The terms opioid and opiate may be used interchangeably, depending on the environment and situation. However, opiates and opioids aren’t exactly the same. Opiates are natural substances derived from the opium poppy. Opioids include the entire class of substances, whether they are natural or manmade.
What Is the Difference Between Opiates & Opioids?
The major difference between opioids and opiates is how they are created. Opiates are created from actual plant material extracted from the opium poppy plant.1,2Opioids tend to refer to chemical compounds that are created or modified in a laboratory. Semi-synthetic opioids are made in a lab, but they start with natural products that originate in the poppy plant. Fully artificial opioids are 100% made in a lab from synthetic ingredients.1,2
All opiates are classified as opioids, but not all opioids are classified as opiates. In recent years, “opioid” has become the umbrella term used to describe all substances that share the ability to produce pain relief by interacting with opioid receptors in the brain and throughout the body. The use of opioids also applies when discussing addiction to these substances. 3
An example may be valuable here. All squares are rectangles because they have four sides and four right angles. Not all rectangles are squares, though, because not all rectangles have equal sides. Using this example, opiates are the squares because they have the additional quality that sets them apart. Opioids are rectangles because they describe the items more generally.
By interacting with chemical messengers throughout the body, opiates and opioids are both powerfully helpful and dangerous. Regardless of their naming, these substances all have the power to create tolerance and dependency leading to addiction.
Examples of opiates include:2,4
- Codeine: A legal pain reliever used in numerous settings including dentistry.
- Heroin: An illegal, dangerous, and highly addictive substance that may be injected or snorted
- Morphine: A prescription painkiller used in a variety of medical settings
- Opium: A controlled substance in the U.S. that may be smoked, injected, or used orally
Since opiates are created from natural plant substances, they are limited in potency and variety. On the other hand, semi-synthetic opioids are numerous and vary greatly.
Examples of semi-synthetic opioids include:1,2
- Oxycodone (Percocet, Roxicet, Oxycontin, Roxicodone): These are legal and widely prescribed for pain. They are marketed and sold under numerous names and sometimes mixed with other pain relievers.
- Hydrocodone (Zohydro, Lorcet, Vicodin): Like oxycodone, these are legal and widely prescribed for pain, either alone or combined with other substances.
- Hydromorphone (Dilaudid, Exalgo): These are legal prescription opioid pain relievers used across settings.
- Oxymorphone (Opana): This prescription pain reliever is used when other opioids are not helpful enough.
Finally, there are fully synthetic opioids. This group contains some of the most potent examples. They also are unique in their ability to produce different effects on the person using them.
Examples of man-made synthetic opioids include: 1,2,3,4
- Buprenorphine (Suboxone, Subutex): This is an opioid medication used in the treatment of opioid use disorder (OUD) as part of medication-assisted treatment (MAT) and medications for opioid use disorder (MOUD).
- Dextromethorphan (NyQuil, Robitussin, TheraFlu, Vicks): This substance is legal and available in the U.S. as an over-the-counter medication.
- Dextropropoxyphene (Darvocet, Darvon): This is a legal prescription pain killer.
- Loperamide (Imodium): This over-the-counter medication is used to treat diarrhea.
- Meperidine (Demerol): This pain reliever is prescribed as a liquid or oral medication.
- Methadone (Dolophine, Methadose): Like buprenorphine, this opioid medication is used in the treatment of opioid use disorder (OUD) as part of medication-assisted treatment (MAT) and medications for opioid use disorder (MOUD).
- Fentanyl/fentanil (Ultiva, Sublimaze, Duragesic, Actiq): This is an extremely powerful opioid available in various legal and illicitly produced forms.
- Carfentanyl/carfentanil (Wildnil): This intensely powerful opioid is usually restricted for sedating large animals for veterinary use.
- Tramadol (Ultram): This prescription opioid was thought to have a lower potential for addiction but is now known to be habit-forming as well.
Synthetic opioids are frequently produced illegally and sold as drugs of abuse. At times, the substances are secretly mixed into other products to enhance or modify their effects.
Common Side Effects of Opiates & Opioids
Whether someone consumes opium, heroin, fentanyl, or oxycodone, the general effects of consuming opiates and opioids are similar. However, there are important differences that impact how these effects are expressed. Doctors, researchers, and other experts prescribe and treat based on the differences between opiates and other opioids. The method these substances enter the body also affects how much is absorbed and how quickly they act.
The main effects of opiates and opioids are compelling and appealing. Someone may desire to use and misuse these drugs due to the pleasant effects like: 4,5
- Relaxation
- Sense of happiness and well-being
- Pain relief
- Euphoria
Common side effects between all types of opioids, including opiates, include:4,5
- Drowsiness: People are typically tired, sleepy, and lacking in energy.
- Confusion. Someone could have poor attention, poor memory, and an increase in confusion.
- Nausea: Upset stomach and vomiting could occur after opioid use.
- Constipation: Those using opioids, especially regular users, could experience constipation.
- Slowed breathing: Opioids can slow the rate a person breathes.
All of the opioid side effects are troubling, but the slowed breathing rates are especially concerning. When slowed breathing results in not enough oxygen getting to the brain, the person could experience short- and long-term consequences like: 5
- Coma
- Brain damage
- Death
Overdose is a major concern linked to opioid use. When someone consumes more opioids than their body can manage, their breathing will stop.
It’s important to note that, although opioids and opiates create the same effects, the intensity, speed, and duration of effects will differ. Someone using a fentanyl patch, for example, will get a steady supply of the drug over a longer period of time. Someone injecting heroin, by contrast, will experience a powerful rush that quickly fades.
Who Is More Likely to Abuse Opiates or Opioids?
It is not always possible to know who may develop an opioid addiction. However, abuse and addiction are associated with a variety of risk factors, such as biology, environment, and personal development. 6 These factors can create what is sometimes referred to as an addictive personality. While some addiction results from recreational use with the intent to get high, it can also begin with legally prescribed medications used to treat pain. Stopping prescription pain medications can be challenging, sometimes leading to withdrawal symptoms and increasing the risk of addiction.
Biological factors include sex, ethnicity, and the occurrence of mental and physical conditions. A person’s genetic makeup is a major biological factor, controlling about half of their overall likelihood of developing a heroin addiction or addiction to another opioid.
A person’s environment includes their life experiences. Traumatic events, like physical, sexual, and emotional abuse or neglect can increase the odds of someone becoming addicted to substances. Early drug use can have a strong impact on brain development and maturation. When a person uses drugs at an earlier age, they are more likely to become addicted.
At times, the specific drug and how it is used lead to a higher risk of addiction. A drug that provides a quick, strong, and pleasant effect will be more addictive than one with a slow, weak, and uncomfortable outcome.
How to Treat an Opiate or Opioid Addiction
Treating opioid addiction, opioid dependence, or an opioid use disorder is a serious situation that requires a concerted effort from medical and mental health treatment professionals. Attempting to treat your substance use disorder yourself could result in poorer outcomes, increased risk of relapse, and higher levels of discomfort.7
Anyone who has been taking an opioid with any consistency may benefit from specialized opioid treatment. Even those who have only used their medication as directed by their prescriber may find it challenging to stop using the medication.
When a person’s body adjusts to the presence of a substance, it adjusts and begins to require it to feel well and function normally. If use ends or greatly decreases suddenly, opioid withdrawal symptoms can appear.
Opioid withdrawal symptoms include:5
- Pain in the muscles and bones
- Problems sleeping
- Nausea, diarrhea, and vomiting
- Cold flashes with goosebumps
- Uncontrollable muscle spasms
- Severe cravings for more of the drug
Left untreated, these symptoms can be quite uncomfortable, often leading to a return to regular substance use to stop the symptoms.
If someone is struggling with an opioid or opiate addiction, helpful treatments include:7
- Detoxification: Medically-assisted detox is a crucial step of the recovery process, but it is only the first step. Detox involves the use of medical supervision and medications to increase comfort and reduce the impact of withdrawal symptoms. Detox can occur at a range of locations from an inpatient hospital setting to an outpatient setting.
- Inpatient and Outpatient Treatment: All professional treatments occur in either an inpatient or outpatient setting. Inpatient includes all locations that require the person to live and sleep at the facility. Outpatient allows people to sleep at home and continue working and maintaining other responsibilities.
- Medication: No matter the setting, the use of medications will be explored. Medications can help with the detox process, or they can help address symptoms of other physical or mental health issues that contribute to opioid use.
When a person is in professional mental health treatment, they will receive one or several types of therapy. Some options include:7
- Individual psychotherapy: Therapists provide one-on-one psychotherapy sessions in a private setting.
- Family counseling: Family counseling sessions include the client, the therapist, and one or more family members. Family members can include close friends or romantic partners as well.
- Group therapy – Group therapy sessions occur in a group setting with people who may not know each other outside of therapy. Group therapy usually brings together people with similar struggles or symptoms.
Support groups are another helpful facet of the recovery process. Online support groups do not involve professionals Instead, they focus on offering and receiving fellowship and support in a group setting.
Finding an online therapist can seem overwhelming, but the process does not have to be complicated. Consider using a therapist directory to locate professionals who are able to help you achieve your goals.
Final Thoughts
Opioids and opiates are commonly used drugs that influence millions of people. Remember that the main difference is that opiates stem from natural sources, while opioids is a broader term that includes opiates as well as semi-synthetic and fully synthetic substances. Opiates and opioids carry some risk of addiction and dependence, so caution and consistency are always needed.
