What Are The Most Potent Opioids In The United States?

DrugRehab.org What are the Most Potent Opioids in the United States_

The most potent opioids in the United States include carfentanil, fentanyl, heroin, hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone, and a new deadly opioid combination drug called Gray Death. While most opioids are prescribed for pain relief, and contain addictive properties, some opioids are more potent than others.

It can be helpful to know which of these are the most dangerous, on the market and on the street, especially if you suspect someone close to you may be abusing these medications. Some opioids are harmful even to the touch, and taking repeated or large doses of them can result in dangerously slowed breathing, which can lead to overdose or coma.

DrugRehab.org What are the Most Potent Opioids in the United States_ Contain Addictive Properties

Others may have fatal results after just one dose, particularly combination opioids. That’s why it’s so important to recognize these medications, their severity, and seek help as needed.

With street drugs, there is never a guarantee for what kind of drug you’re getting or the dosage. It’s best to get out of the vicious, harmful cycle of addiction before you experience damaging effects to your health or worse.

Potent Opioids By Name:

The following are the most potent opioids in the United States, followed by a description of each. When a drug is “potent” it is medicinally effective or has a great ability to bring about a certain result, according to the Merriam-Webster dictionary.


Carfentanil is an opioid analogue of fentanyl, and is “one of the most potent opioids known” according to the U.S. National Library Of Medicine. Its potency level is 10,000 times that of morphine, and 100 times that of fentanyl. Carfentanil is typically used for tranquilizing large animals, including elephants.

Combination Opioid: Gray Death

Opioid combinations tend to be more potent than singular opioids. Gray Death is a current popular and deadly combination in use right now. As Forbes explains, Gray Death “looks like concrete and is so potent that it can be risky to touch and can kill you with one dose.” It contains fentanyl, heroin, carfentanil, and U-47700, a synthetic opioid commonly called Pink—all highly potent opioids.


Fentanyl is the most potent opioid used in hospitals or by doctors, according to CNN. However, much of fentanyl sold on the street is diverted from other countries, and that’s how it can become dangerous. People buying the drug may have no idea that they’re buying fentanyl and take too much without being under care of a doctor. Even a small amount of fentanyl can be lethal, as the drug can be accidentally inhaled or absorbed through the skin on contact.


Heroin affects the brain in a way similar to prescription opioids, causing euphoria, a sense of well-being, and slowing of certain functions. Why is it potent, then? Repeated heroin abuse can cause an excess of the substance in your body, which contributes to overdose. Also, heroin may be laced with additives such as sugar or starch, or with other substances. These can clog the blood vessels that lead to other organs and create permanent damage. Heroin should always be considered potent for the simple fact that there is no guarantee of what’s in it.


Hydrocodone is potent enough that it’s prescribed for patients who will need relief from pain round-the-clock for a long time. Drug label warnings for this medication strongly advise against breaking or crushing the pill, or taking it any other way than prescribed—as this can cause overdose and death. Just taking hydrocodone as prescribed can slow or stop breathing, so abuse of it is dangerous.

Hydromorphone (Dilaudid)

Hydromorphone is more potent than morphine, but not as potent as fentanyl. It’s another opioid that is potent even to the touch. As for the effects of it, the drug can cause withdrawal even with monitored use, and can cause fatal overdose when in the wrong hands.

Morphine (Kadian, Morphabond)

With so many potent opioids out there, morphine may be considered mild in the minds of some. But it’s not to be underestimated, as it can still cause addiction, dependency, and even overdose when taken in high doses. Morphine presents even higher risk of overdose when combined with other substances, like alcohol.

DrugRehab.org What are the Most Potent Opioids in the United States_ Oxycodone

Oxycodone (Oxycontin)

Oxycodone is two times as powerful as morphine, and like most opioids can cause respiratory distress. In the last couple decades, abuse of Oxycodone became quite popular as prescription rates increased. Yet abuse of this medication can be dangerous; it’s typically used for postoperative pain relief.

Oxymorphone (Opana)

Oxymorphone is often used to treat those with terminal cancer or chronic, severe pain issues. Because of this, the level of potency of the drug is high, about twice that of Oxycodone. People taking the drug as directed are advised to not stop taking it without help from a doctor. Abuse of Oxymorphone is far more risky as dosage is not regulated.

Why Are Opioids Addictive?

Opioids are addictive partly because the drugs contain chemical properties that change your perception of pain and your response to pleasure. They’re also addictive because when you take them, you experience an immediate rush of pleasurable feelings: euphoria, well-being, and calm.

This rush happens within the first few minutes, and is followed by a short-term “high,” or extended period of pleasurable feelings with minor side effects like drowsiness or slowed breathing. It’s the rush and subsequent high that gets you, makes you want to keep coming back to opioids even if you aren’t aware of it at first.

With time, you lose control; you can no longer recognize the difference between use and abuse, and will do nearly anything to seek the drug. Once you become addicted, you may form a physical dependence on the drugs, which means you’ll have withdrawal symptoms when not taking them. Withdrawal, while not always life-threatening, can be uncomfortable to the point that you want to avoid it, and so keep abusing the drugs.

Who Is Abusing Opioids In The United States?

If you’re caught in this cycle of opioid addiction, you aren’t the only one. The American Society Of Addiction Medicine (ASAM) states that, in 2015, “2 million [people] had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin.”

Yet few people addicted to opioids ever receive help in treatment, and that is why overdose happens more and more. Plus, if you’ve been addicted to one opioid, it’s quite likely you’ll become addicted to another if you don’t find help. The ASAM estimates that four out of five people who first abused prescription drugs later became addicted to heroin.

DrugRehab.org What are the Most Potent Opioids in the United States_ 591,00 Had A Substance

The number of people addicted to opioids includes youth as young as 12 years of age, though adults in the age group of 18 to 25 abuse these drugs most. Women are particularly affected by prescription opioid abuse, as they are more likely to have chronic pain, seek medication for it, receive opioid medications, and fall into abuse of them.

What Can Be Done For Opioid Addiction?

So, what can we do to reverse the harm of opioid addiction? More all the time, new treatment modalities are developed and backed by evidence to support effective outcomes. Some of the evidence-based methods we employ at our facilities include:

  • Counseling: family, group, and individual
  • Psychosocial therapy: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Motivational Interviewing
  • Adventure therapy
  • Wilderness therapy
  • Treatment specific to men
  • Treatment specific to women
  • Medication-assisted therapy
  • Medically-supervised detoxification
  • Nutritional guidance and exercise support
  • Mindfulness and stress management techniques
  • Aftercare support

In addition to great treatment methods, people struggling with opioid addiction will benefit from the excellent care, peaceful surroundings, and serene landscapes often found at private rehabs. At DrugRehab.org, we have access to all the resources you’ll need to find a rehab that is right for you, and that works to build a treatment program that best fits your individual needs.

Find Hope In Treatment Today

Are you battling abuse of one of the most potent opioids in the United States? If you are, you don’t have to fight alone. We’d like to help you overcome addiction, and rebuild your life.

When you call today, your information will be kept confidential. Learn more about opioid treatment and the best rehab centers today. Contact us at DrugRehab.org.

For more information, call now!

For More Information Related to “What Are The Most Potent Opioids In The United States?” Be Sure To Check Out These Additional Resources From DrugRehab.org:



American Society Of Addiction Medicine—Opioid Addiction: 2016 Facts And Figures
CNN—What You Need To Know About Fentanyl
Forbes—Gray Death: The Most Powerful New Opioid Combo That’s Risky Even To Touch
Merriam-Webster—Definition Of Potent
National Institute On Drug Abuse—DrugFacts: Heroin
National Institutes Of Health—Opioids And Chronic Pain
New York Times—Inside A Killer Drug Epidemic: A Look At America’s Opioid Crisis
U.S. National Library Of Medicine—Carfentanil, Hydrocodone, Hydromorphone, Morphine, Oxycodone, Oxymorphone

Signs and Symptoms of Fentanyl Abuse

DrugRehab.org Signs And Symptoms Of Fentanyl Abuse

It is not uncommon to have heard of the opioid epidemic sweeping the United States in recent years. The dangers of opioid use and addiction have been spotlighted in the news and online. What some people may not realize is that some opioids, such as fentanyl, are much stronger than others.

Take morphine, for example. Morphine is an opioid derived from the leaves of the opium poppy plant and is used in the creation of many other opioids as well as drugs like heroin. While morphine is quite potent and holds a high risk for addiction, other opioids, such as Fentanyl, hold as much as 100 times more potency than morphine.

DrugRehab.org Signs And Symptoms Of Fentanyl Abuse_opioids

Like many prescription opioids, there are legitimate medical reasons for Fentanyl to be taken. It is important, however, to keep in mind that not all prescription opioids are created equal. Some hold significantly higher risks than others. The best thing you can do for yourself is make sure you are educated on the drugs you have been taking, and always be on the lookout for signs of abuse and addiction.

What Is Fentanyl?

Fentanyl is a synthetic, or lab created, opioid that has been around since the 1960s. It was originally marketed for anesthetic use in operating rooms, working with other anesthesia medications to ensure patients were relaxed and stress free as the anesthesiologist prepped the patient for sleep.

In the 1990s, researchers delved deeper into the pain relieving effects of Fentanyl. First creating the Fentanyl patch for long-term or chronic pain patients, pharma companies caught on to the popularity of the drug and eventually went on to make Fentanyl sprays, suckers, dissolving chewables, and pills. This truly brought Fentanyl into the market of synthetic opioid pain relievers.

DrugRehab.org Signs And Symptoms Of Fentanyl Abuse_synthetic pain reliever

By 2012, Fentanyl was the most widely prescribed synthetic pain reliever in the United States. While it is considered safe when used in the highly controlled environment of an operating room, Fentanyl can be extremely dangerous and easy to overdose on. Allowing patients to take home versions of Fentanyl, such as pills, can be a recipe for disaster as it is not uncommon for an individual to accidentally take too much.

How Does Fentanyl Work?

Like other opioids such as oxycodone and morphine, Fentanyl works by binding to opioid receptors in the brain. The opioid receptors are tied to the brain’s ‘reward’ system, which is related to the emotions an individual may feel.

The reward system in the brain is meant to instinctively drive humans towards doing more things that benefit them. For example, when you eat something sweet like a piece of fruit, you body naturally rewards you with feelings of satisfaction and happiness in an attempt to get you to eat it again. Feelings of pleasure are also tied to this, as pleasure is a reward for sex which can lead to procreation, or the production of more offspring.

When opioids like Fentanyl are introduced to the brain, however, this reward system is hijacked by the drug which triggers opioid receptors to produce feelings of euphoria and pleasure without it having been technically ‘earned’ by the individual. Following natural protocol, your body will crave more Fentanyl to receive the reward of these feelings again. This cycle is what drives Fentanyl addiction.

Signs And Symptoms Of Fentanyl Abuse

While Fentanyl can help provide some patients with temporary pain relief and relaxation, it does affect your body in some negative ways. As an opioid, Fentanyl directly affects the body’s respirations, or breathing rate, as well as heart rate.

As potent as Fentanyl is, this risk is greatly increased over other, less potent opioids. If an individual has recreationally taken other opioids before without any issues, they may be tempted to think they can take Fentanyl in the same way. Unfortunately, this sometimes fatal mistake is made when users do not understand the extreme potency of Fentanyl.

DrugRehab.org Signs And Symptoms Of Fentanyl Abuse_synthetic affects

Death from Fentanyl overdose is most commonly caused by a decrease in breathing so severe that it cuts off oxygen from the brain. Although death may seem like an extreme case, Fentanyl can take a toll on other parts of the body as well. Some signs and symptoms of Fentanyl abuse can include:

  • Cold sweats
  • Uncontrollable shakiness
  • Dizziness, headaches, or hallucinations
  • Depression
  • Weight loss or malnutrition due to loss of appetite
  • Constipation and inability to urinate
  • Itchy skin or hives
  • Insomnia and nightmares
  • Difficulty breathing
  • Coma
  • Dry mouth (cotton mouth)

Get Help

If you or a loved one is suffering from Fentanyl abuse, it is important to seek professional help immediately. The extreme potency of Fentanyl makes it difficult to predict the effects it will take on its user, which can lead to dangerous outcomes very quickly.

Fentanyl is highly addictive and difficult to quit, but our addiction specialists are here to support you every step of the way. Call today to learn more about the comprehensive addiction treatment programs we have and get started on your road to recovery.

For more information on fentanyl abuse and addiciton, call now!

For More Information Related to “Signs and Symptoms of Fentanyl Abuse” Be Sure To Check Out These Additional Resources From DrugRehab.org:



BMC Palliative Care – Opioid Switch From Low Dose Of Oral Oxycodone To Transdermal Fentanyl Matrix Patch
Drugs.com – Fentanyl Injection
National Institute on Drug Abuse (NIDA) – What Is Fentanyl?
US National Library of Medicine – Transdermal Fentanyl: Pharmacology And Toxicology

Is Narcan Available Over-The-Counter In The United States?

DrugRehab.org Is Narcan Available Over-The-Counter In The United States_

All across our nation, opioid drug abuse continues to claim the lives of our neighbors, family members, and other loved ones. With proper prevention and/or treatment, these deaths can be prevented. Narcan is a powerful tool which can save a person’s life.

What Is Naloxone?

All opioid drugs depress the central nervous system. This results in decreased blood pressure, breathing, heart, and temperature rates. During overdose these critical life support functions slow even more, to the point where they begin to shut down. Left untreated, these circumstances can lead to death.

DrugRehab.org Is Narcan Available Over-The-Counter In The United States_ Results in Decreased

Naloxone hydrochloride is an opioid antagonist, which, according to the National Institute on Drug Abuse means “that it binds to opioid receptors and can reverse and block the effects of other opioids.” Because of these effects, naloxone holds great success as an overdose reversal drug. This mechanism of action occurs rapidly by “restoring normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications.” Naloxone is available in three FDA-approved formulations, one of which is Narcan.

What Is Narcan?

To stop overdose in its tracks, a medication must be administered in a form which allows the drug to begin working right away. At a time like this when every minute matters, a pill or tablet would take far too long to work. This is why naloxone is administered in rapid-release formulations for overdose, such as with Narcan.

As a nasal spray, Narcan delivers the naloxone to the sensitive tissues within your nasal cavity. These tissues are highly permeable to naloxone, allowing the drug to pass quickly so it can make its way to the brain. Each single dose contains 2 mg or 4 mg of naloxone. According to the manufacturer, this medication begins reversing overdose in two to three minutes.


  • Comes already assembled
  • Does not require an injection
  • Is available over-the-counter in certain locations

Because of these features, Narcan is a life-saving device which is easy to use for family members, friends, and caregivers of opioid drug abusers.

How Do I Use Narcan?

The minute it becomes apparent a person is overdosing, Narcan should be administered. To use this drug, the overdosed individual must be placed on their back. Narcan is then inserted and sprayed into one nostril. At this point, the drug goes to work right away.

Medscape cautions that multiple doses may be required if a person fails to begin breathing or relapses back to unconsciousness and respiratory depression. To meet these needs, each pack of Narcan comes with two dosages. Each dose has enough medication for one use and should only be used once.

DrugRehab.org Is Narcan Available Over-The-Counter In The United States_ Emergency medical Help

Even though Narcan works within minutes to slow or stop overdose, a person isn’t necessarily in the clear. Emergency medical help should still be contacted as soon as possible. While you’re waiting for help to arrive it’s crucial that you continue to watch the individual closely. Emergency medical personnel should monitor the individual for two hours to ensure that they do not suffer from any additional respiratory complications.

Can I Purchase Narcan Over-the-counter?

Narcan is changing the face of the opioid epidemic for many reasons, namely due to its accessibility. While many emergency medical teams and first responders do carry this drug, over-the-counter (OTC) availability puts Narcan into the hands of those who need it.

Like other medications, Narcan is available with a prescription. But with the growing concerns of opioid overdose across our nation, this drug is increasingly becoming available OTC. The manufacturer’s website states “As of December 28, 2016, ten states require a prescription from your healthcare professional to obtain NARCAN® Nasal Spray.” Two nationwide pharmacies have made huge strides in promoting Narcan’s life-saving potential. In 2016, Walgreens and CVS both announced that they were expanding access to Narcan without a prescription.

Keep in mind, state legislation is always changing. As time passes, this medication may become even more widely offered OTC. For example, Narcan was recently made available over-the-counter in Michigan. This option is dependent on state-specific laws regarding the prescription and administration of Narcan.

How Do I Know If Narcan Is Available Without A Prescription In My State?

In order to obtain this drug, it’s important to know if you can purchase it this way in your state. These laws vary. Some states may only dispense Narcan without a prescription to the patient, whereas others will do so for those who wish to protect their loved ones.

The Prescription Drug Abuse Policy System offers resources on the specific legislation and broadened naloxone access laws on a state-by-state basis. Beyond this resource, the easiest way to find out would be to ask your family doctor or local pharmacist.

Who Should Carry Narcan?

Within situations of overdose, time matters. Medications like Narcan help individuals and families have a protective measure in place, should overdose occur. If you have a loved one who abuses opioid drugs, it’s recommended that you keep Narcan on hand. This will allow you to dispense treatment immediately if they start exhibiting signs of overdose.

DrugRehab.org Is Narcan Available Over-The-Counter In The United States_ Available in MichiganAdditionally, a person who is experiencing overdose themselves may not be able to administer the Narcan. Even then, chronic opioid abusers should keep Narcan on or near them. It’s important the user notifies those close to them of the location of this drug, so that these individuals have access to it fast. The prescribing doctor or pharmacist (if purchased over-the-counter) can walk you through using Narcan.

Can You Get In Trouble For Administering Narcan?

Unfortunately, some individuals are apprehensive of administering this drug for fear of liability should something happen. To counter this fear, many states are increasingly developing legislation to protect people who choose to use this drug. These individuals are referred to as lay people and the laws protecting them as Good Samaritan Laws. The Network for Public Health Law has published a fact sheet detailing if and how these protections are in place.

In early 2017 the National Conference of State Legislatures reported that “To encourage people to seek out medical attention for an overdose or for follow-up care after naloxone has been administered, 37 states and the District of Columbia have enacted some form of a Good Samaritan or 911 drug immunity law.”

We Can Help You Fight The Opioid Epidemic

Experiencing an opioid addiction, either personally or within a loved one’s life, can be a very frightening experience, and overdose even more so. If you’re concerned about an opioid overdose and would like to learn more about prevention or treatment options, like Narcan, let DrugRehab.org help. Opioid addictions are serious, but the good news is that they’re treatable. We can help you find a treatment program to help you recover. Contact us now.

For more information, call now!

For More Information Related to “Is Narcan Available Over-The-Counter In The United States?” Be Sure To Check Out These Additional Resources From DrugRehab.org:



DAILYMED — Label: NARCAN- naloxone hydrochloride spray
NARCAN (naloxone HCL) NASAL SPRAY 4 mg — More Questions?
National Conference of State Legislatures — Drug Overdose Immunity and Good Samaritan Laws
National Institute on Drug Abuse — Opioid Overdose Reversal with Naloxone (Narcan, Evzio)