Narcotic is a general term that is used to describe drugs that act on the brain and central nervous system in a specific way, and they’re the same as opioids. Opioids are a class of drugs that includes illegal street drugs such as heroin, as well as prescription pain relievers. While the word “narcotic” is often used in the U.S. used to describe different kinds of illegal drugs, it accurately refers only to opioids. Some shared characteristics of opioids and narcotics include their psychoactive or behavior-altering effects on the user and their tendency to cause drowsiness or sedation. Still, even within the broad category of narcotics there are different classifications.

What Are Opiates?

While “opioid” and “opiate” are often used interchangeably in common speech, there are technical differences between the two. Opiates are drugs that are naturally derived. Opiates refer to certain alkaloids that are naturally occurring in the opium poppy plant, which grows primarily in regions such as South America and Southeast Asia. The alkaloids are extracted from the plant’s resin. Opium has more than 20 alkaloids, but only two, codeine and morphine, are used in narcotic pain medications.

Morphine, one of two naturally-derived prescription opiates, is available in various brand-name drugs. Some of the brand-name drugs that contain morphine include Armyo ER, Roxanol, MS Contin and Roxanol-T. This analgesic has medical uses in the U.S. but is a Schedule II controlled substance because of the inherent abuse and addiction potential. Morphine is prescribed to relieve moderate to severe pain, and it affects the central nervous system. People prescribed morphine are instructed to use it only as directed because, in addition to its potentially addictive properties, it can also cause fatal overdoses.

Codeine is another natural opiate used in pain relievers and cough suppressant medications. When someone takes codeine, a portion of it converts back to morphine in their body. As with morphine, codeine binds to certain receptors in the central nervous system and changes how pain messages are transmitted throughout the brain and body.

Heroin is an opiate made from morphine, although it’s technically classified as semi-synthetic. There are synthetic processes that create the heroin narcotic sold on the streets. Unlike morphine and codeine, heroin has no approved medical uses in the U.S — one of the only narcotics for which this is true. It is a Schedule I drug with a high potential for abuse, and it is illegal. Heroin is usually sold as a white, brown or black substance that can be smoked, snorted or injected. Heroin is often cut with other substances, some of which can be highly potent and deadly. Fentanyl, which is dozens of times more powerful than heroin itself, is an example of the kind of synthetic opioids heroin is mixed with before being sold on the streets.

What Are Semi-Synthetic and Synthetic Opioids?

In addition to natural opiates, there are semi-synthetic and synthetic opioids. If a substance is synthetic, it is technically an opioid, rather than an opiate. Semi-synthetic opioids are partially derived from opium and codeine. Synthetic opioids are fully synthesized, meaning they’re manmade. These drugs, despite the distinctions in how they’re made, all act on the brain and body in the same way. They also all have the potential for addiction and physical dependence.

Semi-synthetic opioids include

  • Hydrocodone
  • Oxycodone
  • Hydromorphone
  • Oxymorphone
  • Buprenorphine

Synthetic opioids made in laboratories include

  • Tramadol
  • Fentanyl
  • Methadone

It’s important for people to realize there is no distinction in the risks associated with these drugs. Morphine, a heroin narcotic and the synthesized opioids all have the same inherent risks for users.

Risks of using naturally-derived or synthetic opiates or opioids include addiction and physical dependence because of the opioid receptors they interact with in the central nervous system. All forms of opioids and opiates, natural or otherwise, bind to opioid receptors and, in so doing, relieve pain and create a sense of euphoria. They all have sedative-like properties as well. Due to the feeling of euphoria they cause, both opioids and opiates can trigger a reward response in the brain that contributes to addiction. There are no major distinctions between natural and synthetic opioids. The only difference is the fact that the heroin narcotic has no medical uses and is always illegal, while other opiates and opioids are controlled substances with some medical applications.

The potential potenency of opioids is one of the reasons the opioid epidemic has become so troubling. It is possible to make synthetic opioids like fentanyl significantly stronger. Fentanyl is commonly cut with heroin, and it is so powerful that it can cause an almost instantaneous overdose. Just a few years ago these synthetic opioids weren’t widely available in the U.S., but countries like China are increasingly manufacturing synthetic opioids, which are coming over the U.S. borders and flooding the marketplace. Their availability is contributing to higher overdose rates nationwide.

If you or a loved one is struggling with opioids of any kind, please reach out to The Recovery Village. We’re here to help you learn more about addiction and treatment, answer specific questions you might have, or discuss options for entering a treatment program.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.