Opioids vs. Opiates: What’s the Difference?
Key takeaways:
The terms opioids and opiates are often used interchangeably. But when comparing opioids vs. opiates, there are some notable differences.
Opioids include any natural, synthetic, or semisynthetic medications and substances that attach to opioid receptors (chemical binding sites). The term opiate is another name for natural opioids.
Opioids and opiates can cause side effects such as nausea and drowsiness. But they can cause more serious side effects too, such as misuse and slowed breathing. To minimize your risk, use prescription opioids and opiates only as prescribed.
Opioids and opiates have long served a role in pain management treatments. But as the two terms are often used interchangeably, it’s hard to know how to tell these two types of medications apart. Below, we’ll discuss the key difference between opiates and opioids, as well as what they have in common.
What are opioids?
The term opioid refers to any chemical that activates (turns on) specific areas on your nerve cells called opioid receptors. There are three different types of opioids: natural, synthetic, and semisynthetic opioids.
Types of opioids
Natural opioids are those derived from natural sources. They're also known as opiates. We’ll talk more about them in the next section.
Synthetic and semisynthetic opioids are both made in a lab. But they are made with different materials. Synthetic opioids are made from human-made materials. Semisynthetic opioids come from natural opioid (opiate) products, such as morphine.
Examples of synthetic, prescription opioids include:
Fentanyl tablets and patches
Methadone (Methadose)
Meperidine
Tramadol (Qdolo, Conzip)
Buprenorphine
Examples of semi-synthetic opioids include:
Hydrocodone / acetaminophen
Oxycodone (Roxicodone, Oxycontin)
Oxycodone / acetaminophen (Percocet, Endocet)
Hydromorphone (Dilaudid)
Oxymorphone
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What are opiates?
Opiates are chemicals that come from natural plant material. Specifically, opiates come from the plant known as opium poppy, or Papaver somniferum L. Two opiates you might find as prescription medications include morphine (MS Contin) and codeine.
Opioids vs. Opiates: What’s the difference?
Opioids and opiates aren’t all that different. As mentioned, an opiate is an opioid. But not all opioids are opiates.
The major difference between opioids versus opiates is that opioids include natural, semisynthetic, and synthetic substances. But only natural substances are referred to as opiates.
This means that prescription medications such as morphine and codeine are opiates. But semisynthetic products (such as oxycodone) or synthetic products (such as methadone) can only be classified as opioids.
What do opioids and opiates have in common?
Opioids and opiates have three major similarities. They both can:
Lower feelings of pain in the body
Cause serious side effects
Lead to misuse and dependence
When opioids and opiates attach to opioid receptors in the brain, they slow down signals in the body that make you feel pain. When used for a short period of time, prescription opioids and opiates are generally safe.
But even with short-term use, opioids can cause side effects such as brain fog, drowsiness, and constipation. More seriously, they can cause dependence, opioid use disorder, and opioid overdose. These serious side effects are more likely when instructions from healthcare providers on taking opioids are not followed.
All opioids are controlled substances. This means they have a higher potential for physical and mental dependence than medications that aren’t controlled substances.
Why are opioids and opiates addictive?
When opioids attach to opioid receptors, a chemical called dopamine is released. Dopamine is a naturally occurring chemical in the body that brings about feelings of pleasure. When you do something enjoyable, your brain releases dopamine to make you feel good. The brain remembers how you feel — and seeks out this experience again. This surge of dopamine after taking opioids and opiates is a major reason they can lead to misuse.
What are some safety best practices if you’re prescribed an opioid or opiate?
Opioids and opiates can be deadly in the event of an overdose. There were over 100,000 overdose deaths in the U.S in 2021, and over 80% of them involved opioids. There are a few ways to minimize your risks from opioids and opiates if your healthcare provider prescribes you one. These include:
Only take prescription opioids and opiates exactly as prescribed. Using your medications as prescribed will help minimize your risk of becoming dependent on them or misusing them.
Take the lowest dose for the shortest amount of time possible. High doses of opioids have a higher risk for misuse and overdose. And even though dependence on opioids can occur even within a few days, long-term use of opioids increases this risk significantly.
Give your pharmacist and healthcare provider a list of all the medications you take. Many medications can interact with opioids. Medications with similar side effects — such as drowsiness or the ability to affect your breathing — are likely to interact with opioids. Examples include benzodiazepines, such as alprazolam (Xanax), and sleep medications, such as zolpidem (Ambien).
Avoid alcohol. No amount of alcohol is considered safe to drink if you take an opioid or opiate. Before taking an opioid, be honest with your healthcare provider if you drink alcohol. They may suggest a different pain medication.
Familiarize yourself with naloxone (Narcan, Zimhi). Even if you take your prescription exactly as prescribed, it’s a good idea to familiarize yourself with the opioid overdose antidote, naloxone (Narcan, Zimhi). The U.S. Surgeon General has urged healthcare providers to write prescriptions for it whenever they prescribe an opioid. And as of September 2023, Narcan is available over the counter.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
The bottom line
The terms opioid and opiate are often used interchangeably. But they aren’t exactly the same. Opiates come from natural sources (the opium poppy plant). Opioids can be natural, synthetic, or semisynthetic. Opiates are a type of opioid, but the reverse isn’t true. Not all opioids are opiates.
When comparing opioids versus opiates, there are many similarities. They can cause side effects, such as nausea and drowsiness. More seriously, they can lead to addiction and overdose. This is more likely when they’re not taken as prescribed. To minimize your risk of side effects, take your opioid prescription exactly as prescribed. And take the lowest dose for the shortest amount of time possible.
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References
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Centers for Disease Control and Prevention. (2021). Commonly used terms.
Department of Justice/Drug Enforcement Administration. (2020). Narcotics.
Department of Justice/Drug Enforcement Administration. (2020). Synthetic opioids.
National Institute on Drug Abuse. (2014). The brain’s response to opioids.
National Institute on Drug Abuse. (2020). Drugs and the brain.
National Institute on Drug Abuse. (2023). Drug overdose death rates.
Oregon.gov. (n.d.). Opiates or opioids — What's the difference?
U.S. Department of Health and Human Services. (2022). U.S. Surgeon General’s advisory on naloxone and opioid overdose.
U.S. Department of Labor, Office of Workers’ Compensation Programs. (n.d.). Risk factors for opioid misuse, addiction, and overdose.
