What is the Difference Between Opioid vs Opiate?

What exactly is an opioid? If you automatically think of heroin when you hear the word “opioid,” you are on the right track as heroin falls under the category of illegal opioids. Drugs classified as opioids include illegal substances as well as manufactured prescription medications. 

Originally, doctors were led to believe that man made opioids such as painkillers, did not have any remarkable, negative side effects. Today, we know this could not be further from the truth as prescription drugs have played a major role in fueling the current opioid epidemic. Although the government has made efforts to make obtaining these addictive medications more difficult and doctors have grown in hesitancy to prescribe them, individuals who rely on these medicines for pain management or who have become addicted, will often turn to the streets in search of cheaper alternatives, such as heroin.

The misuse and abuse of opioids is an increasingly serious problem among Americans, being driven in large part by synthetic opioids. Synthetic opioids include the prescription painkillers hydrocodone and oxycodone, or Vicodin and OxyContin, respectively. Fentanyl and methadone are also synthetic opioids, fentanyl being a driving factor in the increase of heroin overdoses in recent years.

Opioid painkillers are often prescribed to treat mild to severe pain in patients. Their ability to induce a powerful calming effect often leads to misuse, abuse and subsequently, opioid addiction.

Is There A Real Difference Between Opiate and Opioid?

Commonly, we hear the terms opioid or opiate used interchangeably, but there are some notable differences between the two. 

In medicine, any drugs derived naturally from parts of the opium poppy plant are considered opiates, such as morphine and codeine. Although opiates are a natural substance, it is important to note that this does not mean they are less harmful than opioids. Opiates are extremely addictive and thus, misused and abused greatly, just like their opioid counterpart. 

Opioids, on the other hand, are any substance, natural or synthetic, that mimics the effects of opium and binds to the brain’s opioid receptors to relieve pain. Opiates are a type of opioid, but not all opioids are opiates. 

The endorphin-receptor system is the part of the brain where opioid receptors are located. These receptors are responsible for controlling pain, reward, and addictive behaviors. Chemically speaking, both opioids and opiates function in a similar manner, as they will both bind to opioid receptors in the brain. Opioids and opiates will attach themselves to available opioid receptors and send signals to the brain in order to block pain and produce a sense of pleasure or euphoria.

The addictive nature of opioids and opiates can not be emphasized enough. When these substances bind with receptors in the brain, they also act as a catalyst for the brain to produce more opioid receptors. This begins a dangerous game of supply and demand: these receptors will require larger amounts of opioids to bind with each and every time an individual uses the drug.

Types of Opiates

Opiates are prescribed most often for chronic pain management and can be broken down into two main categories: agonists and antagonists.

Agonists mimic the effects of naturally-occurring endorphins in the body, producing a classic opiate effect of blocking pain and providing a sense of euphoria. Morphine and Fentanyl are two incredibly strong and highly addictive agonist opiates, indicated for severe pain in medical settings. Fentanyl is 50 to 100 times more powerful than morphine, and has become a popular cutting agent for heroin. Hydrocodone, Oxycodone, and Buprenorphine are also considered agonists and have a high potential for abuse. 

Antagonists work by blocking agonists from reaching the brain’s opioid receptors. Naloxone and naltrexone are two examples of opioid antagonists. These drugs block the signals that the receptors send to the nervous system, and can actually reverse the effects of opioids already in the system. Often, naltrexone is used when an individual wants to stop abusing opiates or opioids, during the detoxification process and withdrawal treatment process. 

Addiction To Opioids

Statistics consistently show the highly addictive, and even lethal nature of opioids. While there are indications for medical use of synthetic opioids, it is paramount to understand the inextricable risk of dependence and addiction for patients. Opioids were involved in 46,802 overdose deaths in 2018 (69.5% of all drug overdose deaths).1 Two out of three (67.0%) opioid-involved overdose deaths involve synthetic opioids.2

Following an injury or accident, doctors will routinely prescribe patients painkillers to manage any pain or discomfort. Over the course of taking their prescription medication, sometimes individuals may feel like the dose is not having the same effect as it had originally; this describes a tolerance to the drug. 

When an individual begins to “build up” a tolerance to opioid painkillers, they may start to take larger doses in order to effectively manage their pain. Someone who continues to misuse an opiate or opioid will develop a physical dependence. Dependence simply means the need to continue using a substance in order to function normally. Once an individual is dependent on opioids or opiates, it is very challenging to simply quit. These drugs are habit-forming and physically alter how the brain operates in regards to pain and pleasure.

These cravings often develop into intense urges to use, despite any negative consequences. The brain is constantly seeking a state of balance, so when it begins to require larger doses to feel a sense of normalcy, it is only natural to want to satisfy this urge. The compulsive use of any drug, whether an opioid such as a prescription painkiller, or an opiate such as morphine, is considered an addiction. 

Long Term Side Effects Of Opioid Abuse

An opioid use disorder is defined as a problematic pattern of opioid use that leads to serious impairment or distress. Doctors use a specific set of criteria to determine if a person has a substance use problem (source).

Physicians today have become increasingly hesitant to prescribe opiates as liberally as in the past. Except for severe cases of pain, such as in patients battling cancer, medical medical recommendations have been evolving to avoid opioid prescription wherever possible. This change comes as a response to the high risk of abuse, dependence, and addiction for both opioids and opiates.

Aside from these potentially devastating consequences, other side effects of opioid use can include respiratory issues, gastrointestinal problems, and cardiovascular disorders. Central nervous system side effects may include confusion, difficulty concentrating, and insomnia. 

Patients suffering from chronic pain, who are prescribed opioids, will often have a diagnosed psychiatric disorder such as depression or anxiety. Higher levels of emotional distress have been reported in individuals with chronic pain, which can intensify mental and emotional disturbance. Approximately 10% of all patients develop depression while taking opioids.

An actual increase in patient pain is also a possibility when taking opioids. While not fully understood yet, some patients can experience a sudden onset of an increase in pain after taking an opioid painkiller. Whenever this is the case, different avenues must be explore for alternative pain management options.3

The immune system can also be compromised while on opiates. The ability to fight off infection weakens immediately upon taking opioids or opiates, regardless if this effect is obvious to the individual or not. The only way to manage this unwanted side effect is to stop taking the opioid altogether. 

These side effects are serious enough to warrant the careful consideration of the risks vs. benefits of opioid therapy. Wherever possible, opioids should be used for short periods of time. Whenever appropriate, an alternative means of managing pain is preferred altogether.

A Real Treatment 

It can feel impossible to beat a substance abuse disorder alone, given the highly addictive nature of opioids and opiates. Addiction is not an incurable disease or character flaw. Instead, it is an imbalance in the endorphin-receptor system found in the brain. Accelerated Neuro-Regulation brings the brain back to a state of balance, using medication under sedation to cleanse and re-regulate the brain’s opioid receptors.

When you expose your brain to opioids, the substance you are taking will bind with the available opioid-receptors to create pleasurable sensations and block pain signals. With prolonged usage, your brain creates more and more receptors, which requires larger amounts of opioids to bind with said receptors. The urge and cravings many individuals feel when trying to stop using opioids is simply because the endorphin-receptor system is imbalanced and requires more of the external opioid to function. 

Addiction is a neurobiological phenomena and it can be resolved by modern medicine. Traditional rehab facilities follow outdated practices of detoxing and merely managing opioid withdrawal symptoms. Opioid detox at most inpatient treatment centers includes a lengthy stay, requiring individuals to miss out on their daily lives with family and friends, as well as obligations such as work. 

The ANR treatment method can be performed within one single weekend, with the promise of resuming normal life in less than 48 hours. Treating opioid dependency is not complicated; it simply requires the understanding of how the human brain reacts to opioid use and the knowledge of how to address this imbalance. 

The ANR Clinic utilizes a scientific-backed approach to treating opioid and opiate dependence. We view dependence and addiction as manifestations of brain changes resulting from prolonged use and exposure to drugs. As long as there is an endorphin-receptor imbalance in the brain, dependency, addiction, and relapse are essentially inevitable. By treating the physical brain, we have been able to help over 24,000 patients overcome opioid addiction.

If previous attempts at recovery from abusing opioids or opiates ended in relapse, we want to encourage you in knowing that  sobriety is still possible. A life without opioid dependence is within reach and can be achieved without fear of withdrawal syndrome or relapse. 

REFERENCES

  1. Hedegaard H, Miniño AM, Warner M. Drug Overdose Deaths in the United States, 1999–2018. NCHS Data Brief, no 356. Hyattsville, MD: National Center for Health Statistics. 2020.
  1. Wilson N, Kariisa M, Seth P, et al. Drug and Opioid-Involved Overdose Deaths—United States, 2017-2018. MMWR Morb Mortal Wkly Rep 2020;69:290-297.
  1. Family Health Team. The Down Side and Side Effects of Painkillers. Health Essentials. 2013 July [cited May 2018]. Available from: https://health.clevelandclinic.org/the-down-side-and-side-effects-of-painkillers