Opioid VS Opiate VS Narcotics: What Is The Difference Between Them?

Last Updated: June 9, 2020

Reviewed by Michael Espelin APRN

Opioids, opiates, and narcotics are all known as strong pain-relieving medicines and substances. These terms are often used interchangeably. Although certain differences depend on their constitution and whether they are obtained naturally or are synthetically produced. Read further to find out about the difference between opiates vs. opioids vs. narcotics.

Opiate Vs. Opioid: Are They The Same?

What Are Opiates?

Opiates are substances that are obtained from naturally occurring opium from opium poppy plants, Papaver somniferum. Opium derived from poppy had long been known to possess medicinal properties and believed to be responsible for creating a numbing sensation, pain relief, for treating diarrhea and inducing sleep. Opium alkaloids were later extracted from poppy plants and used in medicine for managing pain. These were called opiates and included alkaloids such as morphine, codeine, and thebaine.
Following is a list of opiates:

What Are Opioids?

What is opioid? It is a type of painkiller that is derived from non-natural sources of opium. They are categorized as semi-synthetic and synthetic opioids. Synthetics are completely created chemically, whereas semi-synthetics are derived from a hybrid combination of natural opiates and other chemicals.

Opioid Pills and capsules
Are opioids stimulants? No, they belong to the class of painkillers, whereas stimulants are those medicines that enhance the effects of nerve cells in the brain through the release of neurotransmitters. Stimulants enhance alertness, concentration, and energy in a person’s body, whereas these drugs are primarily used for treating pain and has a sedative effect on the person consuming it.

Difference Of Opioid Vs. Opiate

They are different from each other in that opiates are naturally occurring compounds whereas others are synthetically produced. Opiates are also referred to as natural opioids. Both work in the same way and have a similar effect on the body. Both substances exist in legal and illegal forms.
Because of the high overdose and addiction risk associated with them, they are available legally only through a doctor’s prescription.
The mechanism of action of opioids is the same as that of opiates. There are certain proteins in the human brain, spinal cord, and digestive tract, which are called opioid receptors. These receptors are responsible for the feelings and sensations of how we feel pain, pleasure, and the way we breathe. The brain creates endogenous opioids, including endorphins, which interact with the receptors. In response to pain, endorphins are released to help manage the pain. These endorphins are, however, released in small quantities and for a short time period.
Both substances are prescribed by doctors to manage severe pain. Opioid use mainly encompasses pain relief, treating diarrhea and cough, and for causing sleepiness/ sedation.
They both work by binding themselves to the receptors in the body. According to this study about body receptors and mechanisms of tolerance and dependence, these receptors inhibit pain signals to reach the brain, thus resulting in pain relief.

Examples of Synthetic and Semi-Synthetic Opioids

There are various legal and illegal semi-synthetic and synthetic opioids available.
All of the following are legal synthetic opioids:

  • Methadone (Dolophine, Methadose)
  • Fentanyl (Actiq, Fentora, Duragesic, Subsys, Abstral, Lazanda)
  • Meperidine (Demerol)
  • Tramadol (Ultram, Ultracet, Ryzolt)
  • Carfentanil
  • Buprenorphine (Suboxone, Zubsolv, Bunavail)

Some of the semi-synthetic drugs, not all from the list are legal, are listed below:

Opiates Vs. Opioids: Abuse Potential

Both drugs use can cause tolerance and dependence. With regular use, the body can become tolerant to it, which would require higher doses taken at more frequent intervals. This leads to dependency and addiction. The opioid crisis in America has risen in recent years, with more and more people being addicted. According to the article about the crisis, more than 130 people die every day in the United States after overdosing on these drugs. When taken in high doses, opioids effects can include dangerous symptoms, including breathing difficulties, which can even be fatal.

Narcotic Vs. Opioid: What Is The Difference?

Narcotics are those drugs and chemicals that alter one’s state of mind and cause narcosis. The term narcotics was initially used to refer to those illegal drugs which cause dependency and addiction. However, the United States Drug Enforcement Agency (DEA) uses the term Narcotics to refer to opioids. Hence, narcotics and opioids can be considered to refer to the same substances and chemicals.
prescription opioids spilling from orange bottle

Professional treatment of addiction in this case involves detoxification, medication-assisted treatment (MAT), counseling, behavioral therapies, and various other therapies.

Opioid Vs. Opiate Vs. Narcotic: Are They Safe?

Unfortunately, NO. All of them are considered to be mind-altering medicines or substances that offer pain relief and have a sedative effect. The difference between opioids and opiates primarily is that opiates are naturally occurring substances found in the poppy plant, whereas opioids are obtained either by combining opiates with other chemicals or synthesizing new chemicals entirely. Opiates can, thus, be considered as a subclass of opioids. The difference between opioid and narcotic is that narcotics encompass opioids, thus, they can be considered a subclass of narcotics.
When considering alternatives to these drugs and comparing marijuana vs. opioids as a substitution, medical marijuana has been used for medicinal purposes for many years for pain. According to the study about marijuana, legalization of medical marijuana may significantly lower the overdose deaths. Although, it is essential to mention that marijuana also has its own addictive potential and can be abused. It shouldn’t be used unless it is medically prescribed. In the case of abuse or addiction, one should seek treatment immediately.
Addiction to these drugs can lead to serious and fatal repercussions. Its treatment requires professional help from experienced individuals who can guide patients in transitioning back to a sober and healthy lifestyle.

Page Sources

Waldhoer M, Bartlett SE, Whistler JL, “Opioid Receptors”, https://www.ncbi.nlm.nih.gov/pubmed/15189164 Opioid Overdose Crisis, https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis Kenneth Finn, MD, “Why Marijuana Will Not Fix The Opioid Epidemic”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140166/

Published on: September 17th, 2019

Updated on: June 9th, 2020

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.


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