Is Oxycodone Stronger Than Hydrocodone?

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Prescription opioids have been at the forefront of conversation in the United States for quite some time. Although government officials have worked diligently to limit the number of prescriptions that are given to those who abuse the drugs, the epidemic has steadily grown since the 90s. The National Institute on Drug Abuse (NIDA) estimates that 128 people lose their lives each day to opioid overdoses, which includes synthetic opioids like fentanyl, prescription painkillers, and heroin.

In the 1990s, pharmaceutical companies assured the medical communities that drugs like oxycodone and hydrocodone would not cause addiction in those who used them. Unfortunately, it led to doctors prescribing the medication at much greater rates, leading to the widespread misuse and abuse of prescription opioids. Unfortunately, drugs like oxycodone and hydrocodone were found to be highly addictive, and opioid overdose rates increased dramatically. In 2017, 47,000 Americans lost their lives because of opioids.  

Despite their potential for addiction, oxycodone and hydrocodone are still useful medications to treat moderate to severe pain. Only four to six percent who misuse prescription opioids will transition to heroin. The amount of prescriptions dispensed has declined over the years, but hydrocodone and oxycodone are still readily available. It may lead you to wonder, is oxycodone stronger than hydrocodone?

Continue reading for an overview of both oxycodone and hydrocodone to compare the differences between the two. 

What is Hydrocodone?

Hydrocodone is a prescription opioid used to treat pain. The narcotic pain medication binds to opioid receptors in our body’s central nervous system (CNS) to change the way we perceive pain. Hydrocodone drug brand names include Norco, Zohydro ER, and Vicodin. There are many risks and side effects of hydrocodone and the acetaminophen that accompanies it in many formulations. 

Hydrocodone is responsible for slowing overall activity in the central nervous system, including heart rate, respiration, and blood pressure. When the CNS is slowed, individuals must follow dosing instructions and use the medication as prescribed. 

Some side effects of hydrocodone include itching, constipation, nausea, vomiting, drowsiness, and headache. Despite the adverse side effects, hydrocodone does have therapeutic benefits, which is why opioids are prescribed. However, the risk of dependence and addiction can occur, especially in high doses. Higher doses can lead to feelings of euphoria, which is what can lead to addiction. 

What is Oxycodone?

Oxycodone, like hydrocodone, is a prescription opioid used to treat moderate to severe pain. It might be prescribed after surgery or used to treat chronic pain. As you might expect, like other depressants and opioid drugs, it affects the opioid receptors in the central nervous system to change how we experience pain. Some formulations include OxyContin and Percocet. Side effects are similar to hydrocodone.

Oxycodone Vs. Hydrocodone

When you’re comparing oxycodone and hydrocodone, there are some distinguishable differences. Drugs like OxyContin are extended-release tablets of oxycodone, meaning OxyContin has a significant amount of oxycodone. When someone uses the drug, it’s intended to slowly release into their bloodstream over a period of 12 hours. It’s a beneficial formula for those experiencing severe chronic pain. 

Brand name-drugs of hydrocodone include Zohydro ER and Hysingla ER, which are both extended-release formulations of the drug. Hydrocodone also comes in drugs like Vicodin and Norco that are short-acting and immediate-release. 

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Oxycodone Vs. Hydrocodone High

Unfortunately, prescription painkillers are commonly abused, and it begs the question about the differences between the oxycodone and hydrocodone effects. As was mentioned above, oxycodone is the active ingredient in OxyContin, and OxyContin is time-release, whereas oxycodone is an immediate release. 

Despite their differences, oxycodone and hydrocodone are both potent opioids that should only be used when absolutely necessary.

The potential exists to get high with either oxycodone or hydrocodone, but oxycodone is considered more potent and more likely to cause addiction than hydrocodone. Hydrocodone was once the most misused opioid in the United States until recently because it was easy for a doctor to prescribe and widely available at all pharmacies. 

Both oxycodone and hydrocodone are Schedule II drugs by the Drug Enforcement Administration (DEA), meaning they are both considered to have high potential for misuse and addiction.

Which Is Stronger?

We’ve established that both oxycodone and hydrocodone are potent opioids, but which is the more potent of the two? Both are used to treat pain moderate to severe and are both commonly combined with acetaminophen. Both oxycodone and hydrocodone are available in extended-release versions for those experiencing around-the-clock chronic pain. 

With that said, both are incredibly potent, but oxycodone is 30 percent stronger than hydrocodone, and many studies have shown the effectiveness of oxycodone and acetaminophen working better to treat pain than hydrocodone and acetaminophen.

Side Effects

Despite being the stronger of the two, oxycodone and hydrocodone have similar side effects. The most common side effects of both oxycodone and hydrocodone include:

  • Constipation
  • Nausea
  • Vomiting
  • Drowsiness
  • Itchiness
  • Constricted pupils
  • Headache
  • Dizziness

There is one glaring difference between oxycodone and hydrocodone. Due to the strength of oxycodone,  it’s more likely to cause gastrointestinal effects and constipation over hydrocodone, which can be severe in higher doses. 

Addiction

Is the oxycodone vs. hydrocodone addiction risk similar? Generally speaking, yes, there are identical risks when comparing the two. Both opioids are Schedule II drugs, meaning a high potential for abuse exists. It’s essential for someone to use the medications as instructed by their doctor to avoid the risk of addiction, which might even occur when used as prescribed. You should always speak to your doctor right away if the effects start to diminish instead of using more. It means you’re developing a tolerance.

Another similarity between the two is that brand-name formulations of the medications come in extended-release versions. The primary difference between the two is the sheer strength of oxycodone over its counterpart, hydrocodone. There are many similarities between oxycodone and hydrocodone, and both are commonly used in combination with other drugs or as extended-release. 

Withdrawal Symptoms

Oxycodone and hydrocodone also produce similar withdrawal symptoms. However, since oxycodone is more potent, the symptoms will be more severe than hydrocodone and last longer. Abrupt cessation of either substance is not recommended, and you should always seek professional medical help if you’re ready to stop using either drug, even if you’ve followed the doctor’s instructions. 

The most common hydrocodone withdrawal symptoms include:

  • Runny nose
  • Chills
  • Sweating
  • Muscle aches
  • Fatigue
  • Goosebumps
  • Increased tear production
  • Vomiting
  • Diarrhea
  • Fatigue
  • Mood swings
  • Depression
  • Anxiety
  • Drug cravings

Acute symptoms will last anywhere from five to seven days, and a combination of medications and therapy can help alleviate symptoms and reduce relapse in the future. Withdrawal can start as soon as six to 12 hours after your last dose, peak around 72 hours, and lingering symptoms, such as drug cravings, can persist for up to a month or more. 

One reason many people avoid getting help for opioid addiction is that the withdrawal symptoms are so severe. Although they’re not fatal, oxycodone withdrawal symptoms can be fierce. They’re compared to the “worst flu you’ve ever had.” Although acute symptoms will last up to a week, post-acute symptoms can last years, depending on how long oxycodone was used or abused, the dose, and how many times the individual has gone through withdrawal. 

The most common oxycodone withdrawal symptoms include:

  • Agitation
  • Irritability
  • Severe depression
  • Severe anxiety
  • Insomnia
  • Thoughts of suicide
  • Sweating
  • Body aches
  • Fatigue
  • Diarrhea
  • Inability to concentrate
  • Headaches
  • Runny nose or sniffles
  • Elevated blood pressure
  • Irregular heartbeat

Due to the extreme stress put on your body, it might be worth seeking medical detox to use medications and therapy to overcome the acute symptoms and manage the post-acute symptoms that often drive a person to relapse. Opioid withdrawal is unnecessarily uncomfortable to forego alone, and the risk of relapse is very high. A person who returns to either oxycodone or hydrocodone after detox can die because their tolerance has dropped dramatically. 

If you’ve developed a problem with hydrocodone or oxycodone, it’s ok to reach out for the help you need. Opioid medications are the most commonly abused, and 75 percent of those who abuse opioids admit to either hydrocodone or oxycodone use, with a higher percentage preferring oxycodone. Both can lead to illicit drug use if they’re not available, which can be fatal since you’re unsure of what you’re purchasing illegally. If you’ve reached this point, it’s time to get the help you need and deserve before it goes too far. 

Sources

Healthline (September 2018) Oxycodone Vs. Hydrocodone for Pain Relief. from https://www.healthline.com/health/pain-relief/oxycodone-vs-hydrocodone

DEA (February 2021) Drug Scheduling. from https://www.dea.gov/drug-scheduling

MedlinePlus (February 2021) Hydrocodone. from https://medlineplus.gov/druginfo/meds/a601006.html

NIDA (N.D.) Opioid Overdose Crisis. from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

DEA (February 2021) Oxycodone. from https://www.dea.gov/factsheets/oxycodone

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