An estimated 11.5 million people misused prescription opioids in 2016. More than 42,000 people died because of an opioid overdose in 2016, and more than two million people were classified as having an opioid misuse disorder. The opioid epidemic costs more than $504 billion economically. The opioid epidemic has undoubtedly ravaged families and entire communities. As part of the epidemic, it can be important to learn what different terms mean, particularly if you’re afraid a loved one could be misusing opioids or struggling with an opioid addiction. Three of the most common terms are opioid, opiate and narcotic.

Opioids have been long used for both recreational and medicinal purposes, and some come from natural opium while others are synthetically manufactured to have a structure replicating opium. The term opioid tends to be used to cover any drug that is similar in structure to opium. Within the larger category of opioids, there are natural opiates, synthetic and semi-synthetic substances. The term “narcotic” is typically used interchangeably with the term “opioid.”

What Are Opiates?

Natural opiate drugs come from the poppy plant, and the term opiate in strictest terms refers to naturally-derived substances. Opium and morphine are two of the most commonly misused opiates, recreationally and as pain relievers. It’s estimated that more than ten million people around the world use opium. Opium is incredibly expensive and powerful. Heroin is another common opiate and considered to be one of the most dangerous recreational drugs in the world. Heroin is smoked, snorted or injected and it’s a big part of the opioid epidemic in the United States. Codeine is also a natural opiate, often included in cough medications.

Synthetic opiates are drugs that have opiate-like effects. They’re related to naturally-derived opiates because of their structure and their effects. Fentanyl is one example of a synthetic opiate, and it’s one of the deadliest when misused. Fentanyl is included in a skin patch for around-the-clock pain. Increasingly, fentanyl is being added to other opioids sold on the streets, and when that happens, it causes a spike in overdoses. There are also analogs of fentanyl, such as acetylfentanyl and carfentanil. Semi-synthetic opiates include hydromorphone. Hydrocodone is another popular prescribed and often misused semi-synthetic opioid, which has a mechanism of action similar to codeine. Oxycodone is also semi-synthetic and is derived from a particular opium alkaloid.

Opiate vs. Opioid

Both opiates and opioids activate the same receptors in the brain, and they can cause a euphoric high. Opiates and opioids also slow down the central nervous system and can cause respiratory depression. What distinguishes opiates from opioids is the way they’re created. While opioids can either be manufactured synthetically or derived from poppy plants, opiates are exclusively derived from poppy plants.

Narcotic vs. Opiate

Another term to be aware of is narcotic. The United States Drug Enforcement Administration defines narcotics as opioids. Drugs like hydrocodone and oxycodone can be described as prescription narcotics or opioids. Heroin is also considered a narcotic because it acts on the same receptors in the brain and causes the same effects as prescription opioids.

Narcotics, opiates and opioids are all drugs that reduce the intensity of pain signals reaching the brain. They all affect certain areas of the brain that control emotion and the reward center. The only main difference between opiates and opioids is that opiates are naturally-derived, while opioids are man-made.

If you or a loved one is struggling with opioid addiction, reach out to The Recovery Village. We have program options available to help you or your loved one overcome opioid substance use disorder.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. 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.