Opiates are gaining national attention as the epidemic of opioid addiction continues to sweep the country. There’s really no demographic or area that’s safe from the opioid epidemic, as it affects everyone, whether they’re in a big city or a rural area. So, what’s driving the rising use of opiates?

It’s largely because of the fact that doctors prescribe millions of opioid painkillers each year. The prescription version of opioids are not only easy to get because of the sheer number of prescriptions that are written, but they are also often a gateway to illegal drugs including heroin, which is also an opioid.

Because of the amount of attention opiate use gets in the U.S., there are many questions and misconceptions about these drugs. One such question that’s frequently asked is, “Are opiates NSAIDs?”

The following is some information to help you understand the differences between opiates and NSAIDs.

What Are NSAIDs?

To provide a short answer to this question, it’s no. Opiates are not NSAIDs. The acronym NSAID stands for nonsteroidal anti-inflammatory drugs. These are commonly prescribed to help in the treatment of conditions like arthritis and they’re also available as over-the-counter drugs like aspirin.

However, NSAIDs go beyond only being pain relievers. They can work to reduce inflammation and reduce fevers, and they can also prevent blood from clotting. Although they may be helpful in some cases, NSAIDs are suspected to cause or worsen heart disease, stomach ulcers and impair kidney function.

Drugs that are NSAIDs work through a process that prevents certain enzymes called COX enzymes from doing their jobs. Many NSAID drugs block the action of the enzyme, which actually has two forms, and that’s what alleviates inflammation and pain. There are varying formulations of NSAIDs that may also vary in strength.

Drugs that are in the NSAID category have been shown to help relieve both acute and chronic pain but there is the possibility of bleeding and ulcers in the gastrointestinal tract and clients should consult with their doctors before using them in long-term treatment. Drugs that are NSAIDs are non-narcotic analgesics and they essentially work by decreasing how pain is formed in the peripheral nervous system.

How Opioids Are Different

Opioids are not NSAIDs, and these two types of pain relievers actually perform very differently from one another. First, opioids act to relieve pain by attaching to the brain and central nervous system’s opioid receptors. The brain naturally produces a minimal level of opioids, but what someone gets when they take an opioid drug is hundreds of times more potent. That’s what leads people to feel a rush or high when they take opioids.

Rather than blocking the action of enzymes, opioids instead trigger a flood of dopamine and feel-good chemicals into the body and that’s what relieves pain. Opioid analgesics perform directly on the central nervous system, and they block out pain stimuli that would be sent to the brain.

Opioids, unlike NSAIDs, have a high potential for abuse. This is because since they play such an important role in the brain and central nervous system opioid receptors, and specifically the brain’s reward and pleasure centers. Over time, with continued opioid use, the brain wants to take actions that will allow it to get more of the drug.

Short-acting opioids are effective for a much shorter time than the average NSAID drug. Along with addiction potential, there are many downsides to the use of opioids, particularly in the long-term. For example, some of the problems that can result from long-term opioid abuse include hormonal issues, insomnia, depression and difficulty having natural feelings of pleasure without drugs.

Something else to note about the differences between opiates and NSAIDs is the fact that NSAIDs aren’t classified under the Controlled Substances Act, except in the case of combination drugs, like those that include oxycodone and aspirin.

Opiates are not NSAIDs. Opiates are much stronger and are usually relied on when pain is so severe that non-narcotic analgesics aren’t effective. The biggest differences between these two classes of drugs is in how they produce analgesic effects. Opioids work on nervous system pain receptors in the brain and spinal cord. Non-opioid NSAIDs work directly on the areas of inflammation and injury found in the body’s tissues.

Also, opioids significantly impact the brain by reducing its ability to sense pain, while non-opioids tend to play a role in addressing chemical reactions at the site of tissue injury.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
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.