What is the difference between Opioids, Opiates, and Narcotics?


Medical and scientific terminology can be tricky, especially when we read things in the media where terms are mistakenly used interchangeably. This often happens when there is coverage of the opioid crisis in America, where words like opioid, opiate, and narcotics can sometimes all be found in the same article. There are differences between opioids and opiates and the term “narcotics,” while subtle, it’s good to know about the substances that are causing so much harm to families and communities across the nation.


Opiates: When the term opiate is used, it’s referring to a natural drug derived from the flowering poppy plant. The substances that fall under this category would be opium, heroin, morphine, and codeine. Although morphine and codeine are both used medicinally, their active molecules are still extracted from the poppy.


Opioids: This is a broader term that describes both natural and synthetic substances that bind to opioid receptors in the brain. This includes the opiates listed above, as well as synthetic, laboratory produced substances like methadone and fentanyl. The term also covers semi-synthetic medications such as oxycodone and hydrocodone, as well as the treatment drug buprenorphine, which are made from a combination of naturally occurring and synthetic materials.


Narcotics: The word comes from the ancient Greek word for “stupor” and was used to refer to substances that relieved pain to numb the senses. Some people incorrectly use the term to refer to all drugs, but legally, it’s used to signify substances that are opium, opium derivatives, and semi-synthetic substitutes.


So, every opiate is also an opioid, but not all opioids are opiates and both are narcotics.


Things to note:

  • Just because opiates are naturally derived from the poppy plant, doesn’t mean they are safer! They are still highly addictive substances that can lead to overdose or even death.

  • The synthetic molecules in opioids are created chemically but act just like opiates in the body because the molecules are nearly identical.

  • Both opiates and opioids are considered narcotic analgesics.

  • Opiates can be found in nature, while all opioids are at least partially or fully synthetic.

Opioids and Opiates DEA Drug Schedule

The law has placed opioids and opiates at different levels on the drug schedule due to the fact that some opioids have medicinal purposes. This is partially how the opioid epidemic grew, as many people were becoming addicted to their prescription medication. Most commonly, people focused on “street drugs” like heroin, an opiate, but all the while, there were millions who were becoming dependent on their pain medication and were receiving limitless refills. The three classes that include opioids are:


Schedule I includes controlled substances that have no accepted medicinal use and have the highest potential for misuse, which includes heroin.


Schedule II are controlled substances that have a high potential for abuse which may lead to psychological dependence. This includes both opiates like opium, codeine, and morphine, as well as all common opioids that are both semi and fully synthetic. This also includes methadone though it does have specific value in treating opioid addiction.


Schedule III places controlled substances with a lower potential for abuse and psychological dependence like buprenorphine, a semi-synthetic opioid use in addiction treatment, and no more than 90mg of codeine per unit.


By understanding the terms used, individuals can empower themselves to educate others and be aware of what’s happening in their communities, in their country and around the world. For more information or to begin treatment, contact us today.
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