or similar experiences?

Hi 41,
Just wanted to welcome you to the forum. If you're looking for much advice probably the best way to get it is to start a new thread, but hopefully other members will come along & see yours here.

I too am a Chiarian & can commiserate about how life altering it can be, though I have had nothing that remotely compares to what you have gone through. I so hope you can find some sleep tonight. I'm off to give it a try myself. :)

blessings,
frances