The terms opiate and opioid are used interchangeably in medical practices because opiates and opioids affect the same receptors in the brain tissues and have the same effects on the central nervous system. However, there is a difference between the two terms. Opiates are naturally occurring drugs derived from the opium poppy plant, and include drugs like opium and morphine. Opioids are man-made drugs derived from morphine, and include synthetic drugs like oxycodone, hydrocodone and fentanyl.

All opiates are considered opioids, but not all opioids are naturally occurring opiates. The term opioid is an umbrella term that encompasses both naturally occurring opiates and synthetic opioid drugs.

While opiates are prescribed to relieve acute pain, prolonged use can lead to opiate addiction (opioid addiction) and abuse. Common opioids include prescription painkillers such as dilaudid, oxycodone, hydrocodone and fentanyl, as well as the illicit drug heroin. Opiate addiction (including opioid addiction) is the leading cause of the drug overdose in the United States, with 47,600 deaths attributed to prescription and illicit opioids in 2017. Opiate addiction is a disease that has destroyed the lives and families of millions. While there is no cure for opiate addiction, this disease can be treated in drug addiction rehabilitation or drug rehab.

To fully understand opiate and opioid addiction, it’s important to understand what makes these drugs so addictive, as well as their intended medical purposes.

What Are Opiates?

Opiates are drugs used to treat pain derived from the opium plant. These substances are highly addictive and carry a high risk for opiate addiction (including opioid 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, or 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 not only used to relieve pain, but it was 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. Natural derivatives of the opium poppy plant are called opiates. Opiates can be further manipulated synthetically. Such man-made opiates are called opioids. Collectively, these opiate and opioid derivatives of the poppy plant include morphine, codeine, oxycodone and heroin, among 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 opiates have existed, they have been used for both medicinal and recreational (i.e., to get high) purposes. Opiates exist on the drug market in a few different forms: as prescription pharmaceuticals (morphine, codeine, methadone, etc.), and illicit street drugs (heroin, opium, etc).

All of these drugs can be abused, potentially leading to opiate addiction (opioid addiction), even if they are prescription medications. People 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

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 analgesic. 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. Because many opioids are combination drugs that are formulated with acetaminophen or aspirin, 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. However, if someone is misusing opioids, they may use an unapproved route of administration to feel the effects faster, including:

  • 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 opiate addiction (opioid addiction) may store their pills in traditional orange pill bottles or hide them in mint tins or candy jars. If the person crushes their pills and snorts them, they may keep the powder in small bags, twisted in a piece of cling wrap or in a foil pouch.

Many people begin their opiate addiction (opioid addiction) with a legitimate prescription. These people may have had surgery or an illness for which they were prescribed an opioid painkiller that they became addicted to. 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. Heroin 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 opiate addiction (opioid 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, creating a flood of artificial endorphins and dopamine, which are neurotransmitters responsible for feelings of reward, pleasure and satisfaction. These neurotransmitters create a rush of euphoria. This high is so unlike any naturally-occurring rush of dopamine or endorphins that 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, limiting a person’s ability to experience these feelings again to only when they use opiates. Because of the strong and desirable feelings that flood the brain, and because they can no longer feel pleasure naturally, they may crave an opiate high. People choose to abuse opiates in order to lessen their pain and continue experiencing these euphoric feelings on demand. This is one of the main reasons opiates are highly addictive and why opiate addiction (opioid addiction) is such a concern.

There are several steps in developing opiate addiction (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 opiates set in, which are the hallmark of opiate addiction (opioid addiction).

Many people who experience opiate addiction (opioid addiction) become addicted to opioids unintentionally. Some people begin using opioids with a legitimate prescription in response to a painful accident or surgery. By the time they no longer need the drugs for their pain, however, opiates have taken hold in the brain and have caused a physical dependence starting an opiate addiction (opioid addiction).

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

Many people who start their opiate addiction using prescription opiates end up misusing heroin, as it is cheaper to use and easier to get a hold of. According to the National Institute on Drug Abuse, approximately 80 percent 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.

One of the hallmarks of opiate addiction (opioid addiction) is a person abuses opiates even though it has admitted negative effects on their life. They have strong urges (called cravings) to take opiates and they no longer feel satisfied by naturally pleasurable rewards (e.g., chocolate, sex, television or a walk on the beach).

With stigma still surrounds opioid addiction, many people avoid going to treatment and end up endangering themselves. At The Recovery Village, we believe that there is no shame in opioid addiction or any addiction. Addiction is a disease. And, as with any disease, it requires medical care and attention. With the right course of action, detoxification, treatment plans and supervision from the best staff, you can put opiate addiction (opioid addiction) in the past and lead a happy and successful life. There is no better time to seek treatment than now.

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.