Opiates are natural, intoxicating compounds derived from the opium poppy. These include codeine, morphine, and thebaine. Opiates are commonly used to treat pain and other health disorders. The term “opiate” also sometimes refers to semi-synthetic substances culled from these natural substances, including heroin.
Opioids, comparatively, are any substances that bind to opioid receptors in the brain. The term “opioids” is commonly used to describe both prescription-only and illegal drugs, including those partially derived from opiates, such as oxycodone, as well as those that are entirely synthetic, such as fentanyl.
Due mainly to the confusion involving the two terms and their non-standard usages, the term “opiate” has rapidly become obsolete, in favor of using simply “opioid” to describe all of these substances. With little or no reason to differentiate between natural, semi-synthetic, and synthetic opioids, the term “opioid” is most commonly used, even by health providers, in reference to an entire range of similar-acting drugs.
Moreover, there is some difference between the two chemically, but it is generally accepted to say “opioid” whether the drug is purely natural or not. Substances derived from opium alkaloids and are very chemically similar (e.g., heroin) are often considered opiates and opioids.
Conversely, other substances chemically unlike opium alkaloids but still act on the opioid receptors (e.g., fentanyl) are considered opioids but not opiates.
Opiates are chemicals derived from a poppy plant technically referred to as Papaver somniferum. Humans have cultivated and used these plants for thousands of years to produce opium. This substance has several medicinal uses, including for the treatment of pain, as a cough suppressant, as an anti-diarrheal agent, and to induce drowsiness and sleep.
In addition to these effects, opium is also known to cause intense feelings of well-being, which is the primary reason why opioids and opiates are so addictive.
Opium alkaloids, the chemicals responsible for these medicinal and recreational effects, are often referred to as opiates. They can be used as a stand-alone pharmaceutical product or in the synthesis of other compounds that include the following:
Morphine is the most plentiful alkaloid found in opium and is also the compound that has been used most often for medical reasons. Morphine is commonly administered to manage pain but is also a critical component in deriving several semi-synthetic medications, such as hydromorphone. Heroin is an illicit drug that is also derived from morphine but is much more potent.
Codeine is another vital opium alkaloid used as a medicinal compound and to derive other semi-synthetic substances. In addition to the pain treatment, codeine is contained in some prescription cough syrups.
Thebaine is the most virulent opium alkaloid, but it is used to manufacture popular semi-synthetic painkilling medications, such as oxycodone and hydrocodone.
An opioid is generally considered to be any substance that can be ingested, snorted, inhaled, or injected that interacts with opioid receptors in the body. Opioid receptors are proteins found in the brain, spinal cord, and digestive tract and interact with naturally-made compounds in the body, known as endogenous opioids.
In addition to heroin, semi-synthetic opioids include prescription drugs, such as the following:
- Hydrocodone (e.g., Norco, Vicodin, Lortab, Lorcet)
- Oxycodone (e.g., OxyContin, Oxecta, Roxicodone, Percocet)
- Hydromorphone (e.g., Dilaudid, Exalgo)
Fully synthetic opioids include prescription drugs, such as the following:
- Fentanyl (Abstral, Actiq, Fentora, Duragesic, Subsys)
- Meperidine (Demerol)
- Methadone (Methadose, Dolophine)
- Tramadol (ConZip, Ryzolt, Ultram)
Substances classified as opioids also include drugs that act on opioid receptors but in an antagonistic way. Opioid agonists, such as those mentioned above, activate the receptors to produce their painkilling and euphoric effects. Opioid antagonists, conversely, attach to receptors but do not stimulate them, thereby effectively blocking the action of agonist opioids.
Such opioids, such as naloxone, are used to treat opioid overdoses and to help recovering addicts resist the temptation to relapse. They include naltrexone (Vivitrol), naloxone (Narcan), and buprenorphine (Butrans, Buprenex, Probuphine). Suboxone is a combination product frequently prescribed to reduce cravings and withdrawal symptoms that includes a combination of naloxone and buprenorphine.
Historically, the term narcotic has been used in reference to numerous psychoactive substances. Currently, the Drug Enforcement Administration (DEA) more explicitly defines narcotic drugs as those that reduce pain and dull the senses, effects most commonly associated with opiate and opioid drugs.
Naturally-occurring opiates, semi-synthetic, and fully synthetic opioids are considered narcotics, including both legitimately prescribed and illicit variations.
Below is a list of the most often used narcotic opioid drugs:
Dependence and Withdrawal
Most opiates and opioids carry some potential for tolerance and dependence. Generally speaking, more potent opioids, especially if they are smoked, snorted, or injected, are riskier to use than those that are weaker.
Over time, long-term exposure to these drugs can promote tolerance, a condition in which the person sing needs to administer increasing amounts of a substance to achieve the desired effect. Closely related is dependence, which occurs when an individual is forced to keep using a drug to prevent unpleasant withdrawal symptoms and reduce cravings.
The duration of time it takes to become physically dependent on these substances varies between individuals and depends on the drug itself and the preferred method of administration, as well as the average amount and frequency of use.
Moreover, when the individual stops using the drug, the body needs time to recover and re-establish a balance. During this time, withdrawal symptoms onset, usually within a few hours, can persist for several days. Withdrawal from opioids can manifest at any time prolonged use is discontinued or significantly reduced.
These symptoms are very uncomfortable but are usually not life-threatening. Early symptoms of withdrawal include:
- Muscle aches
- Increased tearing
- Runny nose
Late symptoms of withdrawal may include stomach cramps, diarrhea, nausea, and vomiting.
Taking excessive amounts of an opioid or mixing it with other drugs or alcohol can lead to a life-threatening overdose. If you suspect you or another person is experiencing an overdose, please call 911 immediately. Symptoms may include the following:
- Confusion, delirium, or acting drunk
- Frequent vomiting
- Breathing issues, such as slowed, erratic, or labored breathing
- Excessive drowsiness or the inability to wake up
- Periodic loss of consciousness (aka nodding, or “on the nod”)
- Respiratory arrest
- Cold, clammy, or bluish skin around the lips or under the fingernails
Depressed breathing is the most severe effect of opioid overdose. A significant loss of oxygen to the brain can lead to permanent brain damage and include the failure of other organs, including the heart and kidneys.
Treatment for Opiate or Opioid Addiction
Addiction to opiates or opioids can be successfully managed as a chronic illness through long-term intensive treatment, including ongoing therapy, group and family support, lifestyle changes, and medication for some persons.
Just Believe Recovery offers these research-based services through programs facilitated by caring medical providers with compassion and expertise. We provide those we treat with the support and resources they direly need to achieve abstinence, prevent relapse, and maintain sobriety and wellness indefinitely.