Opioids vs Opiates - Know the Facts

Understanding Opioids and Opiates

Given the rising concern about opioid misuse and addiction, it is important to understand the difference between opioids and opiates, two terms that are often used interchangeably. While they have similar effects on the body, the terms refer to different substances.

Differentiating Opioids and Opiates

As explained by Summit Detox, opiates are drugs naturally derived from the poppy plant, such as opium, morphine, and codeine. Opioids, on the other hand, refer to drugs that are synthesized from an opiate. This category includes substances like methadone, oxycodone, hydrocodone, and heroin.

According to Cleveland Clinic, all opiates are opioids, but not all opioids are opiates. Despite this distinction, both opioids and opiates have a high addiction potential due to their similar molecular structures.

Medical Uses of Opioids and Opiates

Both opioids and opiates are used in the medical field for pain management. These substances work by binding to specific receptors in the brain, causing the brain and central nervous system to slow down, which results in a relaxed feeling. Some common opiates used for this purpose include Hydrocodone (Vicodin), Oxycodone (Percocet), and long-acting Oxycodone (Oxycontin).

Opioids, like opiates, attach to proteins called opioid receptors, blocking the signal to or from the receptor to relieve pain. These are highly effective in pain management but are also highly addictive due to their euphoric effects. Common opioids include fentanyl, methadone, and heroin.

Apart from pain management, prescription opioids are also used for treating intense coughing and chronic diarrhea. Drugs like loperamide are useful for treating diarrhea and irritable bowel syndrome (IBS), while opioids like codeine and dextromethorphan are effective as cough suppressants.

While opioids and opiates have medical uses, Johns Hopkins Medicine warns that regular use can increase a person’s tolerance and dependence, requiring higher and more frequent doses. Additionally, opioids can restrict the ability to breathe when taken at a higher dose, and when misused, can lead to a fatal overdose.

Understanding the difference between opioids and opiates and their effects on the body is crucial in preventing misuse and addiction. It is important for patients to follow their healthcare provider's instructions when using these medications and to seek help immediately if they suspect they are developing an addiction.

Impact of Opioids on Health

Understanding the health implications of opioid usage is crucial in addressing the growing concern surrounding opioids and opiates. This section discusses the detrimental effects of opioids on health, including opioid-related overdoses and the various risks and dangers associated with opioid misuse.

Opioid-Related Overdoses

Opioids, particularly synthetic ones such as fentanyl, are associated with a high rate of overdoses. Fentanyl, a synthetic opioid pain reliever, is significantly more potent than other opioids and is approved for treating severe pain, typically advanced cancer pain. Unfortunately, the illegal production and distribution of fentanyl has been on the rise in several states.

Furthermore, the number of drug overdose deaths remains high, with over 75% of these deaths in 2021 involving opioids. Overdose deaths involving synthetic opioids, including fentanyl, increased by over 22% from 2020 to 2021, with nearly 71,000 drug overdose deaths involving synthetic opioids other than methadone in 2021. The rate of overdose deaths involving synthetic opioids in 2021 was nearly 22 times the rate in 2013.

Furthermore, the latest provisional drug overdose death counts suggest that overdose deaths accelerated during the COVID-19 pandemic, emphasizing the urgent need to ensure those at risk of overdose have access to care and to expand prevention and response activities [4].

Risks and Dangers of Opioids

Along with the risk of overdose, opioids carry several other health risks. Long-term use can lead to physical dependence and withdrawal symptoms when opioids are reduced or stopped. Moreover, opioids can lead to respiratory distress or death if taken in large amounts or when combined with alcohol or certain other medications.

Heroin, an illegal opioid, poses significant health risks. In 2021, an average of 25 people died every day from a heroin overdose in the United States.

These alarming statistics underscore the risks and dangers of opioids, highlighting the importance of awareness, prevention, and access to treatment for those struggling with opioid misuse.

The Opioid Epidemic

The widespread misuse of opioids, both prescription and illegal, has become a serious national crisis in the United States. This epidemic has seen a significant surge in opioid-related overdoses, leading to an alarming number of deaths.

Statistics on Opioid Misuse

The misuse of opioids, including both opioids and opiates, has been on the rise. The impact of this misuse can be seen in the staggering statistics related to opioid overdoses and deaths. The Center for Disease Control and Prevention (CDC) reports that the number of drug overdose deaths remains high, with over 75% of these deaths in 2021 involving opioids.

Fentanyl, a synthetic opioid pain reliever that is many times more potent than other opioids, has also been a major contributor to this crisis. Illegally made and distributed fentanyl has been on the rise in several states, leading to an increase in fentanyl-related overdoses.

Trends in Opioid Overdoses

Overdose deaths involving synthetic opioids, including fentanyl and fentanyl analogs, increased over 22% from 2020 to 2021. The CDC reports that there were nearly 71,000 drug overdose deaths involving synthetic opioids other than methadone in 2021. The rate of overdose deaths involving synthetic opioids in 2021 was nearly 22 times the rate in 2013.

These trends suggest that the opioid epidemic has accelerated during the COVID-19 pandemic, highlighting the urgent need to ensure those at risk of overdose have access to care and to expand prevention and response activities. This alarming situation underscores the importance of understanding the nuances of opioids vs opiates, their effects on the body and brain, and the factors contributing to the current crisis.

Genetic Factors in Addiction

When discussing the topic of addiction, particularly related to opioids and opiates, it's crucial to recognize the genetic factors involved. Understanding how genetics influence addiction and the role opioids play in genetic predisposition can provide a more comprehensive understanding of the complexities of addiction.

Genetic Influence on Addiction

Scientific studies suggest that endogenous opioid peptides, such as enkephalins, endorphins, and dynorphins, play a critical role in addiction. These small molecules, naturally produced in the central nervous system and various glands throughout the body, can induce effects ranging from preventing diarrhea to inducing euphoria and pain relief (i.e., analgesia).

Opioid peptides bind to specific receptors on the surfaces of target cells to affect their functions. The human body contains several types of opioid receptors, including mu, delta, and kappa receptors. The binding of opioid peptides to these receptors initiates biochemical events that lead to various effects, including analgesia and euphoria [5].

Role of Opioids in Genetic Predisposition

Opioid peptides act as neuromodulators that alter the release of other neurotransmitters in the brain and peripheral nervous system. They can inhibit the release of acetylcholine, dopamine, and norepinephrine, and increase or decrease the release of serotonin and gamma-aminobutyric acid. This modulation of neurotransmitter release contributes to the complex neuronal networks involved in behaviors such as alcohol consumption [5].

There is compelling evidence suggesting that the activation of the endogenous opioid system by alcohol plays a role in mediating alcohol reinforcement and excessive alcohol-drinking behavior. Opioid receptor antagonists, which compete with endogenous opioid peptides for binding to opioid receptors, decrease alcohol self-administration in animals and reduce alcohol consumption in human alcoholics. Alcohol alters the activity within opioid peptide systems, increasing opioid peptide release in the brain and decreasing opioid gene expression. Genetic differences in alcohol-drinking behavior may be associated with variations in the responsiveness of the opioid system to alcohol.

In conclusion, both genetics and the role of opioids significantly contribute to the predisposition towards addiction. Understanding these factors can lead to more effective prevention strategies and treatments for those struggling with addiction.

Treatment Options for Opioid Addiction

Addressing the misuse and dependence on both opioids and opiates requires a comprehensive treatment plan incorporating both medical and therapeutic interventions. These treatments aim to mitigate withdrawal symptoms, prevent overdoses, and help individuals regain control over their lives.

Medications for Opioid Addiction

Medications play a critical role in the treatment of opioid addiction. They help individuals manage withdrawal symptoms, prevent overdoses, and reduce cravings for the drugs. According to NIDA, there are several medications available for treating opioid addiction.

• Methadone: A long-acting opioid agonist, methadone is taken orally, preventing the 'high' that comes with the use of opioids and opiates. It's used to reduce withdrawal symptoms during detoxification and as a long-term maintenance medicine for opioid dependence.
• Buprenorphine: Like methadone, buprenorphine suppresses and reduces cravings for opioids. It's often combined with naloxone to prevent misuse and is the first medication that can be prescribed by certified physicians in an office setting.
• Naltrexone: Unlike methadone and buprenorphine, naltrexone blocks the effects of opioids and opiates. If a person relapses and uses the drug, naltrexone prevents the feeling of getting high. It's suitable for detoxified patients who are highly motivated to stay in recovery.
• Naloxone: This medication is used for emergency treatment of a known or suspected opioid overdose, reversing the effects of opioids.

Each of these medications has its own benefits and is used based on an individual's specific needs and circumstances. A healthcare provider will consider various factors, such as the specific opioid used, the degree of addiction, and the patient's overall health, when deciding on the most suitable medication.

Therapies for Opioid Use Disorder

Beyond medications, therapies are vital in treating opioid use disorder. These therapies help individuals change their attitudes and behaviors related to drug use, increase healthy life skills, and persist with other forms of treatment, such as medication.

• Cognitive-Behavioral Therapy (CBT): CBT helps modify the patient's drug-use expectations and behaviors. It also effectively manages triggers and stress.
• Contingency Management (CM): CM uses a voucher-based system where patients earn points based on negative drug tests, which they can exchange for items that encourage healthy living.
• Motivational Enhancement Therapy (MET): A systematic form of intervention designed to produce rapid, internally motivated change; MET does not attempt to treat the person, but mobilize his or her internal resources for change and engagement in treatment.
• 12-Step Facilitation Therapy: This therapy is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups, enhancing the likelihood of abstinence.

The most effective treatment for opioid addiction involves a combination of medication and therapy, customized to meet the individual's needs. With the right treatment plan, individuals struggling with opioid addiction can achieve long-term recovery and lead a healthy life.

Future of Opioid Research

Opioid research is a continually evolving field, with new discoveries and advancements being made regularly. A comprehensive understanding of the nuances of opioids and opiates can contribute significantly to the development of effective prevention and treatment strategies for opioid misuse and addiction. This section discusses the ongoing studies on opioids and potential developments in addiction genetics.

Ongoing Studies on Opioids

Research continues to explore the complex workings of opioids and their effect on the human body. Opioid peptides, such as enkephalins, endorphins, and dynorphins, are naturally produced in the central nervous system and various glands throughout the body. They have a similar effect as traditional opiates like morphine and heroin, functioning both as hormones and neuromodulators. These peptides induce effects ranging from preventing diarrhea to inducing euphoria and pain relief.

Furthermore, studies show that opioid peptides act as neuromodulators that alter the release of other neurotransmitters in the brain and peripheral nervous system. They can inhibit the release of acetylcholine, dopamine, and norepinephrine, and increase or decrease the release of serotonin and gamma-aminobutyric acid. This modulation contributes to the complex neuronal networks involved in behaviors, including alcohol consumption.

Potential Developments in Addiction Genetics

Genetic factors play a significant role in addiction, and research continues to explore this intricate relationship. There is evidence suggesting that alcohol-induced activation of the endogenous opioid system plays a role in mediating alcohol reinforcement and excessive alcohol-drinking behavior. Opioid receptor antagonists, which compete with endogenous opioid peptides for binding to opioid receptors, decrease alcohol self-administration in animals and reduce alcohol consumption in humans suffering from alcoholism. Genetic differences in alcohol-drinking behavior may be associated with variations in the responsiveness of the opioid system to alcohol [5].

Moreover, studies indicate that alcohol can activate the opioid peptide system and contribute to alcohol reinforcement and excessive alcohol consumption. A genetically determined, increased responsiveness of the opioid system to alcohol may contribute to a predisposition for alcoholism in some people.

As research progresses, the understanding of the genetic components of addiction is likely to deepen, paving the way for more effective treatments and preventive measures for opioid addiction. The relationship between opioids and opiates, and their connection to addiction, is a complex one that will continue to be explored and unraveled in the future. The findings will be crucial in mitigating the impact of the opioid epidemic and treating those affected by it.

References

[1]: https://www.summitdetox.com/blog/opiate-vs-opioid/

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

‍[3]: https://www.cdc.gov/opioids/basics/index.html

‍[4]: https://www.cdc.gov/opioids/basics/fentanyl.html

‍[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826828/