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Opioids and Opiates: Understanding the Key Differences

Opioids and Opiates: Understanding the Key Differences


We hear the term all the time- “opioid epidemic”- but people often get the keyword “opioid” confused with “opiate”, and honestly it is a completely understandable mistake. The two seem pretty much interchangeable in a lot of situations. However, there are a few differences that it helps to be aware of.

So what are opioids and opiates?


Opiates is a term classically found in pharmacology, referring to a drug derived from the opium.

So what is opium? This is the dried latex substance makers obtain from the opium poppy. Opium contains some very potent chemical compounds, including:

These are all opiates. They are psychoactive compounds naturally found in the plants. These substances bind to the opioid receptors in the brain, creating feelings of euphoria.

There are dozens of other alkaloids present in opium that have little to no effect on the central nervous system. Those compounds are not considered opiates.


Other compounds work by binding to the same opioid receptors as opiates, but they do not occur naturally. These are considered either semi-synthetic or synthetic opioids.

  • Synthetic opioids are manufactured chemically
  • Semi-synthetic opioids are the results of chemical modifications to natural opiates

Examples of synthetic opioids include:

Semi-synthetic opioids include:

Opioid and opiate medications are primarily used medically for pain relief, including anesthesia.

Opioids and Opiates

These days most people use the term opioids, regardless of if the substance is natural, synthetic or semi-synthetic. If the substance acts on one of the three main opioid receptor systems (mu, kappa, delta), most people simply call it an opioid.

Certain drugs like heroin can blur the line between opioids and opiates a little because the term opiate does sometimes include semi-synthetic derivatives like heroin. Heroin, the most commonly abused opioid drug, is a semi-synthetic derived from morphine.

However, typically opiates are from nature, while opioids are manmade.

It might seem confusing, but it can be helpful to understand the relationship between these two terms. Both opiates and opioids have a high risk for addiction and may result in fatal overdose. Most of these substances are controlled substances, and compounds like heroin and fentanyl are some of the most dangerous drugs in the world.

They both have a number of adverse side effects, and they both can cause a list of withdrawal symptoms once someone has developed a dependence on them.


Technically, we typically categorize opioid medications as narcotics.  However, you may hear the word “narcotic” itself now has some stigma commonly associated with illegal drugs. To be exact, an agent that produces insensibility or narcosis is what we consider to be a narcotic. So prescription opioids like hydrocodone or oxycodone are narcotics. Additionally, heroin is also considered a narcotic. Does this mean hydrocodone is the same as heroin? Not necessarily. But they definitely grew up in the same neighborhood.

Furthermore, when thinking about all these terms in a more general sense, you can think of opiates as being a subclass of opioids, and opioids as a subclass of narcotics.

At the end of the day, it seems like an argument of semantics. Still, it is useful to know what the differences between opioids and opiates are.

Narcotic opioid medications can do a lot of good for people who need them. Pain management can utilize opiate-derived substances in order to treat people. Morphine has been used in hospitals for generations. Nevertheless, whether a medication is a prescription narcotic opioid or not, it’s important to speak with your healthcare provider before taking any drug. Likewise, any kind of opioid abuse, be it opioid medications or illicit drugs like heroin, the risks of addiction, overdose and death are all very real.

Withdrawal Symptoms for Opioids and Opiates

One more thing opioids and opiates have in common is the list of withdrawal symptoms people often experience after developing a dependence. Some of the most common symptoms seen with opioids and opiates include:

  • Cravings
  • Nausea
  • Sweating
  • Vomiting
  • Diarrhea
  • Insomnia
  • Raised blood pressure
  • Stomach cramping
  • Chills or goose-bumps
  • Irritation or agitation
  • Anxiety
  • Muscle aches
  • Shakes or trembling
  • Dilated pupils
  • Bone pain

When people become addicted to opioids and opiates, it can be extremely difficult to get off of the drugs. The discomfort and pain of withdrawal symptoms are frequently a reason people never end of getting the help they need. Too many people are afraid to experience the withdrawal process, and this can keep them sick longer.

This is why medical opioid detox is such a critical element of addiction treatment. As the first step in treatment, medical assistance can be essential to helping someone through the withdrawal period so they have a better opportunity to safely stop using opioids and opiates. This is also an element of relapse prevention since a lot of people end up relapsing because they can’t get through the withdrawals on their own.

Opioids and opiates should not be taken lightly. It is important that anyone who has experienced issues with prescription painkillers, illegal street drugs or deadly synthetics has access to information and support.

Overall, it is important that we do not underestimate the impact of opioids and opiates across the board. Whether a drug is a natural opiate or a synthetic opioid, it has the same lethal potential. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-777-9588. 


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