The relative abuse liability of oral oxycodone, hydrocodone and hydromorphone assessed in prescription opioid abusers

Sharon L. Walsh, Paul A. Nuzzo, Michelle R. Lofwall, Joseph R. Holtman

Research output: Contribution to journalArticlepeer-review

137 Scopus citations


Abuse of prescription opioids has risen precipitously in the United States. Few controlled comparisons of the abuse liability of the most commonly abused opioids have been conducted. This outpatient study employed a double-blind, randomized, within-subject, placebo-controlled design to examine the relative abuse potential and potency of oral oxycodone (10, 20 and 40 mg), hydrocodone (15, 30 and 45 mg), hydromorphone (10, 17.5 and 25 mg) and placebo. Healthy adult volunteers (n = 9) with sporadic prescription opioid abuse participated in 11 experimental sessions (6.5 h in duration) conducted in a hospital setting. All three opioids produced a typical mu opioid agonist profile of subjective (increased ratings of liking, good effects, high and opiate symptoms), observer-rated, and physiological effects (miosis, modest respiratory depression, exophoria and decrements in visual threshold discrimination) that were generally dose-related. Valid relative potency assays revealed that oxycodone was roughly equipotent to or slightly more potent than hydrocodone. Hydromorphone was only modestly more potent (less than two-fold) than either hydrocodone or oxycodone, which is inconsistent with prior estimates arising from analgesic studies. These data suggest that the abuse liability profile and relative potency of these three commonly used opioids do not differ substantially from one another and suggest that analgesic potencies may not accurately reflect relative differences in abuse liability of prescription opioids.

Original languageEnglish
Pages (from-to)191-202
Number of pages12
JournalDrug and Alcohol Dependence
Issue number3
StatePublished - Dec 1 2008

Bibliographical note

Funding Information:
Role of funding source : Grants from the National Institute on Drug Abuse (R01 016717 SLW, K12 14040 MRL) and the National Resources Center (M01-RR02602) provided support for this project. These institutes had no role in the study design, collection, analysis or interpretation of the data, writing of the report or in the decision to submit the paper for publication.


  • Abuse liability
  • Analgesia
  • Human
  • Hydrocodone
  • Hydromorphone
  • Opioid
  • Oxycodone
  • Prescription opioids

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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