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Fentanyl vs. Oxycodone | Similarities & Differences to Know

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Oct 15, 2023 • 8 cited sources

Fentanyl and oxycodone are both powerful opioid drugs used to manage pain in a medical setting and at home, yet there are significant differences between the two substances. 

Both drugs are highly addictive, though fentanyl is more potent than oxycodone. Long-term misuse of either drug can easily and swiftly progress to opioid use disorder (OUD). The presence of OUD heightens the risk of overdose, which can be fatal. 

Fentanyl vs. Oxycodone

Fentanyl is exceptionally potent. People are more susceptible to overdose deaths when using this drug because even a tiny amount can trigger respiratory depression that can be fatal.[1] 

Fentanyl is only prescribed for use at home when other forms of pain control have proven ineffective. For example, fentanyl patches may be prescribed for severe pain related to cancer. In addition, fentanyl is often synthesized on the street and used to augment the strength of other less potent street drugs. 

Oxycodone’s potency is somewhat lower comparatively.[2] The drug is typically prescribed for use at-home after a surgery or injury, or for moderate to severe chronic pain. 

Similarities & Differences Between Fentanyl & Oxycodone

Fentanyl and oxycodone are very similar in terms of their basic properties and function within the brain and body as well as their purpose for use. They are both used in medical settings for pain control, and they are both often misused by those with OUD. 

However, there are some striking differences between the two substances that can affect not only how it is used in a clinical setting and how they are misused. 

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This chart breaks down their similarities and differences:[1-7]

PotencyExtremely potent opioid, about 50 to 100 times stronger than morphinePotent opioid, less potent than fentanyl but still strong.
AdministrationAdministered through patches, injections, and nasal spray.Administered orally, typically in tablet or capsule form.
Duration of actionIntravenous, buccal film, and nasal spray: 30–60 minutes
Intramuscular: 60–90 minutes
Transdermal patch: 72 hours
Immediate release: 3–6 hours 
Extended release: 12 hours
Purpose of usePrimarily used for severe pain management, often in medical settingsUsed for moderate to severe pain management
Potential for OUDHigh potential for OUD due to its extreme potency and rapid onsetHigh potential for OUD due to its opioid nature
Interactions with other drugsDangerous if mixed with alcohol, sedatives or certain medications, as it can slow breathing and even cause deathMixing with other depressants can slow breathing and cause sedation
PriceTypically around $50–$64 per gramTypically around $0.91 per milligram 

Overdoses: Fentanyl vs. Oxycodone

In 2021, the number of overdose deaths linked to synthetic opioids, mainly fentanyl, reached a total of 70,601 reported deaths.[5] This high number is likely due to the fact that fentanyl is often mixed in with other street drugs, and people take it without realizing it.[6] 

The problem is growing. The rate of fentanyl overdose deaths increased more than 22% from 2020 to 2021 and made up roughly 88% of total opioid deaths that year.[7]

In 2021, there were 16,706 reported deaths related to prescription opioids, which include oxycodone.[5] Between 1999 and 2021, approximately 280,000 individuals died due to overdoses involving prescription opioids like oxycodone. By 2021, this number had nearly increased fivefold compared with 1999.[7]

Are Fentanyl & Oxycodone Both Addictive?

Yes, both fentanyl and oxycodone are highly addictive substances that belong to the opioid class. These drugs are well known for their pain-relieving abilities but also for their addictive potential. 

Both fentanyl and oxycodone trigger the pleasure pathway in the brain.[1,2] This mechanism is what defines the high experienced by people taking the drug and explains the release of feel-good chemicals in the brain. 

For people who struggle with mental health issues, such as anxiety and depression, this can be an even more pleasurable experience than for the average person. It can quickly become a response to challenging mental health episodes. Rather than taking the medication to manage physical pain, people may then take the drug to manage emotional pain or tough situations. 


Psychological addiction is just one component of an opioid use disorder. Physical dependence develops with continued and regular use of an opioid like fentanyl or oxycodone. 

While the original dose of fentanyl or oxycodone may be effective in managing pain, it will be necessary over time to take more of the drug to continue to get that same level of pain relief. With continually higher doses and increasing tolerance, dependence is more likely to form.

Once the body becomes accustomed to the continual presence of either drug, it will enter withdrawal when without the drug. Many people continue in a cycle of opioid misuse simply due to the discomfort of withdrawal.

Treatment for Fentanyl & Oxycodone Misuse

Opioid use disorder is treated the same way, whether it’s related to fentanyl or oxycodone misuse. Medication for Addiction Treatment (MAT) is considered the gold standard in treatment for OUD. 

MAT involves use of a medication like Suboxone, which manages withdrawal symptoms and cravings, allowing patients to focus on therapeutic work.[8] At Bicycle Health, we offer MAT to treat both oxycodone and fentanyl misuse. Learn how our telehealth offerings make MAT accessible to anyone who needs it.

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

  1. Fentanyl Citrate Injection, USP. Food and Drug Administration. Accessed August 25, 2023.
  2. Sadiq NM, Dice TJ, Mead T. Oxycodone. StatPearls. Published August 22, 2022. Accessed August 25, 2023.
  3. How much fentanyl is available on the darknet? Australian Institute of Criminology. Published March 2019. Accessed August 25, 2023.
  4. Black J, Margolin ZR, Bau G, Olson R, Iwanicki JL, Dart RC. Web-based discussion and illicit street sales of tapentadol and oxycodone in Australia: Epidemiological surveillance study. JMIR Public Health and Surveillance. 2021;7(12):e29187. doi:10.2196/29187
  5. Drug overdose death rates. National Institute on Drug Abuse. Published June 30, 2023. Accessed August 25, 2023.
  6. Opioid overdose. World Health Organization. Published August 4, 2021. Accessed August 25, 2023.
  7. Opioid overdose | drug overdose. Centers for Disease Control and Prevention. Published August 23, 2023. Accessed August 25, 2023.
  8. Maglione MA, Laura R, Christine C, et al. Effects of medication-assisted treatment (MAT) for opioid use disorder on functional outcomes: A systematic review. Rand Health Q. Published Jun 2020. Accessed August 25, 2023. 2020;8(4):RR-2108-OSD

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