If you’ve watched or read the news in the past several years, you’ve most likely stumbled across the terms opioids and opiates.

They’ve been used to refer to the addiction crisis that America has been facing, but they aren’t always well explained.

If substance use disorder has touched you or someone you love, you know how serious addiction can be. Opioid use disorder is often extremely harmful, and it can turn deadly without much or any warning.

At the same time, opioids are legitimate prescription drugs that serve a specific purpose. In many cases, there’s no alternative option that’s as effective. Maybe you’ve been prescribed some narcotic painkillers, and you’re worried about taking them. You’re looking for more information about this class of drug so that you can make an informed decision and know your risks.

Whatever led you to have questions about an opioid vs. opiate, we’re here to answer them.

What Are Opiates?

There is some overlap between the term “opiate” and the term “opioid.”

What’s even more frustrating is people aren’t always careful to use the correct term. As a result, there’s plenty of confusion around what these two terms mean exactly.

The term “opiate” refers to the psychoactive compounds that occur naturally in the opium poppy. These substances are narcotic sedatives. By lowering central nervous system activity levels, opiates lower both sensations of pain and alertness. Users are left feeling drowsy with little to no pain.

The opium plant has been cultivated for over a thousand years for medicinal use. Opium itself is useful in this way, and modern advancements in the last century have led to purer extracts.

Codeine, morphine and heroin are all opiates derived naturally from the opium poppy—though most heroin available today is synthetic making it technically an opioid.

Benefits of opiates, however, come with a pretty significant price. Opiates are highly addictive, and beating an opiate addiction can be very hard to do without help.

What Are Opioids?

In the 20th century, the addictive properties of opiates, such as morphine, were well known. World War I brought a new scale to the problem, with millions of injured soldiers needing pain relief.

Scientists began attempting to produce synthetic alternatives to natural opiates. The goal was to provide narcotic pain relief without the addictive properties in opiates.

The first step in the journey to fully synthetic opioids was the creation of semi-synthetic opioids. The most well-known were all developed in the 1910s. Some of these are still household names.

They include:

  • Oxymorphone (derived from thebaine, another alkaloid compound found in opium)
  • Oxycodone (also derived from thebaine)
  • Hydrocodone (derived from codeine)

These all improved in some ways upon natural opiates. Yet they remained highly addictive.

In time, scientists succeeded in creating wholly synthetic alternatives to opiates, which were termed opioids. These drugs had no link to the opium plant. But they still attached themselves to the opiate receptors in the brain causing similar psychoactive responses.

Unfortunately, they did not succeed in removing the addictive properties. In fact, most opioids are even more addictive than the opiates they were designed to replace.

There are around 150 total synthetic opioids, as well as several semi-synthetic opioids.

The most common today include these:

  • Demerol (discovered 1932)
  • Methadone (developed 1937)
  • Fentanyl (developed 1959)

Each of these synthetics was more powerful than the last. And each was more addictive than the last, too.

In modern usage, “opioid” can include all the above categories: opiates, semi-synthetics, and synthetic opioids.

What Are Narcotics?

Narcotics is another term that has been used in a variety of ways. In popular culture—think police TV shows—it means illegal drugs.

In medicine, it originally included all sorts of sense-dulling, pain-relieving substances. Some people today still refer to these drugs as narcotics.

However, the DEA states that the term “narcotics” properly refers to opiates, opioids, and semi-synthetic drugs. Because of the confusion surrounding this term, the DEA also recommends using the term “opioid” when referring to the drugs discussed thus far.

Prescription and Illicit Use

Opioids are widely available as a prescription drug. This is part of what has led to the current opioid crisis. In the past decade, patients have routinely been prescribed opioids for pain control after surgery.

Often, doctors prescribe more pills than are necessary, simply out of convenience. As a result, many people’s medicine cabinets contain leftover opioids, making the possibility of addiction worse.

To be clear, many people take opioids during recovery as needed and do not become dependent. But the danger of addiction is great.

Illicit use starts when someone has no medical need for pain relief yet continues to take opioids.

Signs and Symptoms of Opioid Abuse

If you suspect that you or a loved one is struggling with opioid abuse, but aren’t sure, look for the following signs and symptoms:

  • Inability to stop using opioids despite no medical need
  • Increased isolation from loved ones
  • Others’ legally obtained medications going missing
  • Unexplained financial shortfalls
  • Personality changes (cravings, drowsiness, inattention to personal care)

If you see these signs in yourself or a loved one, it’s time to get help.

Treatment for Opioid Addiction

Treatment for opioid addiction is available near you. Once addicted, stopping yourself from taking opioids without help can be next to impossible. The side effects of withdrawal can be severe and even dangerous.

Getting help is essential, but what does help look like? It can take a variety of forms. Both inpatient and outpatient rehab are available. These programs help you detox your body and retrain your brain. Both are essential for a lasting recovery.

Medically assisted treatment (MAT) is also available. Under MAT, a less dangerous medication such as methadone or buprenorphine is used strategically to help a patient detox comfortably. It can also be used to fight off cravings indefinitely when the patient is in recovery.

Help is available and waiting could be deadly. If you or a loved one is struggling with opioid addiction, get help today. Search through our directory to find a treatment center near you.


  1. Definition of Opiate
  2. Youth Substance Abuse: A Reference Handbook
  3. Narcotics (Opioids)
  4. Signs of Opioid Abuse

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