Opium is a combination of natural alkaloids in the poppy plant with its major active ingredients consisting of codeine and morphine.

Heroin is synthesized from morphine and higher in potency than opium. It has a faster onset of action.

Opium and heroin are very similar. They are both extracted from the poppy plant, Papaver somniferum.

Opiates, Opioids & Narcotics

In the classic sense, and according to strict scientific or technical differences, the term opiate refers to natural substances that are derived from opium. Opium is extracted from the opium poppy plant and contains codeine and morphine.

Opioids are synthetic or semisynthetic compounds that act similarly to opiates, but they do not naturally occur. These synthetic opioids are manufactured artificially, and semisynthetic opioids are manufactured by modifying natural opiates.

The term narcotic was originally applied to medications that induced sedation or sleepiness, but it is now associated with any illegal drug.

All three terms — opioids, opiates, and narcotics — are now often used interchangeably, though opioid is the preferred term.

Opium History

Opium is a plant-based, naturally occurring narcotic substance that is produced from the unripe bulbs of the Asian poppy plant.

The Asian poppy plant was used as a medicinal pain reliever and recreational substance in some of the earliest cultures in history, such as the Sumerians. It is known to have been used as early as 4000 BCE. It was introduced to Western cultures in the 1600s.

The natural opioids in opium include recognizable drugs like codeine and morphine.

Heroin History

Heroin was first manufactured in the 19th century as an alternative to morphine and opium. It was intended to be used as an analgesic (pain-relieving) medication that did not produce significant euphoria and addiction compared to opium and morphine.

Heroin was actually the brand name for the chemical morphine diacetate. It was marketed by the Bayer company as a cough medication and initially sold over the counter. It is a semisynthetic opioid substance that is derived from opium.

Scientifically, heroin is made by converting opium to morphine, and the morphine is synthesized into heroin. It is more potent than opium and morphine as a result of the process used to make it.

Heroin is banned in the United States (labeled a Schedule I controlled substance) because it became a major drug of abuse by the early 1900s. It is available in other countries as an analgesic, but there are strict limitations on its use in the areas where it is used medicinally.

Difference Between Opium and Heroin

Despite both of these drugs carrying the “opioid” name and producing similar effects, such as euphoria and pain suppression, there are various differences when comparing the two. Opium comes straight from the naturally occurring narcotic manufacturers extract from the sap of unripe bulbs from a poppy plant. This iteration counts morphine as the active ingredient, meaning it suppresses pain receptors in our brain.

Heroin is considered a synthetic substance that uses opium as the primary active ingredient. The way it’s manufactured dictates how manufacturers convert the opium into morphine, then turn it into chemically changed heroin. The process leads to a substance with a higher potency level than an opium extract, translating to more intense euphoria. However, this also means it’s more addictive and will cause more significant problems down the road.

When you consider the two from a legal standpoint, the U.S. Food and Drug Administration (FDA) considers opium as a legal substance when the substance is synthesized and produced in legal labs and factories. Doctors will prescribe the medication to treat moderate and severe pain, while heroin is considered an illicit substance. This means a person cannot legally produce or sell the drug in the United States without facing stiff penalties. Due to the potency of heroin, it’s in high demand on the street. For that reason, it’s created substantial problems in our society that even non-addicts must encounter. The opioid crisis is worse than ever, and drugs like heroin have compounded the issue.

Both prescription pain relievers like oxycodone and heroin have similar chemical traits. Heroin is an opioid, and in many cases, it’s found cheaper than prescription opioids. For a person who can’t afford to feed a prescription opioid addiction anymore, it’s tempting to turn to heroin as an alternative. Not only is the drug cheaper, but it’s also more potent. From an outside perspective, it sounds like something you could never imagine making sense. However, when you’re wrapped up in addiction, it makes perfect sense.

Drugs like heroin and opium both share responsibility for the substantial increase in overdose deaths. Provisional data released from the U.S. Centers for Disease Control and Prevention (CDC) estimated 93,331 people died from drug overdose deaths in the United States in 2020. These numbers are 29.4 percent higher than the 72,151 deaths in 2019, proving how bad the crisis has become. Since heroin and opium are two very different opioid drugs, you might wonder what the difference is between opioids and opiates.

Opioid Vs. Opiate: Is There a Difference?

If you’ve read information about opioid drugs and saw the term opiate thrown in there, you might be confused about the difference. Like heroin and opium, it’s the same category but means something different. The term opiate refers to a drug derived from naturally occuring opium alkaloid components found in poppy plants. These types of opiate drugs include codeine, opium, and morphine.

It’s understandable as to why a person would be confused, and the term opioid is much broader, referring to drugs synthesized from an opiate that produce the same type of effects. Examples of opioid drugs include oxycodone (OxyContin or Percocet), hydrocodone (Vicodin or Norco), heroin, and methadone. Opioids are natural, synthetic, or partially synthetic substances that bind to opioid receptors in our brain and produce opiate-like effects.

What this means is that while all opiates are opioids, not all opioids are considered opiates. Many organizations use the term opioids interchangeably, but it’s essential to note that despite opiates being derived from naturally occurring substances, they’re not safer than synthetic drugs. All opioid drugs carry the potential for chemical dependency, addiction, and fatal overdoses.

How are They Typically Ingested?

Opium is most often smoked, as this method of administration gets the substance into the bloodstream rather quickly. Opium can also be taken orally — most often eaten or consumed in a tea. It can be injected, but opium injections are not the preferred method of using it unless it is added to other drugs like heroin, cannabis products, or methamphetamine.

Heroin is most commonly injected by mixing the powdery substance with water. Some forms of heroin may be crystallized or appear as a tar-like substance, and these are typically injected as well. Heroin can also be smoked or snorted.

What are their Effects?

Since these substances are chemically very similar, they have similar effects. Both drugs attach to the endogenous opioid receptors in the brain that control the subjective experience of pain or stress.

For Opium, the Effects will Most Often Include the Following:

  • Decreased sensitivity to pain
  • Drowsiness or lethargy
  • Mental confusion
  • Euphoria

When heroin enters the brain from the bloodstream, it is converted into morphine and binds with the same receptors that opium does (opioid receptors).

The Effects of Heroin Typically Include the Following:

  • Lethargy or “nodding” (falling asleep for very short periods, often for a few seconds at a time)
  • Flushing of the skin, especially in the face, and feelings of warmth
  • Heaviness in the arms and legs
  • Decreased sensitivity to painful stimuli
  • Dry mouth
  • Euphoria

Heroin is far more potent than opium in most cases, meaning that a small amount of the drug will produce the intended effects. It is far easier to overdose on heroin than on opium (see below).

Side Effects

The most common side effects of opium use and abuse include the following:

  • Parched mouth
  • Dry sinuses
  • Constipation
  • Tolerance with extended use
  • Withdrawal symptoms after extended use

Many of the complications associated with heroin abuse are related to the purity of the drug and additives in the product. The following side effects are associated with the drug:

  • Significant clouding of mental functioning
  • Nausea
  • Vomiting
  • Constipation
  • A decrease in heart rate and blood pressure
  • Irregular breathing or breathing that can be dangerously slow (respiratory suppression/depression)
  • Tolerance and physical dependence (withdrawal symptoms)

Because of its greater potency, heroin is considered to be far more addictive and serious than opium. Even so, both drugs are highly addictive and potentially dangerous.

Other Detrimental Effects

Because it is more potent, the effects of heroin typically occur much more quickly than the effects of opium.

Over the long term, the following risks are associated with heroin abuse:

  • Changes to the brain’s structure
  • Cognitive changes, including a decrease in decision-making capacities
  • Blood-borne diseases due to a higher likelihood of injection use

For both drugs, the risk of engaging in potentially risky behaviors, like unprotected sex, illegal activities to get more of the drug, and impulsive behaviors, is present. When these drugs are used even in small amounts, they will affect judgment and lower inhibitions.

Overdose Symptoms

The symptoms of an overdose on either drug look similar.

  • The opioid overdose triad: pinpoint pupils, respiratory suppression, and lethargy (or decreased consciousness or a comatose state)
  • Slow heart rate
  • Decreased blood pressure
  • Delirium
  • Loss of motor coordination
  • Slurred speech
  • Potential seizures
  • Psychosis

If it is delivered quickly enough, the opiate antagonist naloxone (brand name: Narcan) can be used to reverse the effects of an overdose of heroin or opium. This drug removes all opioids that are occupying the receptors in the central nervous system and reverses their effects.

Treatment for Abuse

Anyone who has opioid use disorder has a serious psychiatric disorder that requires professional intervention.

The Overall Approach is To:

  • Fully assess psychological, physical, and social functioning.
  • Engage in a physician-assisted medical detox program (a withdrawal management program) that often requires the use of an opioid replacement drug like methadone or Suboxone (naloxone and buprenorphine).
  • Enroll in formal substance use disorder therapy or counseling.
  • Participate in peer support groups like Narcotics Anonymous.
  • Address any other co-occurring conditions.

Detox is just the first stage of rehab. Treatment must continue long after withdrawal. This includes years of therapy, groups, and other forms of support.

Conclusions

Trying to compare opium to heroin is like trying to compare apples to apple butter. They are essentially the same product. Opium is a natural derivative of the Asian poppy plant, and heroin is synthesized from substances that occur in opium.

Heroin is considered more dangerous, although both are hazardous due to their potency and potential for abuse.

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