Opioids is a broad term that refers to all types of opioids, including natural, semi-synthetic, and synthetic. They are a class of drug that is found naturally in the opium poppy plant, and they are mainly used for the treatment of acute pain.
Because the term opioid is used to include all types of opioids, this also means that it includes opiates. However, while all opiates are opioids, not all opioids are opiates.
An opiate, on the other hand, is a specific type of opioid. The term opiate refers to all natural forms of the substance, including heroin, morphine, and codeine. Opiates are not synthetic.
Because opioids and opiates have a natural source, they can be found throughout even some of the earliest history. The original opioids were opiates, and modern technology came along later to help create new semi-synthetic and synthetic forms of the substance.
Scientists believe that the earliest mention of opiates dates back to a clay tablet from 2100 BC, and the natural medication reappears after that throughout both ancient and modern history. During ancient times, opiates are most often represented in historical pieces and artwork through the poppy flower itself.
It wasn’t until the 19th century that scientists were able to research and derive morphine from the poppy plant. From here, the history of opiates evolves as innovations in technology allow for the creation of semisynthetic and synthetic opioids. 1
Opiates were first synthesized as a way to help limit the adverse effects that natural opiates caused. The first non-opiate opioid to appear was meperidine in 1939, followed by methadone in 1946. Both of these substances had unique chemical structures compared to earlier opiates. 2
Despite being created as a way to help reduce the negative impact of opiates, synthetic and semi-synthetic opioids still pose a risk even today. In 2019 alone, over ten million people over the age of twelve reported abusing some form of opioid. Of this number, less than one million people abused heroin, with an overwhelming majority of the reports associated with prescription drug abuse. 3
Just as there are many types of opioids, there are also many types of opiates themselves.
Opium is a schedule II narcotic that is derived directly from the opium poppy plant. It can come in any form, from powder to liquid, but its most commonly, and illicitly, sold form is from the dried stem of the plant. Abuse of this substance can inhibit muscle use and dry out mucous membranes, leading to dry mouth and similar symptoms. 4
Where opium is derived from the plant itself, morphine is derived from opium. It is a schedule II narcotic that is available in a variety of forms, although its original mode of abuse was through injection.
Codeine is a modified form of morphine. This substance was created as a way to help reduce the sedative effects of morphine, making this a more viable pain solution since patients wouldn’t feel as drowsy with its use.
Thebaine is a special type of raw opiate ingredient that is used in the creation of both other natural opiates and semi-synthetic opioids. It is most often found in poppy seeds, which means that certain foods can trigger a positive result when testing for opioid use.
There are several different types of opioids that are used both illicitly and through prescription medicine. The key factor that sets one type of opioid apart from another is how it’s made. As a result, the three types of opioids include natural opioids like opiates, synthetic opioids, and semi-synthetic opioids.
Natural opioids are also known as opiates. These can include morphine and codeine as mentioned above.
Synthetic opioids are pharmaceutical substances made in a laboratory. These are designed to work in the same way as natural opioids, but their synthetic nature allows for more control over how they work. Synthetic opioids are also often more potent than natural forms.
Some of the most common synthetic opioids include fentanyl, tramadol, and methadone.
Fentanyl is a synthetic or lab-made opioid that is up to 100 times stronger than morphine. It was created as a short-term solution for severe pain, such as that found in cancer patients. While Fentanyl is stronger than morphine and begins to work faster in the body, it doesn’t last as long. Its effects can last as little as two hours, which is why there are different approaches to how to legally administer the substance to deliver the best effects for patients. 5
However, it has become a popular illicit substance as well. It has the highest toxicity and possible negative effects of all recreational drugs, and it has been associated with over 50% of overdose deaths. 6
Tramadol is the generic name for medications like ConZip or Ultram. Like other opioids, it interacts with the brain and central nervous system to produce pain-relieving effects. However, unlike many other forms of opioids, this drug has an extended-release form that is designed to safely treat chronic pain.
Tramadol can also come with risky side effects, however, which is why it’s important to use this opioid, and all types of medication, exactly as prescribed. Not only can it result in addiction when abused, but it can also lead to fatal side effects, especially because it can cause one’s breathing to slow.
Methadone is similar to morphine in use, effects, and longevity. However, it is also approved by the Food and Drug Administration (FDA) of the United States as a treatment for opioid use disorder (OUD).
OUD is a form of substance use disorder which can lead to frequent substance abuse and even addiction. Methadone is beneficial in that it works to reduce the discomfort of opioid withdrawal while also helping block the addictive euphoric effects of opioids.
This is considered a form of medication assisted therapy (MAT), and it is most often used for around twelve months, though some patients may require a longer experience to help treat their OUD. 7
Semi-synthetic opioids are a combination of natural and synthetic opioids. These types of substances occur when natural opioids are altered in a lab. Scientists can modify the chemical makeup of opiates, either to reduce negative side effects or improve or change positive side effects.
Oxycodone was first created from thebaine in 1916. Its ability to help reduce moderate or severe pain is comparable to morphine, both in immediate release and extended release form. It has fewer side effects than morphine.
Oxycodone can also easily be mixed with other substances due to its nature, including additional medications like acetaminophen, ibuprofen, naloxone, naltrexone, and aspirin. This can help it target other areas of pain or reduce its tendency to cause addiction and substance use disorders.
Hydrocodone-acetaminophen is the mixture of an opioid (hydrocodone) with a non-opioid (acetaminophen) to help treat a wide spectrum of pain. Hydrocodone targets pain to reduce how it is felt while also altering how the brain reacts to pain. Acetaminophen, however, is an over-the-counter treatment for pain and fever.
In combination, this medication can be beneficial in treating pain and other symptoms with a lower risk of mental dependence.
Hydromorphone is an opioid that is up to eight times more potent than morphine. However, it also has greater side effects, including sedation. It can be beneficial in treating moderate to severe acute and chronic pain when other medications may not work.8
Like methadone, buprenorphine is an opioid that is used to treat pain as well as OUDs. It is available in many different forms, from oral medications to patches to injections. It also places less of a strain on the respiratory system, making it a better choice for individuals that may have asthma or other related conditions.
The main difference between buprenorphine and methadone is the fact that buprenorphine is semi-synthetic while methadone is fully synthetic.
Despite the fact that opiates are a type of opioid, there are many differences between natural opioids and those that are semi-synthetic or synthetic. As seen above, some of the most notable differences are in side effects and pain-relief abilities. However, the differences can go beyond that.
Learning the differences between opioids and opiates isn’t just beneficial when seeking treatment for pain, but also when seeking treatment for an OUD. Because the substances are different, they react to the body in different ways. This means that recovery can look different for natural or synthetic opioids.
Because opioids and opiates are both chemical substances with euphoric effects, both substances have the potential to lead to addiction and dependency, especially when abused. However, studies have found that synthetic opioids may have a higher risk of addiction than natural opiates.9
One of the most important factors to discuss when determining the addictivity of a substance is the speed at which it reaches the brain. Substances that reach the brain faster have a higher risk for addiction, as the euphoric effects that come with opioids are available more rapidly. This is the same reason that substances that are abused through injection are more addictive than those taken orally.
While both opioids and opiates travel throughout the body faster than the body’s natural feel-good chemicals, known as endorphins, research shows that opioids may travel the fastest.
One of the main reasons that synthetic opioids are utilized is because of their reduced symptoms, particularly their reduced sedative qualities. Opium poppies and opiates are known for their tendency to cause drowsiness in patients, which can make them difficult to use as a regular treatment for pain.
Although synthetic opioids have the ability to better control what effects the substances have on the body, this doesn’t mean there are no risks involved. As discussed above, both opioids and opiates have the potential for abuse, addiction, and dependency, especially when used incorrectly.
However, because synthetic opioids are more potent than most opiates, there is a higher chance of more severe side effects, including overdose. Overdoses can be fatal if not treated rapidly and effectively.
No matter whether using opioids or opiates, the involved risks are greatly increased whenever either substance is abused. Abuse is any use of the medicine that strays from its intended purpose and prescription. This can include using more frequently than prescribed, using in combination with other substances, or taking prescriptions that aren’t made out in your name.
Because opioids and opiates have different chemical makeups, they can have different side effects. The most common side effects for both are nausea, drowsiness, and slowed breathing. However, certain side effects may be worse with one form of opioid over another. For instance, opiates are more known for their sedation side effects.
Because both natural and synthetic opioids have addictive qualities, it’s not uncommon for physical dependency to occur with long-term use, even when following a prescription. This means that with use of the substance ends, detox may occur, along with opioid withdrawal symptoms.
Despite their difference, opioids and opiates are handled in similar ways during detox. In many cases, medications such as methadone or buprenorphine are utilized to help reduce the symptoms of withdrawal and the discomfort that comes along with them. 10
The length of an opioid’s presence is not the same for everyone. Instead, there are a variety of factors that can influence how long opiates and opioids stay in your system. One of the most notable factors is the exact substance taken. Different opioids will last longer in the system than others might.
It’s also important to consider factors such as:
All substances are eliminated through what is known as a half-life. This is the time it takes for exactly half of the original dose to be eliminated from the body. Different opiates and opioids have different half-lives.
It’s also important to consider whether the opioid being detected in rapid onset or extended release. Because extended release is used to provide a longer duration of relief from chronic severe pain, it can be detected in the body for a longer period of time. Rapid onset, however, is designed to work and then begin being eliminated in a short period of time. These are often a short-term solution to acute pain.
Urine tests are one of the most common methods of detecting opioids in the body. Based off this test alone, here are some of the durations of the most common opioids and opiates:
Because of everyone’s changing metabolism, these numbers are just estimates and will vary. These numbers are also based on the last dose of the substance, and the timeline resets every time another dose is taken.
As the body begins to process and eliminate opioids and opiates in the body, it can lead to what is known as detoxification. Because the body may become accustomed to the effects of these substances, it may also lead to withdrawal, which are negative symptoms felt as a result of the body trying to return to normal after developing a physical dependence on opioids.
Undergoing detox at home can be dangerous due to the possible severity of opioid withdrawal symptoms, which is why it’s important to reach out to a professional medical facility equipped to provide you with safety and comfort during this time.
Opioid use disorder can place a strain on you and your loved ones. At Genesis Recovery, you’ll find a unique, private escape with around-the-clock nursing staff and an individualized care system designed to best meet your needs during recovery. The healthcare staff at Genesis Recovery is prepared to offer everything from medical assisted treatment to withdrawal management as well.
Withdrawal from opiates and opioids can be uncomfortable or even distressing, but here at Genesis Recovery, you’ll find that each program is designed to help care for you not only during your detox but through your next steps into recovery as well.
Genesis Recovery is here to help you or your loved one’s recover from opiates or opioids. Please give us a call today if you want to look into starting the recovery process. We will be with you every step of the way and will help tailor a plan that best suits your needs.