Morphine Versus Other Opioids

Is morphine different from other opioids/opiates?

Opioids are a class of drugs prescribed by doctors to relieve short and long-term pain in patients. Like other opioids, morphine is synthesized from the opioid poppy (papaver somniferum).

Dilaudid (hydromorphone) vs morphine

Drug characteristics

Both Dilaudid (brand name for Hydromorphone) and morphine are prescription opioids used to relieve acute and chronic pain.

Both work by binding to opioid receptors in your nervous system, flooding the brain with dopamine and relieving pain. As they both work similarly, both have a similar side effect profile.^[1]

Both morphine and hydromorphone are stored at room temperature.

How are they taken?

Morphine and hydromorphone can both be injected intravenously and intramuscularly, but only hydromorphone can be injected subcutaneously.

They are both available as an immediate-release oral tablet and an extended-release oral tablet^[1], but only morphine comes in an extended-release oral capsule.

Price

Hydromorphone and Morphine are similarly priced when sold as unbranded tablets. When sold under the brand name Dilaudid, the price per tablet increases.

The street value of hydromorphone is greater than morphine, a strong indicator of its popularity and recreational use potential.^[2]

Potency

The primary difference between hydromorphone and morphine is potency. Hydromorphone is 5 to 10 times more potent than morphine. Hydromorphone reaches the brain faster, resulting in a faster onset and more powerful sedation.^[2]

Overdose symptoms

Both hydromorphone and morphine are extremely addictive. They cause similar overdose symptoms including respiratory depression, constricted pupils, extremely low blood pressure, low heart rate, and coma.

Fentanyl vs morphine

Drug characteristics

Whilst both fentanyl and morphine are powerful opioids, fentanyl is considered far stronger than morphine. Fentanyl is a short-term analgesic whilst morphine is a long-term analgesic. Fentanyl is a synthetic opioid created entirely artificially in laboratories, whilst morphine is a naturally occurring opioid that can be isolated from the opium poppy.^[3]

Both work by binding to opioid receptors in the brain, catalyzing the release of dopamine and relieving pain.

Studies show no significant differences regarding side effects between morphine users and fentanyl users.^[3] 

Both morphine and fentanyl are stored at room temperature.

How are they taken?

Both fentanyl and morphine are available in tablets, capsules, and injections. Fentanyl is also administered in the form of lozenges and nasal sprays.

Pharmaceutical fentanyl, applied in patches on the skin, was developed for managing pain during cancer treatment.^[4] 

Illegal fentanyl can be found in the form of powder or spiked onto blotter paper. It is commonly mixed with heroin and other substances and illegally sold.

Price

Fentanyl is more expensive than morphine with a wholesale price of $0.83 dollar compared to $0.71.^[5]

Potency

While both fentanyl and morphine are powerful opioids, fentanyl is considered to have 50 to 100 times the potency of morphine.^[6] As such, morphine is more regularly prescribed for pain management.

Whilst any non-medical use of opiates is incredibly dangerous, fentanyl affects you at much lower doses than others. Just 0.25mg of fentanyl can lead to an overdose and as illegal fentanyl is often mixed into heroin without the user’s knowledge, overdose deaths have increased in the US since 2013.^[7]

Overdose symptoms

Fentanyl and morphine are both extremely addictive opioids and have similar overdose symptom profiles. These include stupor, pupil dilation, cyanosis, coma, and respiratory depression.

Oxycodone vs morphine

Drug characteristics

Oxycodone is a semi-synthetic opioid developed from the opium plant, and like morphine, is used to treat short-term and long-term pain.

Marketed under a variety of brand names, primarily Roxicodone and OxyContin, oxycodone has a similar chemical structure to morphine, and both work by binding to opioid receptors in the brain.

Both have similar side-effect profiles.

Both oxycodone and morphine can be stored at room temperature.

How are they taken?

Oxycodone comes as a liquid solution, a concentrate solution, a short-release tablet, a capsule, and an extended-release tablet (oxycontin). In the US, oxycodone is only approved for oral consumption, unlike morphine which can be injected.

Typically, the extended-release tablet is taken every 12 hours whilst all other forms of oxycodone are taken every 4-6 hours.^[9] Take the medication exactly as directed by a medical professional.

Price

Oxycodone is far more expensive than morphine, with 100 30mg tablets costing over 11 times as much.^[11]

Potency

Whilst it is similar in chemical structure to morphine, the consensus in the medical community is that oxycodone is around 1.5 to 2 times more potent.^[8] It is recommended to start with morphine before switching to oxycodone if the pain remains unmanageable.^[10] This is because oxycodone is both stronger and more expensive than morphine.

Overdose symptoms

Symptoms of oxycodone overdose and morphine overdose are similar. They include respiratory difficulty, stupor, clamminess, muscle failure, shallow breathing, pupil dilation, and unconsciousness.

Heroin vs morphine

Drug characteristics

Heroin is the only illegal opioid on our list. Like morphine, heroin is derived from the poppy. When taken, both drugs flood the brain with dopamine creating a euphoric high in the user.

Heroin is a semi-synthetic drug, taken from morphine and chemically enhanced to increase its potency.

How are they taken?

Heroin is usually injected intravenously or intramuscularly, whereas Morphine can be taken in both oral forms and injections.

Price

Heroin cannot be purchased legally. Its black-market value is considerably lower than morphine and easier to acquire, making it an incredibly dangerous substance.

Potency

One of the most notable differences between heroin and morphine is how much more potent the former is than the latter. Heroin activates neural pathways roughly 3 times faster than morphine. Generally, the more fast-acting a drug is, the more addictive it can be. Read here to learn more about how long heroin stays in your system.

Overdose symptoms

Due to its increased potency, heroin requires a far smaller dose than morphine to reach overdose levels. The overdose symptom profile for both is extremely similar.

Meperidine (Demerol) vs morphine

Drug characteristics

Both Meperidine, sold under the brand name Demerol, and morphine are opioids with similar chemical structures.

Meperidine is used to treat sudden outbreaks of moderate to severe pain and ought not be used to treat long-term pain. Morphine can be used to treat both short-term and long-term pain.

Meperidine is used far less often in the USA than morphine as it is associated with an increased risk of adverse side effects, such as vomiting and seizures.^[12]

How are they taken?

Meperidine generally comes in tablet and liquid form and can be taken every 3-4 hours. Ensure you swallow the tablets whole and don’t break or crush them.^[13]

Price

Meperidine is similarly priced to morphine if anything slightly more expensive for similar doses.

Potency

Meperidine has a shorter half-life than morphine and is therefore less effective for long-term pain relief. Meperidine is roughly half to three-quarters less potent than morphine.

Overdose symptoms

Symptoms of overdose from meperidine and morphine are similar, including shallow breathing, clammy skin, unconsciousness, and slow heartbeat.