Opioids vs Opiates: Demystifying the Differences

Demystifying opioids vs opiates: Know the differences, risks, and medical uses. Get informed now!

July 4, 2024

Understanding Opioids

In order to grasp the nuances of opioids and opiates, it is important to explore their distinctions and understand their usage.

Opioids vs. Opiates

The terms "opioids" and "opiates" are often used interchangeably, but they have subtle differences. Opiates are chemical compounds that are extracted or refined from natural plant matter, such as the sap and fibers of the poppy plant. On the other hand, opioids are typically not derived directly from natural plant matter, but are often synthesized or made in laboratories. While some opioid molecules, like hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), and oxycodone (e.g., Oxycontin, Percocet), may be partially synthesized from the chemical components of opium, other common opioid molecules are entirely designed and manufactured in labs.

Both opiates and opioids have medical uses, including pain relief, anesthesia, cough suppression, diarrhea suppression, and treatment of opiate/opioid use disorder. Additionally, both groups of drugs can be misused by individuals with substance use disorders [1]. The distinction lies in their origin and manufacturing process, highlighting the contrast between these two types of narcotic drugs.

Opioid Use in the US

Opioids are widely used in the United States for various medical purposes. These drugs belong to a class of substances that are either derived from or mimic the natural substances found in the opium poppy plant. They act on the brain to produce a range of effects, including pain relief [2].

Prescription opioids, when legally prescribed by a doctor and used as directed, can help relax the body and alleviate symptoms of illnesses, injuries, or surgical procedures. They play a vital role in managing pain for patients in need.

However, it is important to note that opioids also carry risks. These drugs, when taken at higher doses or misused, can restrict the ability to breathe and may lead to a fatal overdose. The risk of respiratory depression (slowing) or respiratory arrest (when breathing stops completely) is higher in individuals who misuse opioids.

To better understand opioids and their impact, it is crucial to explore the statistics and risks associated with opioid use, which will be covered in subsequent sections of this article.

Impact of Opioids

Opioids have had a profound impact on individuals and communities, leading to a range of consequences. It is crucial to understand the potential risks and side effects associated with their use to promote informed decision-making and develop effective strategies for harm reduction.

Opioid Overdose Statistics

The opioid epidemic has had devastating effects, with a significant number of overdose deaths linked to opioids. According to the Centers for Disease Control and Prevention (CDC), over 75% of the nearly 107,000 drug overdose deaths in 2021 involved an opioid. From 1999 to 2021, nearly 645,000 people died from an overdose involving any opioid, including prescription and illicit opioids [3].

It is important to note that many opioid-involved overdose deaths also involve other drugs, highlighting the complexity of substance misuse and the need for comprehensive approaches to address this public health crisis.

Risks and Side Effects

The use of opioids is associated with various risks and side effects. Some of the common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression [4].

In addition to these common side effects, opioids have been linked to a range of other potential risks and complications. These include delayed gastric emptying, hyperalgesia (increased sensitivity to pain), immunologic and hormonal dysfunction, muscle rigidity, and myoclonus (involuntary muscle jerks).

It is essential for individuals using opioids, whether prescribed or obtained illegally, to be aware of these risks and side effects. Open communication with healthcare professionals, adherence to prescribed dosages, and regular monitoring can help mitigate potential harm associated with opioid use.

Understanding the impact of opioids and the associated risks is crucial in addressing the opioid epidemic and promoting safer practices for pain management and treatment applications. By raising awareness about opioid overdose statistics and the potential risks and side effects, we can work towards preventing opioid-related harm and improving the well-being of individuals and communities affected by opioid use.

Types of Opioids

Opioids are a class of drugs that include both prescription opioids and illegal opioids. These substances have potent analgesic properties, making them effective for managing pain. However, their misuse and addictive nature pose significant risks to individuals who use them.

Prescription Opioids

Prescription opioids are synthetic or partly synthetic drugs that are chemically similar to natural opiates derived from the opium poppy plant. They may be produced directly from the plant or synthesized in laboratories. These medications are commonly prescribed by healthcare professionals to relieve pain, suppress cough, and treat diarrhea.

Prescription opioids work by binding to and activating opioid receptors in the brain, spinal cord, and other parts of the body. This interaction blocks pain signals and releases large amounts of dopamine, which contributes to a sense of relaxation and euphoria. However, these effects also increase the risk of misuse and addiction, as highlighted by the National Institute on Drug Abuse.

Some commonly prescribed prescription opioids include:

Common Brand Names for Prescription Opioids

  • Oxycodone: OxyContin, Percocet
  • Hydrocodone: Vicodin, Norco
  • Morphine: MS Contin, Kadian
  • Codeine: Tylenol with Codeine
  • Fentanyl: Duragesic, Actiq

Misuse of prescription opioids can take various forms, including swallowing the medication, crushing pills to inject the powder, opening capsules to dissolve the contents for injection, or snorting the powder. These methods of misuse can lead to addiction and serious health consequences, including overdoses that can result in slowed or stopped breathing, coma, brain damage, or death [5].

Illegal Opioids

Illegal opioids are substances that are obtained and used without a prescription. Heroin, a highly addictive opioid derived from morphine, is one of the most dangerous illegal opioids. It is typically sold as a white or brownish powder or as a black sticky substance known as black tar heroin.

Illegal opioids carry a high risk of addiction and are associated with numerous health and societal consequences. Research indicates that a significant percentage of individuals who misuse prescription opioids transition to heroin use. In fact, about 80% of people who first used heroin had previously misused prescription opioids.

Other illegal opioids include illicitly manufactured fentanyl and its analogs, which are extremely potent and can be mixed with heroin or pressed into counterfeit prescription pills. These synthetic opioids have contributed to a significant increase in overdose deaths in recent years.

It is important to note that the use of illegal opioids is associated with a higher risk of exposure to dangerous substances, inconsistent potency, and uncertain purity. These factors increase the risks of overdose and other adverse effects.

Both prescription opioids and illegal opioids pose significant risks when misused. It is crucial to use them only as prescribed by a healthcare professional and to seek help if you or someone you know is struggling with opioid misuse or addiction. Substance use disorder and addiction can be effectively treated with a combination of medications and behavioral therapies.

Addiction and Dependency

Understanding the complexities of addiction and dependency is crucial when discussing opioids. Opioid addiction and tolerance are significant aspects that play a role in the impact of these substances on individuals.

Opioid Addiction

Opioid addiction is a chronic brain disorder characterized by compulsive drug-seeking and use, despite harmful consequences. Chronic abuse of opioids, such as heroin or prescription painkillers, can lead to brain abnormalities that contribute to addiction. The brain's reward system is stimulated when opioids attach to mu opioid receptors on opiate-sensitive neurons, triggering the release of dopamine and causing feelings of pleasure. Over time, the brain creates memories associating these pleasurable feelings with the circumstances and environment, leading to cravings and driving individuals to seek out more drugs.

It's important to note that opioid addiction is distinct from dependence and tolerance. While dependence and tolerance are related to physiological changes in the body, addiction involves more complex and long-lasting brain abnormalities, which can produce cravings that lead to relapse even after an individual is no longer physically dependent on opioids [6].

Tolerance and Dependence

Tolerance and dependence are additional aspects related to opioid use. Opioid tolerance occurs when the brain cells with opioid receptors become less responsive to the opioid stimulation. As a result, higher doses of opioids are required to achieve the same effect. This phenomenon can contribute to the risk of overdose, as individuals may increase their opioid intake to compensate for the reduced sensitivity of the brain cells.

Opioid dependence, on the other hand, involves changes in the locus ceruleus area of the brain. Neurons in this region adjust by increasing their activity level to offset the suppressive impact of opioids. When opioids are not present, these neurons release excessive amounts of noradrenaline, which can trigger withdrawal symptoms. The symptoms of opioid withdrawal may include restlessness, muscle and bone pain, insomnia, diarrhea, and more [6].

It's important to seek professional help when experiencing opioid addiction, tolerance, or dependence. Medical interventions, counseling, and support systems can be beneficial in managing these conditions.

Understanding the complexities of addiction and dependence associated with opioid use is crucial in addressing the challenges faced by individuals and developing effective strategies for prevention, treatment, and support.

Medical Uses of Opioids

Opioids have been utilized for medical purposes to manage pain and provide treatment in various healthcare settings. Understanding the medical applications of opioids is crucial in recognizing their role in patient care.

Pain Management

One of the primary medical uses of opioids is in the management of pain. Prescription opioids are commonly prescribed to individuals experiencing moderate to severe pain [5]. They work by binding to opioid receptors in the brain, spinal cord, and other parts of the body, reducing the perception of pain.

Opioids can be administered in different forms, including oral tablets, patches applied to the skin, sublingual tablets, or even through injections. When used as directed under medical supervision, opioids can provide effective pain relief, helping patients manage pain associated with illnesses, injuries, or surgical procedures.

It's important to note that opioids should be used judiciously and in accordance with prescribed guidelines to minimize the risk of misuse and dependence. Regular communication with healthcare professionals is essential to ensure the safe and effective use of opioids for pain management.

Treatment Applications

Apart from pain management, opioids also have treatment applications for specific medical conditions. In certain cases, prescription opioids can be used to address coughing and diarrhea. They work by suppressing cough reflexes and reducing gastrointestinal motility, respectively.

In the treatment of opioid use disorder, medications such as methadone, buprenorphine, and naltrexone may be prescribed. These medications help reduce cravings and withdrawal symptoms, facilitating the process of recovery and reducing the risk of relapse.

It is important to highlight that opioids, even when used for treatment purposes, carry risks. They can lead to tolerance and dependence, affecting an individual's ability to breathe properly. Misuse of opioids, including using them without a prescription or in higher doses than prescribed, can result in a fatal overdose. Therefore, it is crucial to follow medical guidance and engage in open communication with healthcare professionals when using opioids for treatment purposes.

Understanding the medical uses of opioids is essential for both healthcare providers and patients. By utilizing opioids appropriately, healthcare professionals can effectively manage pain and provide necessary treatments while minimizing the potential risks associated with these medications.

Opioids vs. Opiates

To understand the differences between opioids and opiates, it's essential to examine their chemical composition and the implications of misuse and addiction.

Chemical Composition

Opiates, such as opium, heroin, morphine, and codeine, are derived from the naturally occurring poppy plant (Papaver somniferum) Cleveland Clinic. These drugs are chemical compounds extracted or refined from plant matter like poppy sap and fibers Oregon.gov.

On the other hand, opioids are a broader class of drugs that include opiates but are not limited to them. While some opioid molecules, like hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), and oxycodone (e.g., Oxycontin, Percocet), may be partially synthesized from opium's chemical components, other common opioid molecules are entirely designed and manufactured in laboratories. Opioids can be derived from natural substances found in the opium poppy plant, be synthetic, or be semi-synthetic.

Misuse and Addiction

Both opioids and opiates have the potential for misuse and addiction. When these drugs are used improperly or in higher doses than prescribed, they can lead to dependence, tolerance, and addiction.

The misuse of opioids and opiates can have severe consequences on an individual's health and well-being. Over time, continued misuse can result in an increased tolerance to the drugs, meaning higher doses are needed to achieve the same effects. This can escalate the risk of addiction, as individuals may seek out higher doses or engage in dangerous behaviors to obtain the drugs.

Addiction to opioids and opiates can have devastating effects on individuals and their communities. It is important to note that addiction can occur regardless of whether the substance is naturally derived (opiate) or synthesized (opioid).

Understanding the differences between opioids and opiates helps shed light on the complexity of these drugs and their potential impact on individuals. It is crucial to prioritize proper medical use and be aware of the risks associated with misuse to ensure the safe and responsible use of these substances.


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