Opioids vs Opiate

Understanding Opioids and Opiates

The terms opioids and opiates are often used interchangeably, but they have distinct differences that are important to understand. To fully comprehend the debate surrounding 'opioids vs opiate', it's necessary to define each term separately.

Definition of Opioids

Opioids, as defined by Johns Hopkins Medicine, are a class of drugs that derive from, or mimic, natural substances found in the opium poppy plant. They work in the brain to produce a variety of effects, including pain relief.

Opioids contain chemicals that relax the body and can lead to feelings of relaxation and euphoria, thus making them prone to misuse. While some opioid drugs are derived from the naturally occurring plant compounds (alkaloids) in the opium poppy, others are synthetic, meaning they are human-made substances created in a laboratory. This class of drugs includes prescription pain medicines and illegal drugs, and some people use opioids because of the euphoria (“high”) they can produce. However, they can cause addiction, also known as opioid use disorder (OUD).

Definition of Opiates

Opiates, on the other hand, are a subset of opioids that are derived directly from the naturally occurring poppy plant (Papaver somniferum) that creates the active ingredient in drugs like opium, heroin, morphine, and codeine [2].

In simpler terms, all opiates are opioids, but not all opioids are opiates. This key distinction is mainly due to the origin and production of these substances. Opiates are naturally derived, while opioids can be naturally derived, synthetic, or semi-synthetic.

Both opioids and opiates work in similar ways to reduce the perception of pain in the body and brain. However, their usage and potential for misuse and addiction have led to a growing public health crisis worldwide. Understanding the differences and similarities between these two classes of drugs is crucial for tackling this issue effectively.

Key Differences Between Opioids and Opiates

Understanding the nuances in meaning between opioids and opiates is crucial when discussing narcotic drugs. This section will delve into the key differences between these two terms, specifically focusing on their origin and production, and their usage and medical applications.

Origin and Production

Opiates are derived from the naturally occurring poppy plant (Papaver somniferum) that creates the active ingredient in drugs like opium, heroin, morphine, and codeine. On the other hand, an opioid is a substance that can be derived from the poppy plant, be synthetic, or be semi-synthetic, including morphine, oxycodone, Oxycontin®, hydrocodone, fentanyl, and more [2].

In simple terms, opiates are chemical compounds extracted or refined from natural plant matter (poppy sap and fibers), while opioids are chemical compounds generally not derived from natural plant matter, often synthesized in labs [3].

To clarify, all opiates are opioids, but not all opioids are opiates. Some opioids, like Hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), and oxycodone (e.g., Oxycontin, Percocet), are partially synthesized from chemical components of opium, with the pharmaceutical industry creating over 500 different opioid molecules, some of which are widely used medically [3].

Usage and Medical Applications

Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly, and others are made by scientists in labs using the same chemical structure. Prescription opioids are used mostly to treat moderate to severe pain, though some opioids can be used to treat coughing and diarrhea.

It's important to note that people with substance use disorder may use both opiates and opioids illicitly. Because of their similarities, switching from one opiate or opioid to another can help maintain dependency or addiction, helping to prevent withdrawal symptoms for individuals dependent on these drugs.

Prescription opioids, when legally prescribed by a doctor and used as directed, can relax the body and relieve symptoms of an illness, an injury, or a surgical procedure [1]. Yet, these drugs contain chemicals that relax the body and can lead to feelings of relaxation and euphoria, making them prone to misuse.

Given the potential for misuse and the severe consequences that can result, it's essential to use opioids and opiates responsibly and under the guidance of a healthcare professional.

The Impact of Opioids and Opiates

While opioids and opiates play a significant role in pain management and other medical applications, their impact on the body and potential for addiction and dependency can't be ignored.

Effects on the Body

Opioids, a class of drugs derived from or mimicking substances found in the opium poppy plant, perform a variety of effects on the body, the most prominent being pain relief. Opioids work in the brain to dull pain and can also induce feelings of relaxation and euphoria, heightening their potential for non-medical use.

An opioid overdose is a grave risk associated with these substances, posing potentially life-threatening consequences. Symptoms of an overdose include slowed or stopped breathing, reducing oxygen flow to the brain, potentially resulting in a coma, permanent brain damage, or death.

Addiction and Dependency

The euphoric "high" produced by opioids can lead to repeated drug use, raising the risk of addiction, also known as opioid use disorder (OUD). Even opioids prescribed by a doctor carry a high risk of addiction, with misuse leading to substance use disorder, overdose, and death.

Long-term use of prescription opioids can lead to tolerance, requiring higher or more frequent doses to achieve the same effect. Dependence can also develop from regular use, causing a physiological need for the drug to function normally.

Prescription opioid misuse can also contribute to subsequent heroin use. Research indicates that approximately 4 to 6 percent of individuals who misuse prescription opioids transition to heroin.

Substance use disorder (SUD) or addiction, a complex medical condition, can result from continued misuse of prescription opioids. This condition results in brain changes, health issues, and an inability to fulfill obligations. Severe withdrawal symptoms can complicate cessation efforts, but effective treatments such as medications and behavioral therapies can help individuals modify drug-related behaviors and recover from addiction.

Misuse and Consequences

Misuse of opioids, whether they are prescription medications or illicit substances, can lead to severe, and sometimes life-threatening, consequences. Understanding the risks associated with opioid misuse and the potential transition from prescription opioids to heroin can help in formulating effective prevention and treatment strategies.

Risks of Misusing Opioids

Prescription opioids are generally safe when taken for a short time and as prescribed by a doctor. However, misuse can cause devastating effects such as addiction, overdoses, and death [4]. Prescription opioids can lead to addiction, and repeated misuse can cause a substance use disorder ranging from mild to severe. This disorder can have long-lasting negative impacts on health and daily functioning.

Misuse of prescription opioids can take various forms such as swallowing the medicine in higher doses than prescribed, crushing pills to inject, or snorting the powder. This misuse can lead to addiction and harmful effects on the individual's health.

Transition from Prescription Opioids to Heroin

Prescription opioids and heroin are chemically similar, and data indicates that misuse of prescription opioids can lead some individuals to switch to using heroin [4]. This underscores the interconnected nature of prescription opioid misuse and heroin use.

Heroin is often cheaper and easier to acquire than prescription opioids in some places, leading to some individuals switching to using heroin instead. Data from 2011 showed that an estimated 4 to 6 percent of individuals who misuse prescription opioids switch to heroin, and about 80 percent of people who used heroin first misused prescription opioids.

The transition from prescription opioids to heroin can increase the risk of overdose and other health complications. Therefore, it is crucial to monitor and manage the use of prescription opioids effectively to prevent the potential transition to more dangerous substances.

Treatment and Recovery

Addressing the issue of opioid and opiate misuse requires a well-rounded approach that includes both treatment and recovery. This often involves a combination of medical intervention, therapy, and lifestyle changes.

Addressing Substance Use Disorder

Substance use disorder (SUD), a complex medical condition, arises from persistent misuse of substances like opioids and opiates, leading to significant impairment or distress. SUD can vary in severity, chronicity, and complexity from mild to severe, with severe SUD often referred to as addiction. SUD can cause health issues and an inability to meet responsibilities at work, school, or home.

Addiction, specifically opioid addiction, is characterized by compulsive drug seeking and use despite adverse consequences. This disorder results in long-lasting brain changes and harmful behaviors. Withdrawal symptoms can be severe when individuals addicted to opioids stop using the drug, which makes the recovery process challenging.

Treatment for opioid addiction often involves medications and behavioral therapies aimed at helping individuals modify their attitudes and behaviors related to drug use. By providing a whole-patient approach to treatment, healthcare providers can help individuals manage their symptoms, reduce their drug cravings, and regain control over their lives.

Strategies for Overcoming Addiction

Overcoming addiction to opioids or opiates requires a comprehensive approach that addresses both the physical and psychological aspects of the disorder. Here are some strategies that can aid in recovery:

1. Medication-Assisted Treatment (MAT): MAT combines medications with counseling and behavioral therapies to treat substance use disorders. This approach has been shown to be effective in helping patients manage their cravings and reduce their illicit opioid use.
2. Counseling and Cognitive Behavioral Therapy (CBT): These therapies can help individuals understand the root causes of their addiction, develop healthier coping strategies, and learn skills to manage stress and environmental triggers.
3. Support Groups: Peer support can be a vital part of recovery. Support groups provide a safe space for individuals to share their experiences, learn from others, and receive emotional support.
4. Healthy Lifestyle Changes: Regular exercise, a balanced diet, adequate sleep, and stress management techniques such as mindfulness and meditation can all contribute to recovery by improving overall health and well-being.
5. Continued Care: Recovery from opioid addiction is a long-term process that requires ongoing care. This might include regular check-ups with healthcare providers, continuous therapy sessions, and long-term medication management.

Remember, recovery is a personal journey that looks different for everyone. It's crucial to work with healthcare professionals to develop a customized plan that addresses individual needs and circumstances. Overcoming addiction is challenging, but with the right support and resources, recovery is entirely possible.

Opioid Crisis: Statistics and Impact

The misuse of opioids, including prescription opioids, heroin, and synthetic opioids such as fentanyl, has led to a severe public health crisis commonly referred to as the opioid epidemic or opioid crisis. In this section, we'll explore the impact of this crisis in terms of opioid-related deaths and trends in opioid consumption.

Opioid-Related Deaths

In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses, underscoring the severity of the crisis. Meanwhile, in Canada, the situation is just as alarming. In 2016, there were 2,861 apparent opioid-related deaths, equivalent to eight people dying each day. On average, 16 Canadians were hospitalized each day due to opioid-related poisonings [5].

The rate of apparent opioid-related deaths in Canada in 2016 was 7.9 per 100,000 population, with the rates highest in the western provinces of British Columbia and Alberta, as well as in Yukon and the Northwest Territories. Most deaths occurred among males and individuals between 30 and 39 years of age [5].

Moreover, the proportion of reported apparent opioid-related deaths involving fentanyl or an analogue was 53% in 2016 and appears to be on the rise [5].

Trends in Opioid Consumption

The opioid crisis is closely linked to patterns of opioid consumption. In Canada, the volume of opioids sold to hospitals and pharmacies for prescriptions has increased by more than 3000% since the early 1980s. In 2016, over 20 million prescriptions for opioids were dispensed, making Canada the second-largest consumer of prescription opioids in the world, after the USA.

These statistics underline the gravity of the opioid crisis and the urgent need for effective prevention and treatment strategies. By understanding the scale and impact of this crisis, policymakers, medical professionals, and the public can work together to address the misuse and addiction of opioids. The challenge of distinguishing between opioids vs opiate use becomes a critical part of this conversation.

References

[1]: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/opioids

‍[2]: https://my.clevelandclinic.org/health/drugs/21127-opioids

‍[3]: https://www.oregon.gov/adpc/pages/opiate-opioid.aspx

‍[4]: https://nida.nih.gov/publications/drugfacts/prescription-opioids

‍[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034966/