The words narcotic, opiate, and opioid are often used interchangeably to describe addictive drugs that are or have been used as pain medications. While “narcotic” is often thought of as a synonym for “illegal drug,” it really describes a drug that induces narcosis or insensibility. The word narcotic is also a broader term than either opiate or opioid; while all opiates are narcotics, not all narcotics are opiates.
An opiate is a natural substance derived from opium, which is itself an extract from the opium poppy. Opium contains chemical compounds like codeine and morphine. These compounds are thus opiates. The word “opioid” originally described a synthetic or semi-synthetic substance. While it binds to the same receptors as an opiate and has the same effects, an opioid did not occur naturally. Wholly synthetic opioids like methadone and fentanyl are manufactured in a lab. Semi-synthetic opioids like hydrocodone and oxycodone are opiates that have been chemically modified. The word “opioid” is now applied to natural, semi-synthetic, and synthetic drugs derived from opium.
What are narcotics?
The Greek physician Galen (130 -210 AD) is believed to have coined the word narcotic, which comes from the Greek word “narkō,” which means “to numb.” He used the word to describe any drug that dulled pain or induced sleep. Galen classed poppy juice and mandrake root as narcotics. Today, narcotics used in medicine are considered a type of powerful analgesic.
Narcotics not only block pain, they also cause euphoria and other altered mental states. Such effects encourage people to abuse narcotics and make them addictive. Consequently, the UN implemented the Single Convention in 1961 to regulate the sale and use of narcotics. The UN used the word “narcotic” to describe drugs like cocaine or cannabis, as well as opioids. While these drugs are not derived from opium, they have many of the same effects. They can block pain sensations, alter mood and/or induce euphoria, and cause addiction. The US Drug Enforcement Administration (DEA), by contrast, considers only drugs derived from opium to be narcotics. It also treats the words “opioids” and “narcotics” as synonyms.
What are opioids?
Opioids are drugs derived from opium. While the word originally described only synthetic and semi-synthetic drugs, it now includes natural derivatives of opium. It is thus more or less synonymous with “narcotics.”
Opioids are also defined as anything that can bind to the opioid receptors found on some nerve cells. Once there, they send a message to the brain that slows breathing, blocks pain, and reduces stress and depression. The body can actually produce its own opioids; they are called endorphins. It cannot, however, produce enough endorphins to relieve chronic or severe pain.
Examples of opiates
Opiates are natural derivatives of opium. They are sometimes called “natural opioids” in contrast to the semi-synthetic or wholly synthetic opioids. Codeine and morphine are opiates. Morphine is considered one of the world’s most effective pain relievers. It could originally only be taken through injection, but can now be taken orally or as a suppository. In addition to blocking pain, it also slows respiration, heart rate, and blood flow, and it causes a feeling of euphoria. People can become dependent on morphine to feel pleasure, and that dependency can lead to addiction. It may take only a few doses to become psychologically dependent on morphine.
Examples of opioids
Opioids work the same way opiates do and have the same analgesic effects. Some weaker opioids can be used to treat severe diarrhea or to suppress coughs. Opioids can be taken in a variety of ways that include the following:
• By mouth
• Skin patch
• Implanted pump
• Injection into muscle, vein, or area surrounding the spinal cord
• Nasal spray
• Tablet dissolved between the cheek and gum or under the tongue
Opioids are used to treat severe pain caused by injury or surgery. Most doctors use them to treat acute pain that lasts only for a few days. Opioids vary widely in strength; some are effective for only three to four hours, while the effects of the stronger opioids can last for up to half a day.
Examples of synthetic and semi-synthetic opioids include the following:
Hydrocodone is the generic form of such medications as Vicodin, Norco, and Lortab. It is the most commonly prescribed opioid in the US, and it is also the most commonly abused opioid. Hydrocodone is generally used to treat moderate to severe pain, and it can also be used as a cough medicine.
Fentanyl is prescribed to people who suffer from severe chronic pain. It is the generic form of such medications as Abstral, Actiq, Duragesic, and Fentora. In addition to being 50 to 100 times stronger than morphine, fentanyl is made in illegal laboratories. Fentanyl causes an immediate feeling of euphoria, and its potency makes it extremely addictive. Fentanyl’s potency also means that even a small dose can kill.
Heroin is an illegal drug with no medical use. It is less expensive than many prescription drugs, so many people start using it instead of a costlier medication. The CDC found that 75 percent of the people who use heroin had started by abusing a prescription opioid, and nearly 50 percent of the people who use heroin are also addicted to another opioid. Heroin is notoriously addictive, and an overdose is often lethal.
What makes opioids so dangerous?
Opioids can be extremely addictive, and an overdose can kill. According to the American Society of Addiction Medicine, over 52,400 people died from drug overdoses in 2015, making drug overdose the most common cause of accidental death in 2015. Over 60 percent of those deaths were caused by opioids. Heroin alone caused 12,990 overdose deaths, while opioid prescription pain medications caused over 20,000 deaths. These deaths have been increasing since the turn of the century; four times as many people died from opioid overdose in 2008 as in 1999. Sales of prescription pain relievers showed a similar increase. In 2012, doctors wrote 259 million prescriptions for opioids – enough to medicate every adult in the US.
“Getting clean” is difficult, for opioid withdrawal causes symptoms similar to those of a bad case flu. Anxiety and depression often accompany the physical symptoms. If you have an opioid addiction you will need to undergo a medical detox, and you will also need a doctor’s help and guidance.
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