Opioid pain medications: the list, ranked by safety record
All 11 opioids we track, ranked by our independent FDA recall-safety score. Unlike a plain list, every drug here carries its safety record, what it treats, whether a generic exists, and how long it stays in your body.
Opioids, sometimes called narcotics, are strong prescription pain relievers — the group includes oxycodone, hydrocodone, fentanyl, and tramadol. Providers prescribe them to reduce pain after major injury or surgery, for severe pain from conditions such as cancer, and sometimes for ongoing chronic pain.
How they work: Opioids act on opioid receptors in the central nervous system. The mu receptors they bind mediate pain relief, but the same receptors also drive sedation, gut slowing, physical dependence, and a reduced drive to breathe.
What everyone taking one should know
Every drug in this class can cause addiction and physical dependence (withdrawal symptoms when it is stopped), and can slow breathing enough to cause a fatal overdose — the risks that make opioids among the most tightly controlled medicines. These dangers apply class-wide, not just to the strongest agents. Never start, stop, or change how you take an opioid on your own; that is a decision for your prescriber.
| Drug | Safety | Generic? | Treats |
|---|---|---|---|
| loperamide hydrochlorideboxed warning Half-life: about 10.8 hours | 72/100 | Brand only | Functional Colonic Diseases, Diarrhea |
| methadone hydrochlorideboxed warning Half-life: about 8 to 59 hours | 70/100 | Brand only | Opioid-Related Disorders, Intractable Pain |
| morphine sulfateboxed warning Half-life: about 2 hours | 70/100 | Brand only | Dyspnea, Intractable Pain |
| remifentanil hydrochlorideboxed warning | 70/100 | Brand only | Pain |
| tramadol hydrochlorideboxed warning Half-life: about 6 hours | 70/100 | Brand only | Pain |
| hydromorphone hydrochlorideboxed warning Half-life: about 2.3 hours | 66/100 | Brand only | Cough, Postoperative Pain |
| meperidine hydrochlorideboxed warning | 58/100 | Brand only | Pain |
| buprenorphine hydrochlorideboxed warning | unrated | Brand only | Heroin Dependence, Pain |
| fentanylboxed warning | unrated | Brand only | Pain |
| oxycodone hydrochlorideboxed warning Half-life: about 3.5 to 4 hours | unrated | Brand only | Postoperative Pain |
| tapentadol hydrochlorideboxed warning Half-life: about 5 hours | unrated | Brand only | Pain |
Ranked by our independent recall-safety score (higher is better), which reflects the FDA recall and enforcement record — not effectiveness. A higher score is not medical advice to switch; which drug is right for you is a prescriber’s decision. 4 are unrated (too little regulatory history to score) and sort last.
Sources
Other drug classes: NSAIDs · Statins · Benzodiazepines · Beta blockers · SSRIs · SNRIs · ACE inhibitors · ARBs · Proton pump inhibitors · Calcium channel blockers · Macrolide antibiotics.
The list is built from the FDA’s Established Pharmacologic Class tags, so it reflects the drugs in this class that we track (one row per active ingredient). Safety scores come from the FDA recall and enforcement record. This is general reference information, not medical advice — do not start, stop or switch a medication based on it; talk to your prescriber or pharmacist.