Pain medicines, explained properly.

Morphine is a strong opioid painkiller used for severe pain that cannot be controlled with weaker medicines. In the UK it is most often used in cancer pain, palliative care and pain after major surgery or serious injury.

Oxycodone is a strong opioid used for moderate to severe pain. It is roughly one and a half to two times as potent as oral morphine, so it is used where morphine is not suitable or not effective enough.

Hydrocodone is an opioid painkiller that is widely used in the United States but is not authorised for use in the United Kingdom. It is not available on the UK market and UK prescribers do not prescribe it.

Fentanyl is a very potent synthetic opioid, many times stronger than morphine. In the UK it is used as patches for stable, severe long-term pain in people already used to opioids, and in anaesthesia and specialist palliative care.

Hydromorphone is a strong opioid used for severe pain, particularly in palliative and cancer care. It is more potent than morphine and is usually chosen by a specialist when morphine is not working well or is not tolerated.

Codeine is a weaker opioid used for mild to moderate pain and for cough. On its own it is prescription-only; low-dose tablets combined with paracetamol or ibuprofen can be bought from a pharmacy after a pharmacist's assessment.

Tramadol is a prescription-only painkiller used for moderate to severe pain. It works partly like an opioid and partly like an antidepressant, which explains both its benefits and its particular risks.

Buprenorphine is a partial opioid that is used two very different ways: as patches for long-term pain, and as a treatment for opioid dependence. It is safer in overdose than full opioids but can trigger withdrawal if started too soon.