There actually is a difference between opiates and opioids. An opiate is any drug derived from a poppy plant or a derivative of a drug derived from a poppy plant. Opiates include opium, morphine, codeine, and heroin. Heroin is derived from morphine, which is derived from opium, which is derived from the poppy plant. Codeine is derived from opium and metabolized into morphine in the liver. Codeine is the most commonly taken opiate in the world.
An opioid is a more general term for drugs that work on opioid receptors in the brain to suppress pain. These may or may not be chemically similar to opiates. Opioids also include drugs like hydrocodone, oxycodone, methadone, and fentanyl.
‘Opioid’ is an umbrella term, so opiates are also opioids. You see ‘opiates’ used less and less in media coverage and the term is beginning to sound antiquated. The reason is that up until the 1950s, there weren’t many synthetic painkillers being used and misused. They were all opiates, derived from poppies. Synthetic opioids have appeared and multiplied in the past 50 years or so. These drugs have become a problem because of their abundance, and in some cases, their potency. While you can’t patent morphine or heroin, you can patent novel synthetic drugs that act on the same receptors. The push in the 1990s to market these drugs as non-addictive is part of the reason opioid addiction has become such a widespread problem.
Now that addiction to prescription opioids has contributed to an increase in addiction to heroin–an opiate–there are more and more deaths attributed to the cheaper and more potent fentanyl–an opioid. Codeine and heroin are both opiates, but one is relatively mild, something you can take for a cough, and the other can kill you.
Clearly, specifying ‘opiate’ or ‘opioid’ when discussing the current addiction crisis is not only confusing, it’s also pointless. Many synthetic opioids are chemically similar to naturally derived opiates, and anyway, they all do pretty much the same thing. They suppress pain and cause euphoria to various degrees by interacting with opioid receptors. When taken in excess, they can suppress breathing and heart rate, causing death. ‘Opioid’ is an adequate way of describing all of these drugs and it isn’t necessary to bother with ‘opiate’ at all.
