Opiate and opioid drugs affect the same brain receptors and have the same effects on the central nervous system. Opiates are derived naturally, but opioids are man-made. However, while the term “opiates” only describes natural drugs, “opioids” is used as an umbrella term for both natural opiates and synthetic opioids.

While opioids are prescribed to relieve acute pain, prolonged use can lead to addiction and abuse. Common opioids include prescription painkillers such as Dilaudid, oxycodone, hydrocodone, and fentanyl, as well as the illicit drug heroin. Opioid addiction is a large contributor to overdose deaths in the United States. In 2018, there were 67,367 fatal overdoses, and opioids were responsible for 69.5% of these deaths. Opioid addiction is a disease that has destroyed the lives and families of millions. While there is no cure for opioid addiction, this disease can be treated in drug addiction rehabilitation.

To fully understand opioid addiction, it’s important to understand why these drugs are so addictive and why they’re used in medicine.

What Are Opiates?

Opiates are derived from the opium plant and used to treat pain. These substances carry a high risk of addiction for anyone who takes them for a prolonged period, even if they are used as prescribed.

The Sumerians first cultivated the opium poppy plant (Papaver somniferum), in 3,400 B.C. They referred to it as the “joy plant,” and the wonder drug was soon passed around the world as merchants learned of its multiple uses. Opium was used not only to relieve pain but also used to induce sleep and relieve bowel issues. Opiates are also frequently used to treat coughs.

Opium byproducts have been used for medical purposes for many years. These ingredients occur naturally in the sap of the opium poppy, but opiates can be further manipulated synthetically. These man-made opiates are called opioids. Collectively, opiate and opioid derivatives of the poppy plant include morphine, codeine, oxycodone, heroin, and many other opioid drugs.

While there is no major difference in the effectiveness of the drugs, opioids are synthetic or partly synthetic drugs that act similarly to opiates. With opioids, the active ingredients are synthesized by chemical processes. However, because they are similar in how they affect the body and brain, the terms opiate and opioid are often used interchangeably.

For almost as long as they have existed, opiates have been used for both medicinal and recreational purposes. Opiates and opioids exist on the drug market in a few different forms: prescription pharmaceuticals (morphine, codeine, methadone), and illicit street drugs (heroin, opium).

All of these drugs can be abused and cause addiction to develop, even if they are prescription medications.

Common Opiates & Intended Use

Opiate pain medications are prescribed mainly to treat moderate to severe pain. In most cases, opiates are prescribed following surgery or a medical procedure. Common legal opiate drugs include:

  • Morphine is a highly addictive, naturally occurring substance found in the opium plant.
  • Meperidine, similar to morphine, is a synthetic prescription medication.
  • Codeine, a less powerful but still addictive substance, is primarily used as a cough suppressant. Codeine is typically prescribed as a combination medication.
  • Hydrocodone is a semi-synthetic opioid. It’s the most frequently prescribed opiate medication on the market and is included in drugs like Lortab and Vicodin.
  • Oxycodone is another semi-synthetic opioid. Common brand names are Percocet (a combination drug containing oxycodone) and OxyContin.
  • Fentanyl is a highly addictive opiate that is produced synthetically, so it is known as a synthetic opioid painkiller. Fentanyl is commonly prescribed as a transdermal patch.

What Do Opiates Look Like?

Opiates can range in appearance. Drugs like oxycodone and hydrocodone come in pill form. Many opioids are combination drugs that are formulated with acetaminophen or aspirin, so different pill colors can denote different strengths of the drug. These combinations may be pink, blue, peach, or yellow.

Opiates are usually swallowed as pills to treat pain. If someone is misusing opioids, however, they may use an unapproved route of administration to feel the effects faster. These methods include:

  • Chewing the drug in order to increase absorption
  • Crushing and snorting pills for faster entry into the bloodstream
  • Dissolving crushed pills in water and injecting them intravenously
  • Misusing opioid intravenous solutions (morphine, hydrocodone, and fentanyl are manufactured as intravenous solutions for use in hospitals)

People who struggle with opioid addiction may store their pills in traditional orange pill bottles or hide them in mint tins or candy jars. If the person crushes pills and snorts them, they may keep the powder in small bags, foil pouches, or twisted pieces of cling wrap.

Many people begin their opioid addiction with a legitimate prescription. These people may have had surgery or an illness in which they were prescribed an opioid painkiller, resulting in addiction. For many people, prescription painkiller use leads to heroin addiction. In many cases, people who are in treatment for heroin addiction resorted to using heroin because prescription pills were more expensive and harder to obtain.

Heroin is derived from morphine and is typically sold in powder form. The drug varies in color from white to brown. Besides powder form, heroin can also be found as granules and brown, crystalline pieces called “rocks.”

Are Opiates Addictive?

Opiates are highly addictive drugs, making addiction a very real possibility for people who use these drugs. When a person takes an opiate, the drug enters the brain through the bloodstream and creates a flood of artificial endorphins and dopamine. These are neurotransmitters responsible for feelings of reward, pleasure, and satisfaction, and an opioid’s effect on them creates a rush of euphoria. Because the high is unlike any naturally-occurring rush of dopamine or endorphins, the only way a person can experience it again is by using the drug again.

After repeated use, however, the brain will stop creating dopamine and endorphins naturally. As a result, a person may only be able to experience these feelings again when they use opioids. Because of the strong and desirable feelings that flood the brain, and because they can no longer feel pleasure naturally, they may crave an opioid high. People choose to abuse opioids to lessen their pain and continue experiencing these euphoric feelings on demand. This is one of the main reasons opioids are highly addictive.

There are several steps to developing an opioid addiction. These include:

  • Tolerance: When a person has to use increasingly larger doses of opiates to experience the same high
  • Physical dependence: When the body will enter withdrawal if the person stops taking the drug
  • Psychological dependence: Cravings for opioids set in, which are the hallmark of opioid addiction.

Some people may fake continued pain symptoms to get refills of their prescription, or “doctor shop” by visiting different doctors to obtain multiple prescriptions at once. Prescription painkillers are also available illicitly on the black market or dark web, though it can be expensive.

Many people who start their addiction by using prescription opioids end up misusing heroin, as it is cheaper to use and easier to obtain. According to the National Institute on Drug Abuse, approximately 80% of people who currently use heroin previously misused prescription opioids.

Long-term opioid use changes the way nerve cells work in the brain. This happens even to people who take opioids for a long time to treat pain as prescribed by their doctor. The nerve cells grow used to the presence of opioids, so when they are taken away suddenly, the brain has a volatile reaction. This results in unpleasant feelings and reactions, known as withdrawal symptoms.

Opioid addiction causes a person to abuse opioids even though it has created negative effects in their life. People who are addicted to opiates have strong cravings to take these drugs, and they no longer feel satisfied by naturally pleasurable rewards.

FAQs About Opiates

  • What are common street names for opiates/opioids?

    People who abuse these drugs frequently refer to opioids using slang words and phrases to evade police attention. Some of the street names for a variety of opiates and opioids include:

    • H
    • Hammer
    • Skag
    • Gear
    • Smack
    • Horse
    • Elephant
    • Rock
    • Nose drops
    • Black tar
    • China white
    • White
    • Chinese H
    • White dynamite
    • Dragon

With stigma still surrounding opioid addiction, many people avoid going to treatment and end up endangering themselves. At The Recovery Village, we believe there is no shame in addiction to opioids or any other substance. Addiction is a disease, and like any disease, it requires medical care and attention. With the right course of action, including detoxification, treatment plans, and supervision from qualified staff, you can put opioid addiction in the past and lead a happy and successful life. There is no better time to seek treatment than now — contact us today to learn more.

Related: Teletherapy for Addiction & Mental Health

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.