Opiates are narcotics found within opium. They include morphine, codeine and thebaine, plus every narcotic that’s derived from opium. On the other hand, opioids include all opium-like narcotics regardless of the source. You could say that opiates are like Toyotas and opioids are like cars. Every Toyota is a car, but not every car is a Toyota. In the same way, you can say that every opiate is an opioid, but you cannot say that every opioid is an opiate. Yet what makes this story confusing is that the term “opiate” is often used interchangeably with the term “opioid.”

The Scientific Relationship Between Opium and Opiates

Opium comes from the sap of the poppy plant seed pod. After the sap is harvested, cleaned of organic materials and dried, the sap becomes “opium.” Opium contains alkaloids, which come under two sub-heads; quinoline and phenanthrene alkaloids. The term alkaloid simply means an organic compound that comes from a plant, that has physiological effects on humans.
 
Examples of quinoline alkaloids are papaverine, which is used to make Viagra, and narcotine, which is a cancer drug.
 
Examples of phenanthrene alkaloids are morphine, codeine and thebaine, which are derived biosynthetically from quinoline alkaloids. In other words, all phenanthrene alkaloids were once quinoline alkaloids.
 

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The term “opiate” more precisely describes the phenanthrene alkaloids of opium (codeine, morphine and thebaine), plus all opium-like narcotics derived from these three alkaloids, and that includes drugs, such as oxycodone and heroin.
 
 
 
 
 

Opiates (Phenanthrene Alkaloids and Derivatives)

As we just learned, opiates are found within or made from opium. The primary opiates are morphine, codeine, thebaine, heroin (a derivative of morphine) and oxycodone (a derivative of thebaine). Morphine, codeine and to a lessor extent oxycodone are the main opiate drugs in medical use today. Heroin, on the other hand, is mainly used to get high.
 
 

The Thebaine anomaly

Thebaine is a unique phenanthrene alkaloid. It is an opiate, and is chemically similar in structure to both morphine and codeine, but has psychostimulant effects rather than analgesic or psychodepressant effects. Along with morphine, codeine and thebaine, opium poppy produces approximately 80 alkaloids, but these other alkaloids have little to no drug-effects, and thus are not considered opiates.
 
 

Synthetic opioids

Synthetic opioids are 100% artificially made. Synthetic opioids act exactly like other opioids, but are not derived from opium. Synthetic opioids include drugs such as methadone, fentanyl, sufentanil and alfentanil.
 
 

Endogenous opioids

This brings us to our final category – endogenous opioids. Endogenous means originating from within the body. The endogenous opioid system is one of the most studied innate pain-relieving systems. The pain-relief system consists of widely scattered neurons that produce three opioids: endorphins, enkephalins, and dynorphins. These opioids act as neurotransmitters and neuromodulators at three major classes of opioid-receptors, termed mu (μ), delta (δ), and kappa (κ). All three endogenous opioids (enkephalins, dynorphins and endorphins) produce analgesia (pain relief).
 
Early classical pharmacological studies identified several classes of opioid receptors. At least three classes of opioid receptors, named mu (μ), delta (δ) and kappa (κ). These classical opioid receptors belong to the family of the guanine regulatory binding (G) protein-coupled receptor and are coupled to the second messenger systems via inhibitory G proteins (Gi/Go). Opioid receptors mediate the actions of endogenous and exogenous opioids and are present in the brain and throughout the body, including the endocrine organs, such as the adrenal cortex and the gonads
 

 
 

Psychoactive Alkaloids

Psychoactive alkaloids are chemical substances that have significant effect on mental function, i.e. they alter consciousness. When opiates are administered they blunt or diminish the sensation of pain, ergo analgesia, but opioids can also influence mood. Heroin is primarily taken to influence mood. When drugs such as codeine, morphine and heroin are administered in doses greater than doses given for analgesia, the effect is pleasure or euphoria, ergo psychoactive effect. In the cases of heroin, oxycodone and morphine, and to a lessor extent codeine, the effect is a depressant effect, ergo psychodepressant.
 

Morphine (psychodepressant)

Opium poppy is the only plant known to produce morphine and codeine. Morphine, named after the Greek god of dreams Morpheus, is a powerful painkiller, which is why doctors use it to treat pain. Morphine was the first active drug purified from a plant source. Not until after the invention of the hypodermic needle, back in 1857, was Morphine widely used.
 
In the medical profession, morphine is regarded as the gold standard of opioid pain relievers. It is used primarily to relieve severe pain and suffering. The risk of morphine use is it has great potential for tolerance, physical dependence, and addiction, all of which develop rapidly.

 

Codeine (psychodepressant)

Codeine is an opiate used for its analgesic, antitussive, antidiarrheal, antihypertensive, antianxiety, sedative and hypnotic properties, to suppress premature labor contractions, myocardial infarction, suppress coughing, as well as many other uses.

 

Thebaine (psychostimulant)

Thebaine resembles morphine and codeine in chemical structure but differs in that it produces psychostimulatory effects as opposed to the psychodepressant drug effects. Thebaine is not used therapeutically, but it can be transformed pharmaceutically into a variety of chemical substances, such as oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone, and buprenorphine.

 
 

Derivatives of Morphine

There are several semi-synthetic opioids derived from morphine. The most infamous being heroin (diacetylmorphine), which is a prodrug, meaning that it is inactive until metabolized within the body. As soon as heroin enters the blood it begins metabolizing into 6-monoacetylmorphine (6-MAM). All of the acute drug effects of heroin are actually caused by 6MAM – not heroin.

 
 

Heroin withdrawal

Heroin withdrawal occurs following abrupt cessation or rapid tapering of heroin use following prolonged heroin use. The onset of heroin withdrawal syndrome often begin 6 to 10 hours following the patient’s last dose. Symptoms tend to get worse over the first few days and peak intensity generally occurs on the third day, then subsides over the next several days. Withdrawal symptoms may persist for 7-days or so but some symptoms, such as drug dreams and sleep disturbances may persist for weeks.

 
 
 

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