Opioid vs. Opiate: How Are They Different?

Opioids and opiates are exceedingly addictive substances that can all too easily lead to Opioid Use Disorder (OUD), a chronic though treatable medical condition that affects an estimated 2.7 million people—and that’s just in the United States alone.¹

While opioids and opiates have similar effects on the brain and body and are often used in conversations interchangeably, there are important distinctions between the two. 

Whether you or someone close to you has made the crucial, life-changing decision to address your use of opioids or opiates, knowing how they compare may help inform your (or your loved one’s) course of treatment.

Read on as we unpack the opioid vs. opiate question and explain how, and when to seek opioid treatment.

What’s an Opiate?

Opiates are a class of narcotics that are derived from the opium, or poppy, plant²—a flowering shrub native to Turkey that was used for medicinal and cultural purposes for centuries.³ 

The naturally occurring alkaloids within this plant operate as depressants on the central nervous system (CNS) and stimulate the body’s opioid receptors, which have a tremendous influence on sensations of pain and euphoria.⁴ Research shows that the effects of opiates mimic endorphins, which you may know as the hormones that are organically produced through activities such as exercise.

Types of Opiates

Princeton University reports that more than 50 alkaloids have been identified in the poppy plant.⁵Of those, 25 have pain-relieving effects on the human body. Some of the most well-known types of opiates include:

• Codeine
• Oripavine
• Thebaine
• Morphine

Most Addictive Opiates

Due to the soothing, euphoria-inducing, and pain-relieving properties of opiates, all of them may lead to an addiction.

That said, the most addictive opiates are generally thought to be:

• Morphine – Like other opiates, morphine is characterized by the effects it has on the central nervous system. As one of the five major alkaloids produced by the opium plant, it impacts dopamine—a key neurotransmitter that plays a part in eliciting feelings of pleasure.⁶ Morphine belongs to a cluster of drugs deemed narcotic analgesics, and it’s primarily prescribed for the treatment of severe chronic (or enduring) and acute (or temporary) pain.⁷

• Codeine – Codeine may call to mind trips to the dentist because its chief purpose, when prescribed, is to help patients manage moderate to intense pain (although it’s also used to treat severe coughing, restless leg syndrome, and diarrhea).⁸ It, too, is one of the chief alkaloids in the opium plant and can be extremely habit-forming, which may lead to psychological and physical dependence. 

• Opium – Opium creates opiates such as morphine and codeine, but it also exists in a class of its own. Derived from the opium plant’s milky substance (or latex), it promotes feelings of mental relaxation and elation while also muffling pain.⁹ Once used widely in patent (and legal) medications, it fell out of favor in the 20th century as more potent pain-relieving drugs were introduced (legally and illegally) to the market.

The danger of opiates is this: An overdose of opiates (or opioids) can suppress breathing and heart rate and may ultimately result in death. That’s why when discussing opioid vs. opiates, it’s important to recognize that both are equally dangerous.

What’s an Opioid?

The term “opioids” is essentially an umbrella term for drugs that, like opiates, activate opioid receptors, mitigate pain, and stimulate feelings of euphoria.¹⁰ However, opioids are either partially or completely synthetic—meaning, they’re made in a laboratory. So when considering opioid vs opiate, think synthetically derived vs naturally derived.

Types of Opioids

Opioids run the gamut from hazardous, extremely addictive street and designer drugs to prescription pain medications. 

Although fully synthetic and semi-synthetic opioids are crafted to resemble the naturally-derived structures of opiate alkaloids, they often contain dangerously elevated potencies. Fentanyl, for example, is 50 times stronger than heroin and an astonishing 100 times more powerful than morphine.¹¹ To emphasize just how addictive and dangerous fentanyl and other opioids can be, remember that 150 people die per day in the United States from an opioid overdose.

In addition to fentanyl, the most common types of opioids include:

• Heroin
• Demerol
• Oxycodone (Oxycontin) 
• Percocet
• Oxymorphone
• Hydromorphone
• Hydrocodone

Most Addictive Opioids

The inherent addictive nature of opioids leaves a user at risk of developing a tolerance and dependence on them. That said, in safe, controlled settings and when used exactly as prescribed, opioids can also be a tremendously valuable form of pain management—for instance with advanced stages of cancer, or after a traumatic car accident.¹²

But this is where it gets a bit blurry, tricky, and, unfortunately, political.

In 2017, doctors across the country submitted more than 191 million opioid prescriptions, with notable fluctuations between the states. Folks in Alabama were prescribed the most opioids. Residents of Hawaii—the most expensive state in the country—had the fewest prescriptions.¹³ At the same time, 75% of US residents with OUD assert that their addiction began with prescription opioids.¹⁴

Simply put, opioid prescriptions and opioid addictions are more prevalent in poorer, more rural regions. 

The CDC reports that all opioids are addictive—and that anyone can be addicted to them, despite their age, gender, income levels, and the state in which they reside. The most addictive opioids, both legal and illegal, include:

• Methadone
• Vicodin
• Oxycontin
• Heroin
• Fentanyl

So while the differences between opioid vs. opiate are encoded in their formation, their risks and dangers are equivalent.

What’s the Difference Between Opioid vs Opiate?

Still confused on the opiate vs opioid question? That’s understandable—there are huge overlaps between the two. The simplest way to recognize and remember the distinction between them is this:

• Opiates are derived from the opium plant
• Opioids can be natural, but are generally synthetic, man-made narcotics

The most important thing to remember is that misusing one or the other or both can lead to grave and potentially lethal consequences, particularly if these narcotics are paired with other drugs or alcohol.

How Are Opioids and Opiates Similar?

Opioids and opiates are similar in the ways described above: They both affect the central nervous system and opioid receptors. In turn, they diminish chronic pain and prompt feelings of relaxation and euphoria. 

It’s precisely these dramatic effects that spur an addiction. To phrase it differently, whether it’s an opiate vs opioid, they both affect the reward system of the brain. The brain then becomes reliant on these drugs to feel well and to prevent withdrawals from occurring. 

The most common signs of opioid addiction include:¹⁵

• A growing inability to control use
• Intense cravings 
• Increasing tolerance and dependence, both physically and mentally
• Continual use of the drug despite the presence of financial, interpersonal, professional, and health consequences
• The presence of withdrawal symptoms when consumption ceases or is substantially cut back, such as anxiety, abdominal pain, insomnia, bone and muscle aches, irritability, runny nose, fever, nausea, and vomiting¹⁶

Fortunately, help for addiction is amply available—more on this below.

Risk Factors

Some people may be at a greater risk for addiction than others. These may include individuals who have:

• Accessibility to opiates and opioids (e.g., through a doctor who continues to fill their prescription)
• A preexisting or past substance abuse disorder, such as alcoholism
• Exposure to opioids and opiates, like a family member who uses one or both of them
• An untreated co-occurring mental health condition like depression, anxiety, bipolar disorder, or post-traumatic stress disorder (PTSD)
• A history of childhood sexual abuse or legal issues¹⁷
• Age, with those who are younger having a higher susceptibility to addiction
• An environment in which opiate and opioid use has been normalized
• Miscommunications between a healthcare practitioner and the patient

Thankfully, holistic rehab centers, such as Elevate Addiction Services, treat not just opioid use disorder but also the underlying causes that may have contributed to the addiction. 

How to Get Help

Whether it’s your partner, close friend, sibling, parent, or other loved one you’re concerned about or you recognize the signs of addiction in yourself, please know that help is just a phone call away. Inpatient and outpatient treatment centers can help you or the person you care about combat this addiction through a blend of:

• Pharmacological assistance, such as the use of suboxone or methadone
• Behavioral therapy
• Group and individual counseling
• Education on coping strategies and lifestyle changes to overcome cravings and prevent a relapse
• The treatment of any underlying psychological or physical conditions

The earlier you reach out, the sooner you can return to yourself.

Discover Lasting Relief from OUD with Elevated Rehab

For many, opioids and opiates may seem synonymous, but the former is fully or semi-manufactured, while the latter is extracted naturally. But don’t let the word “naturally” deceive you: Both can be damaging to your health and well-being. There is, in the end, no opiate vs opioid debate at all, just a need to pursue recovery if abuse, misuse, or addiction has ensued.

Elevate Rehab’s world-class opioid treatment programs can help you restore your sense of self and start your opioid detox. With locations in beautiful Santa Barbara and the ever-glorious Lake Tahoe, we provide compassionate care and expertise to help you find—and sustain—sobriety through a combination of traditional and alternative therapies, including yoga, meditation, and body rejuvenation therapy.

Reach out to us today. We would be glad to help—and delighted to see you reclaim your wellness.

Sources: 

1. CDC. Opioid use disorder.euph https://www.cdc.gov/dotw/opioid-use-disorder/index.html
2. MedlinePlus Medical Encyclopedia. Opiate and opioid withdrawal.  https://medlineplus.gov/ency/article/000949.htm
3. Britannica. Poppy / Description, major species, uses & facts. https://www.britannica.com/plant/poppy
4. CDC. The opioid epidemic: what labs have to do with it? https://www.cdc.gov/cliac/docs/fall-2018/10_King_Opioid_Crisis.pdf
5. Opiate.com. A list of opiates. https://www.opiate.com/opiates/a-list-of-opiates/
6. ResearchGate. Opium alkaloids. https://www.researchgate.net/publication/339805388_Opium_Alkaloids
7. Mayo Clinic. Morphine (oral route) description and brand names. https://www.mayoclinic.org/drugs-supplements/morphine-oral-route/description/drg-20074216
8. National Library of Medicine. Codeine. https://www.ncbi.nlm.nih.gov/books/NBK526029/
9. Alcohol and Drug Foundation. Opium. https://adf.org.au/drug-facts/opium/
10. Journal of Pain & Palliative Care Pharmacology. Adverse effects of opioids on the central nervous system of palliative care patients.  https://pubmed.ncbi.nlm.nih.gov/17430825/
11. CDC. Fentanyl facts. https://www.cdc.gov/stopoverdose/fentanyl/index.html
12. CDC. Prescription opioids. https://www.cdc.gov/opioids/basics/prescribed.html
13. CNBC. These are America’s 10 most expensive states to live in. https://www.cnbc.com/2021/07/15/these-are-americas-most-expensive-states-to-live-in.html
14. John Hopkins Medicine. Opioids. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/opioids
15. Yale Medicine. Opioid use disorder–fact sheet. https://www.yalemedicine.org/conditions/opioid-use-disorder
16. National Library of Medicine. Opioid withdrawal. https://www.ncbi.nlm.nih.gov/books/NBK526012/
17. Anesthesia & Analgesia. Risk factors for opioid-use disorder and overdose. https://journals.lww.com/anesthesia-analgesia/Fulltext/2017/11000/Risk_Factors_for_Opioid_Use_Disorder_and_Overdose.41.aspx