Opiate, Opioid, Narcotic - What's the Difference?


The terms opiate, opioid and narcotic are often used in what would seem the same way. With prescription pain medications reaching their highest point in years, it’s wise to know the difference between each of these terms and how they work.


Classically, the term opiate refers to natural substances that come from opium. Opium itself can be extracted from the opium poppy and contains chemical compounds, including morphine and codeine. Thus, examples of opiates are morphine and codeine.


There are also products that work by binding to the same receptors as opiates, but do not occur naturally, known as semi-synthetic or synthetic opioids. While synthetic opioids are manufactured chemically, semi-synthetic opioids are a hybrid resulting from chemical modifications to natural opiates.

Examples of synthetic opioids include fentanyl and methadone, while oxycodone and hydrocodone are examples of semi-synthetic opioids.

Opioid vs Opiate

Most people have now moved away from differentiating between opiate and opioid and use the term opioid for both natural or synthetic (or semi-synthetic) substances that act at one of the three main opioid receptor systems (mu, kappa, delta). If the term opiate is used it is thought of as the naturally occurring substances within the opioid class.

Though opioids are prescribed mainly to relieve pain symptoms, they can have negative effects including drowsiness and physical dependence. Because opioids have the potential for abuse and addiction, prescription opioid use is regulated by the Controlled Substances Act in the United States. However, not all opioids are available to be prescribed for pain treatment. Non-prescription opioids include heroin, which is a derivative of morphine, and is an illegal opioid commonly abused by injection.


Opioids are technically categorized under the term narcotic.  However, due to the negative association the term narcotic has with illegal drugs, it has fallen out of use in medical settings. The narcotic definition pertains to an agent that produces insensibility or narcosis.  When thinking about these terms broadly, you can think of opiates as being a subclass of opioids, and opioids as a subclass of narcotics. 

No matter what the medication is classified as or how it was created, it’s important to speak with your healthcare provider before taking any drug, prescription or not. Your pharmacist can also be a valuable resource when trying to identify what class the medication is considered and whether the medication has any potential drug-on-drug interactions.

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