Since the United States has found itself battling an opioid addiction and overdose crisis, hundreds of publications and news outlets have talked about opioids and opiates. Is there a difference between these two terms, or are they synonyms? They are often used interchangeably, but they do have one clear difference. Whether a substance is an opiate or an opioid depends on whether it was produced by nature or by humans in a lab.
Opiates are naturally occurring psychoactive substances found in opium poppy plants. The plants have been used for their psychoactive effects for centuries, but the active chemicals in them have only been known and isolated since the 1800s.
The opium poppy plant, scientifically called Papaver somniferum, contains a latex secretion that can be tried to make opium. About 12 percent of this opium substance contains psychoactive alkaloids that can be used for analgesia (pain relief), sedation, and euphoria. The chemical that’s found in opium in the highest amounts is called morphine, which can bind to opioid receptors in the human brain.
Morphine is chemically similar to a natural chemical in your body called endorphins, which is responsible for regulating your body’s pain response. Endorphins weren’t discovered until 1974, decades after the discovery of morphine. The word endorphin is an abbreviation of the phrase “endogenous morphine.” Opium also contains two other opiates: codeine and thebaine. Codeine is weaker than morphine, and it’s used in milder medications.
It has been historically used to treat coughs and other irritations. Thebaine is found only in small amounts in opium, and it has stimulant effects rather than depressant effects that are common among most other opioids. It’s found in larger quantities in different species of poppy plants and used to make other substances, such as synthetic opioids.
“Opioid” is a catch-all term that includes naturally occurring opiates as well as synthetic and semi-synthetic opioids. Any substance that acts in the brain and body by binding to and activating opioid receptors may be considered an opioid.
“Semi-synthetic opioids” is a term used to describe substances that are created by chemically altering natural opiates. For instance, heroin is a semi-synthetic opioid that’s made by chemically altering morphine. Other opioids are entirely synthetic, like Demerol, methadone, and fentanyl.
Synthetic opioids are made in laboratories without the need for an opiate starting point. Demerol was also the first opioid to not have a chemical structure that’s similar to morphine. Some synthetic opioids are much stronger than naturally occurring ones.
Fentanyl is said to be 50 to 100 times stronger than morphine. One of its analogs, called carfentanil, which is exclusively used to treat large animals, is said to be 10,000 times stronger than morphine.
Strong synthetic opioids are cheaper and easier to make because you need only a tiny amount to be effective. Plus, fentanyl starts working within minutes, so it’s often used when quick pain relief is needed, such as in situations involving labor pains or combat medical emergencies. Powerful opioids, however, have led to a recent spike in overdose deaths among people who abuse them.
All of these opioids have the possibility to cause dependence, addiction, and overdose when they are abused or taken in high doses.