What Is the Strongest Painkiller?

Medically Reviewed on 5/11/2022
What is the strongest pain killer?
Many people suffer from everyday pain, and they turn to opioid drugs for comfort.

The most powerful pain reliever is a class of medications known as “opioids,” which have a significant risk of addiction and dependency. These drugs are routinely recommended by doctors for severe pain treatment, as well as a variety of other illnesses.

Opioids have gained a well-deserved reputation as the most potent pain relievers known to man, as proven by startling statistics from the Centers for Disease Control and Prevention.

Many people suffer from everyday pain, and they turn to opioid drugs for comfort. Their use of opioids begins as recommended by their doctor, but the drug's reputation for addiction is widespread.

3 types of potent opioids

  1. Carfentanil:
    • Carfentanil, a synthetic opioid, is a 100-fold stronger version of fentanyl. It has 5,000 times the potency of heroin and 10,000 times the potency of morphine.
    • There has been an increase in the amount of carfentanil in narcotics, and this substance nearly invariably results in overdose and death.
  2. Fentanyl:
    • Fentanyl is a synthetic opioid and is said to be 30 to 50 times stronger than heroin.
    • This prescription medication is used to treat severe pain after surgery and chronic pain in opioid-dependent people.
    • Fentanyl is responsible for the vast majority of opioid overdose deaths.
  3. Hydromorphone and oxymorphone:
    • Hydromorphone and oxymorphone are two of the most powerful opioids.
    • They are several times more powerful than morphine and, like other opiates and opioids, have a significant potential for addiction.

Mechanism of opioids and opiates as painkillers

Opiates and opioids are two names that are frequently used interchangeably even though they are not the same thing. Although opiates are naturally formed from opium and opioids are synthetically produced, both have a comparable effect on the brain.

  • Opiates and opioids bind to opioid receptors in the brain and spinal cord. As a result, they alter the user's perception of pain.
  • Aside from pain treatment, opiates and opioids can provide sensations of pleasure or a high. 
  • These medicines cause the brain to respond with reward and emotion, which can lead to addiction.
  • The misuse of opioids has led to an epidemic in the United States, with more than two million people reportedly addicted to these drugs.

Opioid addiction may lead to overdose, which accounts for 68 percent of all drug overdose deaths in the United States each year.

Although the potency of opiates and opioids varies, it's crucial to remember that they're all addictive and can lead to physical dependency. Opioids do not cure the illness, but they do help the person manage the discomfort. They are powerful drugs with a variety of adverse effects that can lead to overuse, abuse, and addiction.

Here are some precautions to take when taking long-acting opioid pain medicines to avoid misusing them:

  • Keep the doctor informed.
  • Create a treatment strategy.
  • Be aware of and comprehend the adverse effects.
  • Follow the instructions precisely and thoroughly.
  • Reduce the possibility of medication interactions.


Rheumatoid Arthritis Exercises: Joint-Friendly Workouts See Slideshow

What are the types of painkillers?

Because everyone's pain experience is unique, different methods of pain management are required. Different pain-relief alternatives are appropriate for different situations.

Over-the-counter (OTC) medicines

These pain relievers can be purchased from your pharmacist without a prescription for mild-to-moderate discomfort. Although OTC medications are more freely accessible, they nevertheless pose some common unwanted side effects. These medications can occasionally induce undesired side effects and impair the effectiveness of other medications, particularly prescription medications. Your pharmacist can advise you on whether it is safe to take OTC pain relievers alongside your other medications.

Two common types of OTC pain medications include:

  1. Acetaminophen: If you experience short-term pain, this is frequently the first drug you should take.
  2. Nonsteroidal anti-inflammatory drugs (NSAIDs) (may require a prescription): They are a class of medications that functions by lowering swelling while also alleviating pain. Aspirin and ibuprofen are the most common NSAIDs.

Prescription medicines

Certain medications can only be obtained from a pharmacist with a doctor's prescription. These medications can be prescribed by dentists and some licensed nurses.

Prescription NSAIDs


  • Opioids such as oxycodone, morphine, and codeine can be used to relieve moderate to severe short-term (acute) pain, such as after surgery or an accident, as well as chronic pain in people with cancer
  • They should only be used if your doctor determines that other therapies are unable to control your pain or that you are unable to tolerate them.
  • Opioids are highly addictive and can result in major adverse effects such as life-threatening respiratory issues. 
  • Nausea, vomiting, constipation, and sleepiness are all possible side effects.
  • The longer a person takes opioids, the more likely they are to develop negative side effects. It is better to use opioids for as little period as feasible.

Anti-epileptic medicines


  • Antidepressants operate by altering how you perceive pain.
  • Antidepressants are occasionally given to assist control-specific forms of chronic pain, such as nerve pain (neuralgia) and fibromyalgia.


  • Prednisolone or prednisones are common steroids that are used to treat pain caused by inflammation or arthritis.

Muscle relaxants

Medicinal cannabis

  • If no other medications are useful in treating neuropathic pain, this medication may be worth a try.
  • However, medication must be given by a doctor who has specialized knowledge of its usage in pain treatment.

Topical painkillers

  • Some pain relievers can be administered directly to the skin at the place of your discomfort. These are known as topical medications, and they can be beneficial for short-term pain relief (for example, in osteoarthritis).
  • Topical pain relievers frequently contain NSAIDs such as ibuprofen or diclofenac. They function by reducing inflammation.
  • Capsaicin is a chili pepper extract that is occasionally used in topical pain relievers.
  • Because topical medications can absorb a small amount of medicine into your circulation, it is critical to apply the correct dose. 
  • Before using any product, always read the instructions on the packaging. If you are unsure what to do, you can consult your pharmacist or doctor.


  • Although there is minimal evidence to support this for some specific disorders, some people find that taking supplements can help them manage their chronic pain.
  • Some people find that taking glucosamine or chondroitin can assist with persistent pain caused by osteoarthritis.
  • There is evidence that omega-3 fatty acids can assist with chronic pain that affects vast portions of your body, as well as neck and shoulder discomfort and menstruation pain.
  • Caffeine can be added to other pain relievers to boost their effectiveness.

Taking pain reliever medications daily can be an important aspect of controlling various health disorders such as rheumatoid arthritis. There may be alternative, non-medicine-based strategies to effectively manage your pain for some health issues and forms of pain.

Contact your doctor to use the best painkiller or supplement for your condition.

How to choose a painkiller

Knowing about all over-the-counter (OTC) painkillers available is one thing, but knowing when to take each sort of drug is another. Pain treatment medicine works in a variety of ways to alleviate pain. Understanding the source of your pain will assist you in selecting the best pain treatment for you. Remember, if you're unsure about the sort of medication you require, it's always advisable to consult with your doctor first.

Acetaminophen: Acetaminophen is best used to treat mild to severe pain. Acetaminophen has some anti-inflammatory action and can help relieve pain caused by swelling and inflammation. It can be used for the following:

Moreover, it can help lower a temperature and is frequently used for flu-like conditions.

Ibuprofen: It is a nonsteroidal anti-inflammatory drug (NSAID) that alters the way your body responds to swelling. It is commonly used to treat the following:

  • Inflammation-related pain in the muscle and joint
  • Bone injuries such as sprains, fractured bones, and arthritis
  • Cold and flu symptoms
  • Period discomfort
  • Headaches

Naproxen: It is an NSAID and acts by decreasing inflammation-causing hormones in the body. It is similar to ibuprofen in that it’s effective at reducing inflammation-based pain such as:

  • Arthritis
  • Gout
  • Back pain
  • Sprains
  • Swelling after surgery
  • Period pain

Aspirin: It is a pain reliever that is occasionally taken in moderate doses to prevent heart attacks and strokes in people who are at high risk. Aspirin is available as pills, suppositories, and gel OTC. Although it is not as widely used as a pain reliever as it once was, aspirin is nevertheless used to treat the following:

Combination medications: These are a mix of two painkillers—codeine and acetaminophen.

  • Codeine is an opiate. Opiates function by lowering the central nervous system and altering how the body responds to pain. 
  • Codeine is a potent and addictive drug that may be harmful if taken for an extended period. 
  • This is why codeine is only available through prescription, and its usage is constantly supervised by a doctor.
  • The strongest painkiller for moderate to severe pain is a combination of medications such as codeine and acetaminophen.

Ten best painkillers in the United States

  1. Vicodin (hydrocodone-combination)
  2. Percocet (oxycodone with acetaminophen)
  3. OxyContin (oxycodone HCL)
  4. Acetaminophen with codeine
  5. Morphine sulfate
  6. Fentanyl
  7. OxyContin
  8. Methadone
  9. Dilaudid (hydromorphone HCL)
  10. Opana ER (oxymorphone HCL, extended-release)

Each medication has its own set of potential adverse effects. Most drugs might have some unintended side effects from time to time. Even if you take your pain relievers exactly as prescribed by your doctor, you may encounter adverse effects. Some adverse effects may go away after a period of using the medication. Therefore, before discontinuing or changing your medications, consult with your doctor or pharmacist. If you have any concerns about the side effects, contact your doctor as soon as possible.

Health Solutions From Our Sponsors

Medically Reviewed on 5/11/2022
Image Source: iStock Image

Pain Relievers: https://my.clevelandclinic.org/health/treatments/12058-pain-relievers

Treatments to Relieve Chronic Pain: https://www.choosingwisely.org/patient-resources/treatments-to-relieve-chronic-pain/

Pain Management in the Emergency Department: a Review Article on Options and Methods: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548151/

Pain Drug Comparison Chart: https://www.sutterhealth.org/pdf/incentive-content/painkiller-comparison-guide.pdf