Demerol vs. Morphine: Which Is Best for Pain Relief?

Demerol is much stronger than morphine, so it’s rarely a doctor’s first choice for pain control. But of the two, only morphine can be used for long-term pain. If your condition isn’t likely to resolve, your doctor might suggest this therapy to help you.

Demerol and morphine are both prescription opioid painkillers. If you’re struggling with pain and remedies like heat, massage, or other medications haven’t helped, your doctor may suggest an opioid like these. Both Demerol and morphine have a high risk of misuse, potentially leading to opioid use disorder (OUD).

This table can help you understand both drugs at a glance:[1,2]

What Is Demerol? 

Demerol is a brand-name opioid pain medication containing meperidine.[1] Tablets and oral solutions of Demerol are available. Doctors use it to treat pain that’s so severe it hasn’t responded to other medications.[1]

Demerol is an oral medication. People typically take the drug without food every three to four hours for pain control.[3] Every patient who accesses this drug is given a pamphlet that explains how the drug works and how it should be used safely. People who buy the drug on the street don’t get the same information. 

People who misuse Demerol swallow or inject the drug. Common street names include demmies and pain killer.[4] 

Demerol isn’t designed for chronic pain. Each dose breaks down into the metabolite normeperidine. This substance can be toxic and cause seizures.[1] The longer you take the drug, the more buildup can occur and the higher the risk of life-threatening seizures. 

Dependence & Withdrawal

Long-term use of Demerol can lead to physical dependence. Your brain and body become accustomed to the constant presence of the substance. If you quit using it abruptly, you can develop significant withdrawal symptoms like the following:[1]

• Restlessness 
• Watery eyes
• Runny nose
• Yawning
• Sweating
• Chills
• Muscle and joint pain 
• Anxiety 
• Weakness 
• Abdominal cramping
• Insomnia
• Nausea 
• Anorexia 
• Vomiting
• Diarrhea 
• High blood pressure 
• Fast heart rate 

Doctors may help their patients withdraw from Demerol safely. But people who misuse the drug will not get this help from their drug dealers. In severe cases, withdrawal can cause life-threatening dehydration. 

Medical supervision is always recommended for Demerol withdrawal. 

What Is Morphine? 

Morphine is a generic drug derived from opium. Doctors use it to treat pain. Some medications contain morphine only, but the substance can also be processed into codeine and other substances.[5]

Both acute and chronic pain are targets for morphine treatment.[2] If you pull a muscle, break a bone or have another acute injury, your doctor might recommend over-the-counter medications and therapies like heat or ice. 

If they don’t work, morphine might come next. If a chronic condition like cancer causes the pain, your morphine treatment might continue indefinitely. 

Morphine forms include oral solutions, immediate-release tablets and extended-release forms. Brand-name medications containing morphine include MS Contin, Roxanol and Kadian.[5] 

Common street names for morphine include the following:[5]

• Dreamer 
• Emsel
• First line 
• God’s drug 
• Mister blue 
• Morpho 
• Unkie 

Dependence & Withdrawal

While morphine is designed for long-term use, this approach can cause problems. Your brain and body can become accustomed to the medication. Quit abruptly, and withdrawal symptoms can appear. 

Episodes begin with mild signs like restlessness, chills, and muscle pain. They can progress to nausea, diarrhea and high blood pressure.[2] Some people develop suicidal thoughts during these episodes. Others relapse to drug use to make the problem fade. 

What’s the Difference Between Demerol & Morphine?

Demerol and morphine are both opioid painkillers, so they’re made to reduce discomfort. But they’re very different medications. Here’s what sets them apart:[1,2] 

Potency 

Demerol is much stronger than morphine. These two medications are made to ease discomfort. But Demerol is much more powerful. A doctor might start treating pain with morphine and then use Demerol if the person is still struggling with pain. 

Onset of Action 

Injectable forms of morphine work faster than oral forms of Demerol. When medications can enter the bloodstream without using the digestive tract, they tend to work faster. But there’s little difference in onset between oral versions of these drugs. 

Duration of Effects

Demerol can persist in the body for 12 hours or longer, experts say. But some metabolites can stay within the system for much longer.[1]

Morphine wears off faster after about eight hours. But some studies suggest morphine lasts for 15 hours or longer. The drug’s persistence can vary by administration type, as pills might last longer than injectable forms.[2]

Administration 

Demerol is an oral medication. Morphine is much more variable, as it’s available in multiple formats. Some types of morphine are injectable, and others are time-released, so they release medication slowly. 

Side Effects 

Opioids like Demerol and morphine come with significant risks of respiratory depression, overdose, misuse and OUD. But Demerol comes with two side effects that morphine doesn’t share. 

Demerol can spark a serotonin syndrome, which is life-threatening. Too much serotonin can cause multiple changes throughout the body.[6] Demerol can block the body’s ability to recycle serotonin, allowing this chemical to build up. Researchers say this problem can happen after just one dose of Demerol.[7]

Long-term Demerol use can also lead to seizures as the metabolite normeperidine builds up. Toxicity can lead to seizures.[1] Morphine doesn’t come with this risk, so it can be used for chronic pain. 

Medical Use 

Morphine can be used for acute or chronic pain. Multiple formats of this medication exist, so there are plenty of choices available. 

Demerol is an oral medication that’s used orally. Doctors use it for significant, short-term pain only. 

Is Demerol Stronger Than Morphine? 

Yes. Demerol is much stronger than morphine. Doctors only use this medication when other therapies haven’t kept pain under control. 

If you’re injured, your doctor might start treatment with morphine. If it doesn’t work, you might escalate to Demerol. 

What Is the Misuse Potential of Demerol & Morphine? 

All opioids, including Demerol and morphine, come with a high risk of misuse. Continued misuse can lead to OUD and all its negative effects. 

Demerol’s packaging states that the medication comes with a high risk of addiction, abuse and misuse. Even if you use the medication at recommended doses, it can cause a misuse issue.[1] This is why it should always be used with caution, even when prescribed.

Morphine’s packaging also states that the medication can result in addiction, abuse and misuse.[2] Even if you use this medication as recommended, an OUD can develop. Never veer from prescription instructions, and talk to your doctor if you’re tempted to increase your dosing.

Opioid Misuse & MAT 

An OUD, or addiction, is characterized by compulsive opioid use despite the consequences. People with OUD may want to quit misusing Demerol or morphine, but they may be physically and mentally unable to do so. Medication for Addiction Treatment (MAT) can help. 

MAT programs use therapies like Suboxone to ease chemical imbalances. Using these therapies can mean relieving withdrawal symptoms and drug cravings. 

You won’t get high on Suboxone, but you can feel focused on a healthy future. While recovery from OUD might have felt impossible in the past, it feels within reach with Suboxone.

Bicycle Health offers MAT via telemedicine. Meet with an expert via a video appointment, and pick up a prescription at a nearby pharmacy. You can often get this prescription the same day that you meet with an expert. 

Stay in touch with your treatment team via more video appointments. Contact us to find out if this approach is right for you.