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Fentanyl vs. Morphine: Comparing These Opioids

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated May 13, 2023 • 8 cited sources
morphine medical liquid in glass vial

Fentanyl and morphine are both opioids — prescription painkillers. While these medications are designed for a very specific purpose, they are also common targets of misuse. 

Morphine is the weaker of the two drugs, and many people think this substance is a good misuse target. In a study of social media posts about opioids, 70% of people said they misused drugs in this class to get a good night’s sleep or get high.[1] 

But dealers often add fentanyl to drugs they market as morphine. It’s stronger, easier to smuggle and more addictive, so it’s ideal for a dealer’s product. But this stronger drug could also cause overdose. 

Know that neither fentanyl or morphine is safe for recreational abuse. These are strong drugs that should only be used for short periods under a doctor’s care. If you’re misusing opioids, you will need treatment to quit.

What Are These Drugs?

While both fentanyl and morphine are opioids, they are very different. 

Morphine is made to treat moderate-to-severe pain. It comes in the following formulations:[2]

  • Liquid
  • Extended-release tablet
  • Extended-release caplet

Fentanyl is a stronger drug, designed for people with significant pain that hasn’t responded to other opioids. It comes in the following formulations:[3]

  • Lozenge
  • Sublingual tablet
  • Film
  • Dissolving tablet 

People with significant pain might use both medications. Morphine eases their daily pain, while fentanyl helps with breakthrough discomfort. 

But the average person shouldn’t consider these drugs interchangeable. Unfortunately, many people who buy drugs from dealers do just that, and the results can be catastrophic. 

How Are Fentanyl & Morphine Similar?

Both morphine and fentanyl are opioids. They attach to the same receptors inside the brain and nervous system, triggering pain relief and euphoria. 

Both can cause tolerance, meaning that with repeated use people need larger doses to attain the experiences that once came easily. Both can trigger compulsive use and an opioid use disorder (OUD).

More than 11% of Americans had pain every day for the prior three months.[4] If you’re one of them, you may have been exposed to opioids by a doctor. That exposure could turn into an OUD in time. 

How Are They Different?

Fentanyl is 50 to 100 times more potent than morphine.[5] While it latches to the same receptors, it triggers much stronger changes. 

A dose of morphine that seems safe to you (such as one pill) could be far too much fentanyl. 

How Dangerous Are These Drugs?

While opioids can be useful in addressing short-term pain, they come with many side effects that could hurt you.

Known harmful opioid side effects include the following:[6]

  • Confusion
  • Constipation
  • Nausea
  • Slowed breathing

A doctor can manage your opioid exposure and ensure that you’re not taking too many for too long. But many people don’t work with doctors to get opioids. They buy them from dealers. Any or all of these side effects could occur in someone who misuses fentanyl or morphine. 

Comparing Overdose Risks 

All opioids are dangerous, capable of overwhelming the central nervous system, slowing breathing and causing brain death. No opioid is safe to misuse. But the stronger the drug, the higher the overdose risk. 

In 2021, more than 106,000 people died from overdoses of both illicit and prescription opioids.[7] But experts are growing even more concerned about the presence of fentanyl. Deaths due to synthetic opioids like fentanyl are responsible for more and more overdose deaths each year.

It’s impossible to tell the difference between fentanyl and morphine by sight, smell or taste. Someone accustomed to morphine could buy fentanyl-contaminated doses and overdose immediately. That’s the only way they might know that their drug contained a stronger one. 

Nasal administration of the opioid antagonist naloxone can reverse an overdose. But fentanyl is so strong that it rarely responds to one dose. First responders often administer multiple naloxone doses to awaken people, and sometimes, they overdose again on the way to the hospital. 

While fentanyl is certainly stronger and more dangerous than morphine, neither drug is truly safe to misuse. Anyone who uses opioids runs the risk of an overdose. 

Getting Help for OUD With MAT

OUD is a chronic condition caused by chemical changes due to long-term opioid exposure. These changes make it hard for you to get sober without significant illness, and if you do get sober, relapse due to cravings is likely.

Medication for Addiction Treatment (MAT) programs correct these chemical imbalances with drugs like Suboxone.

Suboxone contains buprenorphine, a weak opioid agonist. It latches to the same receptors used by morphine and fentanyl, easing cravings and withdrawal symptoms. 

Suboxone also contains naloxone, which works to deter misuse of the medication. If Suboxone is misused, naloxone will become active and trigger withdrawal.

People in MAT programs don’t use their medications to get high. Instead, they’re using science-based treatments to address a very real illness. And their commitment can help them maintain sobriety. In one study, 84% of people taking MAT were abstinent from opioid misuse one year after starting treatment.[8]

If you’re struggling to stop using opioids, consider enrolling in an MAT program. The help you get here could change your life.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. The Canary in the Coal Mine Tweets: Social Media Reveals Public Perceptions of Nonmedical Use of Opioids. PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135072. August 2015. Accessed March 2023.
  2. Morphine. U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a682133.html. February 2021. Accessed March 2023.
  3. Fentanyl. U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a605043.html. January 2021. Accessed March 2023.
  4. NIH Analysis Shows Americans Are in Pain. National Institutes of Health. https://www.nih.gov/news-events/news-releases/nih-analysis-shows-americans-are-pain. August 2015. Accessed March 2023.
  5. Fentanyl Drug Facts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/fentanyl. June 2021. Accessed March 2023.
  6. Prescription Opioids Drug Facts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/prescription-opioids. June 2021. Accessed March 2023.
  7. Drug Overdose Death Rates. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates. February 2023. Accessed March 2023.
  8. Trends in abstinence and retention associated with implementing a Medication Assisted Treatment program for people with opioid use disorders using a Collective Impact approach. Progress in community health partnerships: research, education, and action. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751497/. Accessed May 2023.
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