Opiates vs Opioids

What is the Difference?

Opiates vs Opioids

What is the Difference?

Table of Contents

Introduction

The classic poppy flower is a thing of beauty. However, it is also the source of what we know as opiates. The waxy, ridged, and textured petals and dark centers typically come in vivid colors. Opium poppies (Papaver somniferum) bloom best in temperate climates; their blooms are instantly recognizable.

The poppy plant is no ordinary bloom, they contain the basics for the creation of opiates. The resulting opium effects, because they’re both so medicinal and so destructive, are still something our society contends with today.

What are Opiates?

The molecules necessary to make opiates are within the poppy plant. Opium, morphine, and codeine are made directly from poppy plants and are considered opiates. All opiates are called narcotics and have a strong effect on the central nervous system, causing feelings of pleasure and pain reduction.

A shortlist of some of the most well-known opiates:

  • Heroin
  • Morphine
  • Opium
  • Codeine

Opioids, on the other hand, contain active ingredients that mimic opiates but are created — at least partially — in a synthetic manner. When it comes to opiates vs opioids, the effects of opioids on the body mirrors opiates in much the same way.

Some common partially synthetic opioids are:

  • Hydrocodone
  • Oxycodone
  • Oxymorphone

Some opioids are entirely synthetic. They’re produced artificially but have the same effects as natural opiates, and are sometimes much more potent. Some of these fully synthetic opioids are:

  • Fentanyl
  • Meperidine
  • Methadone

Opiates vs Opioids

The classification of opioid is often used as an umbrella term to encompass all types of drugs that are either naturally derived from the poppy plant or copy the effects of opiates. Any list of opiates, whether partially or fully synthetic, are opioids and all are considered narcotics.1

A Brief History of Opiates vs Opioids

They say history repeats itself, and the story of opiates underscores this point. The desire to keep the benefits of opiates without their addictive properties has resulted in society’s repeated underestimation of the opiate’s addictive nature, regardless of its synthetic properties or not.

Throughout history, opium from the poppy plant has served as both a lifesaver and a killer. The poppy plant was used 6,000 years ago by ancient Sumerians and Egyptians as a potent pain reliever. Opium, however, is powerfully addictive.

Opium in the 1800s

In the 1800s, the addictive properties of opium resulted in the growth of opium dens throughout Asia, Europe, and even in the U.S. Opium effects were difficult to recover from or overcome, resulting in addiction and even deaths from overdoses.

The Discovery of Morphine

The 1800s also saw the discovery of morphine, which was hailed as a less addictive and medically useful form of opium. Lauded as a medical miracle, morphine found its way into hospitals and battlefields. Unfortunately, morphine turned out to be as addictive and life-threatening as opium. Like opium, a morphine overdose can lead to death.

The Emergence of Heroin

In the late 1800s, heroin was discovered and — like morphine — was considered to be another medical miracle with all the benefits of morphine and none of its addictive properties. Heroin was used for the treatment of tuberculosis and pneumonia by suppressing coughing and relieving pains. Just like morphine, however, heroin was found to be highly addictive and a heroin overdose remains lethal.

Modern Opiate Use

Despite heroin’s role in medicine, it was found to be so addictive that it’s now illegal in the U.S. Under the Controlled Substances Act, heroin is a Schedule 1 substance, meaning it has a very high potential for abuse and does not have any legitimate use in the U.S.

In an effort to relieve pain without addiction, Oxycontin was released in the 2000s. This was during a time when the reduction of patient pain was a national patient goal in the medical community. Described as a “safe” medication for chronic pain due to its 12 hour “time-release” design, it was prescribed for everything from back pain, to headaches, to cancer. Oxycontin’s popularity in patient treatment grew. At the same time, people found a way to get around Oxycontin’s time-release protections — crushing or dissolving the drug for its abuse.

Like morphine and heroin before it, Oxycontin –and other opioids– tragically resulted in addiction and deaths. In 2017, opioid abuse ravaged the U.S., resulting in 70,237 opiate-related deaths.2

What Opiates Do to the Body?

Opiates attach to receptors in the central nervous system (brain, spinal cord, and nerves). By attaching to these specific receptors, the opiates relieve pain and create enjoyable feelings. Their use as a painkiller is accepted in the medical community. However, they also have serious and dangerous side effects.3

These drugs slow down digestion and breathing, with higher doses causing slower breathing. Psychological and physical addiction can occur, leading to abuse and higher doses. When addiction occurs, the likelihood that higher doses are used increases — making it more probable that breathing will slow or stop.

Heroin and Opium

Heroin and opium are illegal in the U.S. due to its lethal potential. Pure heroin is a bitter, white, or brown powder with no quality control (or as sticky “black tar”), so it’s impossible to tell what the strength or contents of the drug are. This uncertainty, combined with the respiratory issues that come with all opioids, is what leads to deaths from a heroin overdose. For example, some opiates contain powerful opioids like fentanyl, leading to deaths for the unsuspecting.

Heroin and opium penetrate the brain much quicker than other opiates. If injected intravenously, heroin causes effects in seconds (7-8). When injected into the muscle, heroin takes effect in 5-8 minutes. If smoked or sniffed, effects are felt in 10-15 minutes. However, even after the “high” of the drug is gone, the drug may still be in the system — but there may be a desire for more. Other opiates also cause an addictive feeling of euphoria, like codeine and morphine, leading to codeine and morphine overdose.

Opiate Withdrawal

Opiate withdrawal is a difficult process, and the duration of the withdrawal process depends on a variety of factors. Heroin, in particular, can include extremely intense cravings and withdrawal symptoms.

Morphine and codeine withdrawals, because they are also opiates, are very much like the withdrawals from heroin. Every person’s withdrawal experience is unique.
How long the withdrawal lasts depends on:

  • How long the person has been using opiates like heroin, morphine, or codeine
  • How the drug was abused (intravenously, inhalation,etc.)
  • The amount typically abused
  • A person’s own body chemistry and health

Withdrawal Symptoms

Opiates typically have the same kinds of withdrawal symptoms, though how the symptoms present themselves in each person is unique. For each person, the opiate withdrawal timeline and presentation vary. It’s essential to keep this in mind when helping a person through an opiate withdrawal.

Because these drugs are quick-acting, withdrawal symptoms usually start as soon as the opiate leaves the bloodstream. The withdrawal symptoms of opiates are generally the following:

  • Severe drug cravings
  • Cramping in the abdomen
  • Nausea, vomiting, and diarrhea
  • Muscle aches
  • Muscle spasms
  • Insomnia
  • Agitation
  • Irritability
  • Rapid heart rate
  • Difficulty breathing
  • Depression
  • Anxiety
  • Deep aching in the bones
  • Runny nose and teary eyes
  • Extreme fatigue

Withdrawal occurs because the body becomes accustomed to taking in large amounts of the drug. When the drugs are no longer taken, the body must adapt to the change in chemicals, and withdrawal occurs. The opiate withdrawal timeline is different for each person and depends on the drug they’ve used most often in the past, but a typical timeline uses the following pattern:

Early Symptoms

Short-Acting Opiate: 6-12 hours

Long-Acting Opiate: 30 hours

  • Tearing
  • Muscle aches
  • High-blood pressure
  • High heart-rate
  • Runny nose
  • Yawning
  • Insomnia
  • Fever sweating

Late Symptoms

Both Short Acting and Long-Acting: 72 Hours

  • Nausea and vomiting
  • Diarrhea
  • Irritability
  • Stomach cramps
  • Depression
  • Intense cravings

Opiate Overdose

An overdose occurs when breathing slows to a point where the brain no longer receives the amount of oxygen it needs. A morphine or heroin overdose can occur even if it’s the first time the drug was ever abused. It’s essential to remember that all opiates can result in an overdose.

For example, although codeine is an opiate, it’s often prescribed mixed with Tylenol for cough. However, codeine with Tylenol can also be addictive, and result in overdoses; especially when taken with other substances. When a long time passes without enough oxygen to the brain, death can occur. Whether it’s a codeine overdose or morphine overdose, the effects can still be deadly.

Signs of an opiate overdose may include:

  • Small, constricted pupils (otherwise known as pinpoint pupils)
  • Loss of consciousness
  • Slow, shallow breathing
  • A limp body
  • Cold, pale skin
  • Bluish tint to face
  • Convulsions

How Long do Opiates Stay in Your System?

Despite their similarities, opiates don’t remain in the body for the same length of time. Just like withdrawal is different for every person, the length of time the drugs remain in someone’s body depends on a variety of factors. Opiates tend to have a short half-life, meaning they don’t stay long within the system. How long they remain depends on the following:
  • What kind of drug was taken (Heroin, morphine, codeine, etc.)
  • How the drug was taken
  • How often a drug is taken
  • The age of the person
  • The person’s metabolism (some people’s body’s break down drugs more efficiently)
  • The person’s body weight and fat content
  • How healthy the person is (especially their liver or kidneys)
  • The purity of the drug
Heroin is especially fast-acting, with an exceptionally short half-life. Within 10 minutes, almost half of the drug has cleared the system. On average, the drug remains in the body for 1-2 days. Codeine is also a fast-acting opiate, with a half-life of 3 hours, meaning in approximately 3 hours, about half of the drug is eliminated from the system. The rest of the codeine remains in the body for up to 3 days. Unlike heroin and codeine, morphine takes longer to work when taken. The half-life of morphine is 2-4 hours, with most of the drug eliminating blood within 1 day and from the urine within 3.

Addiction Treatment for Opiate Use Disorder

The first step to addiction treatment is detox, and the withdrawal symptoms can make detoxing from opiates very uncomfortable.

Detoxification, or detox, allows the drug to be eliminated from the body. For some people, medication-assisted therapy (treatment), also referred to as MAT, is a way to ease off of opiate use with the help of medications such as methadone and naltrexone.4

Unlike other types of detox, stopping opiate use all at once doesn’t pose major health risks — but it is exceptionally challenging to do because of how addictive this class of drugs is. However, medication-assisted treatment, therapy, or a treatment facility can help provide as much support as possible.5

Therapy or counseling may also be another recovery option for someone with opiate addiction. With a variety of therapy approaches to choose from —cognitive-behavioral therapy, family therapy, or individual counseling are a few—it’s possible to choose the best option for the individual situations.

Treatment settings also provide an opportunity for recovery from opiate addiction.6 Treatment settings can be long-term residential, short-term residential, or outpatient. These facilities are staffed with people whose sole purpose is to help support the recovery process and encourage a drug-free socialization process.

Regardless of the type of addiction treatment you choose, it’s important to remember that drug addiction can be treated. Addiction to opiates is not a character flaw nor is it permanent. Opiate addiction can be treated. Find recovery today.


Resources

  1. https://www.dea.gov/taxonomy/term/331
  2. https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
  3. https://pubmed.ncbi.nlm.nih.gov/18443635/
  4. https://www.samhsa.gov/medication-assisted-treatment
  5. https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction
  6. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

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