Fentanyl vs. OxyContin: The Deadly Difference

The opioid epidemic has been ravaging the United States for years, with no end in sight. Hundreds of thousands of people have died as a consequence of misusing prescription opioids since 2000. As the numbers increase, two of the most commonly abused opioids, fentanyl and OxyContin, are being singled out as the most destructive and deadly. These two drugs are often compared due to their potency and popularity among recreational drug users. However, there are some significant differences between the two drugs, and understanding these differences could help in making a difference in the fight against addiction and overdose. 

History of Fentanyl and OxyContin

Fentanyl was first synthesized in 1959 by Belgian physician Paul Janssen. It was initially used as an anesthetic for surgical procedures and much more potent than morphine. In later years, the drug became the go-to narcotic prescribed for the treatment of severe, chronic pain from late stage cancer and intensive surgeries. Due to its potency, fentanyl historically has not been a drug prescribed to the masses and it wasn’t until the last few years that the rise of fentanyl as a street drug began.  

OxyContin, on the other hand, was first introduced in 1996 by Purdue Pharma. The drug was marketed as a safer alternative to other opioids, as it was designed to release its active ingredient, oxycodone, over 12 hours. It was largely prescribed in the treatment of pain management for medical issues such as arthritis, back pain, etc. However, the drug was highly addictive and easily abused, leading to an increase in opioid addiction and overdose deaths. It was the unethical marketing campaigns and incentivized prescribing practices throughout the late 90’s and 2000’s that led to the boom of opioid abuse which has now found its tailwind via fentanyl. 

The Differences: Fentanyl & OxyContin

While both drugs work by binding to the opioid receptors in the brain and spinal cord and reducing the perception of pain, there are some significant differences between fentanyl and OxyContin when it comes to their abuse potential. They are: 

Potency: Fentanyl is significantly more potent than OxyContin, making it more dangerous when abused. Fentanyl is 50-100 times more potent than morphine, while OxyContin is only two times more potent than morphine.

Method of Administration: Fentanyl is typically injected or smoked, while OxyContin is often crushed and snorted. Oxycontin has only ever been made in a tablet form whereas fentanyl is available as transdermal patches, lozenges, nasal sprays, injectable solutions, and tablets. 

Prescription vs. Illicit Use: Both drugs are prescribed for pain relief, but fentanyl is more often created and distributed by illegal means, whereas OxyContin is often prescribed by a doctor. The majority of the fentanyl in the United States is made by the Mexican Cartels. All of the Oxycontin in the United States is made by pharmaceutical companies. Before the widespread use of prescription drug-monitoring programs across state lines, it was very easy for addicts to get multiple doctors to prescribe them medicine for the same ailment. This practice is known as “doctor shopping.” The incentivization of prescribing opioids along with doctor shopping led to the initial boom in popularity and supply. As federal regulations came down tightening the outflow of prescription painkillers, the cartels stepped in to fill the demand with fentanyl. Currently, fentanyl is much more widespread than Oxycontin. 

Risk of Overdose: While both drugs can be lethal when abused, fentanyl is much more likely to cause an overdose due to its potency. Even in small amounts, fentanyl can be deadly. Fentanyl is also being pressed into counterfeit Oxycontin pills and mixed with an assortment of other street drugs to provide an even more potent and dangerous high. 

The Risks of Opioid Abuse

Regardless of the specific opioid used, the risks of abuse are significant. Opioids are highly addictive, and even individuals who start taking them for legitimate medical reasons can develop an addiction. The longer a person takes opioids, the more likely they are to become addicted, and the more likely they are to experience negative side effects, such as respiratory depression, constipation, and sedation. Abrupt cessation of these drugs can lead to horrific withdrawal symptoms. Opioid addiction can also lead to the contraction of transmissable, blood-borne diseases such as HIV, Hepatitis B, and Hepatitis C. 

Opioid abuse also leads to overdose, which can be deadly. In 2021 over 70,000 people died as a result of a synthetic opioid overdose - with fentanyl being the most common one. 

How Residential Treatment Can Help

Addiction to fentanyl or OxyContin is a serious and life-threatening condition. Residential treatment can provide individuals struggling with addiction the support and resources they need to overcome their addiction.

Residential treatment programs offer 24/7 medical care and supervision, ensuring that individuals undergoing withdrawal are kept safe and comfortable. These programs also provide a wide range of evidence-based therapies to address the underlying causes of addiction, such as individual and group therapy, cognitive-behavioral therapy, and family therapy.

Moreover, residential treatment programs also equip individuals with the tools and skills necessary to maintain their sobriety long after they leave the program. This includes relapse prevention strategies, ongoing therapy, and support groups.


If you or someone you know has struggled with opioid abuse and found sobriety - cherish them. If someone you know is currently dealing with addiction to opioids, call Sunflower Recovery Center for help, information, and hope.

Fentanyl vs. OxyContin: The Deadly Difference