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Fentanyl vs. Morphine | Strength and Side Effects – Which is Stronger?

Every year, every month, nearly every day, the opioid crisis becomes direr. Of the 64,000 drug overdose deaths 2016, more than half were due to opioids. Currently, more than 90 Americans are fatally overdosing on opioids per day.

Morphine and fentanyl are both opioids that block the brain’s pain receptors and produce feelings of sedation and euphoria. They have also both had roles to play in the opioid epidemic. Fentanyl, in particular, has seen a 540 percent rise in overdose deaths within the past three years.

Getting an understanding of how fentanyl and morphine work, the side effects and dangers of both substances, and just how much more potent and deadly fentanyl is compared to morphine can hopefully help to prevent overdose deaths and get people into treatment sooner.

Are Fentanyl and Morphine the Same?

Morphine is no stranger to the opioid scene, having been in use since as far back as the early 1800s. It has also been classified as a Schedule II drug (meaning that it is currently accepted for medical use but with extreme restrictions based on its high potential for abuse) since the 1970s.

Fentanyl, on the other hand, was first synthesized in 1959 and was not introduced to wider medicinal use until the 1990s. It is also classified as a Schedule II drug.

While they are both opioids, the primary difference between the two is that morphine is a naturally occurring, plant-based substance, whereas fentanyl is entirely synthetic. Fentanyl is also significantly more potent, roughly 100 times stronger than morphine.

Both morphine and fentanyl have established medical uses in treating a variety of moderate-to-severe pain, including:

  • Before or after major surgery
  • Chronic pain requiring continuous opioid use
  • Pain resulting from cancer and cancer treatment
  • Following a heart attack or for patients with poor heart function

Unlike morphine though, fentanyl is often specifically prescribed for patients who have become opioid-intolerant to the point where drugs like morphine can no longer provide adequate pain relief. Morphine also has a distinct use in medically-assisted opioid treatment, where it is used to wean patients in detox off of stronger opioids such as heroin.

Morphine can be administered in several ways, including:

  • Tablets
  • Capsules
  • Intravenous injection
  • Intramuscular injection
  • Rectal suppository
  • Oral solution

The injectable form of morphine is known to be about three times stronger than the oral form, making it the typical method of choice for recreational users.

Fentanyl, meanwhile, comes in more forms than nearly any other prescription painkiller, including:

  • Transdermal patches
  • Intramuscular injection
  • Intravenous injection
  • Lozenges and lollipops (meant to dissolve very slowly to avoid overdose)
  • Dissolving strips and tablets
  • Nasal spray

And, in its illicit forms:

  • Blotter paper
  • Powder
  • Pressed pills and tablets meant to mimic other drugs such as Xanax

How Do Fentanyl and Morphine Work?

Both fentanyl and morphine are what is known as opioid analgesics. Analgesics are drugs meant to treat chronic pain, outlasting the temporary effects of anesthetics. They also both work the same way, binding themselves to the body’s opioid receptors, which blocks the brain from receiving pain signals. They also increase the levels of dopamine in the central nervous system, which is what produces the “high” of sedation and euphoria.

Both drugs have the typical side effects of regular opioid abuse, including:

  • Fatigue
  • Nausea
  • Drowsiness
  • Depressed or shallow breathing
  • Paranoia

As well as more intense long-term side effects:

  • Hallucinations
  • Vomiting
  • Gastrointestinal issues like constipation and bloating
  • Abdominal distention
  • Low blood pressure
  • Lack of muscle coordination
  • Dangerously shallow or irregular breathing
  • Slow or irregular heartbeat

These symptoms will be markedly more intense and potentially fatal with fentanyl due to its immense potency. Fentanyl and morphine’s withdrawal symptoms are also very similar; they include:

  • Stomach cramps
  • Flu-like symptoms
  • Diarrhea
  • Nausea and vomiting
  • Depression
  • Anxiety
  • Elevated heart rate and blood pressure
  • Insomnia
  • Muscle pain

The major difference is that, since morphine has a much shorter half-life, withdrawal symptoms can begin as early as six hours after the last dose. Fentanyl; however, depending on the form, can have a half-life of 17 hours and can take more than 24 hours for withdrawal symptoms to start appearing.

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The Deadly Consequences

Long-term use of opioids comes with a whole host of damaging effects, and morphine is no different. Dangers of abusing morphine for an extended period include not just a decrease in sexual interest but also impotence, an inability to get pregnant, and impaired motor function and reaction times. A morphine overdose can cause seizures, uncontrolled vomiting, a decrease in breathing, and heart rate to the point of becoming comatose, and even death.

The U.S. Centers for Disease Control and Prevention also report that people who regularly inject morphine have a 50 to 70 percent risk of contracting hepatitis B, and an up to 80 percent risk of hepatitis C within five years of starting injection-based use.

Still, as undeniably dangerous as morphine is, it simply cannot compare to fentanyl. Those who use fentanyl are far more likely to die of an overdose than suffer the damages of abusing it long-term. To give an idea of just how small a lethal dose of fentanyl is, a typical dosage of baby aspirin is 81 milligrams. The amount of fentanyl needed to kill someone is one-quarter of a single milligram.

Someone who has been abusing morphine long-term will eventually have built up a tolerance and can no longer get the same high they used to. In seeking out a stronger high, many users will try fentanyl and take the same amount as they would have of morphine, resulting in an overdose.

Sudden death from fentanyl overdose can be caused by:

  • Severe respiratory depression or total respiratory arrest
  • Cardiac arrest
  • Cardiovascular collapse
  • Seizures
  • Severe anaphylactic reaction

Fentanyl is so potent that just absorbing an incremental amount of powder through your skin is enough to trigger an overdose. Heroin is also being cut with fentanyl, leading to a rise in accidental overdoses. Even more chilling is the substance known as Gray Death, a mix of several potent drugs that include fentanyl, which can cause a fatal overdose just by accidentally inhaling airborne particles of it.

Just five years ago, only four percent of illicit drug overdose deaths were due to fentanyl. Now in 2017, fentanyl has been detected in 81 percent of fatal overdoses from illicit drugs in the span of January to August alone.

Don’t Wait to Make a Change

As opioids, fentanyl and morphine share many of the same harmful effects and dangers. However, fentanyl’s frightening potency will often not allow enough time for long-term abuse before causing a deadly overdose. If you or someone you know is struggling with a dependency on either morphine or fentanyl, call Ocean Breeze Recovery today at (844) 657-9704 or contact us online to learn more about your options.


Stephanie T.

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