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Opioids vs Opiates
Introduction
For patients experiencing acute or chronic pain, certain drugs that interact with the opioid receptors in the brain and other parts of the body can help in managing intense discomfort and improving quality of life. Opioids and opiates are two such groups of medications often prescribed for severe pain management. They each influence different aspects of this intricate receptor system, but both have profound analgesic effects in patients dealing with extreme pain.
Opiates are naturally derived from opium poppy plants; they include morphine, codeine among others. On the other hand, opioids is a broader term which refers to all substances (natural or synthetic) that bind to opioid receptors. This group includes natural opiates as well as semi-synthetic derivatives like heroin, oxycodone, and hydrocodone; fully synthetic opioids such as fentanyl and methadone are also part of this category.
While these medications have similar mechanisms - primarily reducing perception of pain by inhibiting neurotransmission within the central nervous system - their potency varies significantly across individual compounds due to differences in molecular structure.
Opioids vs Opiates Side By Side
| Attribute | Oxy contin | Morphine sulfate er |
|---|---|---|
| Brand Name | OxyContin | Morphine Sulfate ER |
| Contraindications | Should not be taken with or after MAO inhibitors, can exacerbate depression or anxiety, risk of dependency and addiction | Should not be taken with or after MAO inhibitors, can exacerbate depression or anxiety, risk of dependency and addiction |
| Cost | Around $380 for a month's supply (30 tablets) | Roughly between $50-$200 for a month's supply depending on dosage |
| Generic Name | Oxycodone | Morphine |
| Most Serious Side Effect | Dependency and addiction, respiratory depression | Dependency and addiction, respiratory depression |
| Severe Drug Interactions | MAO inhibitors, alcohol, benzodiazepines, other CNS depressants | MAO inhibitors, alcohol, benzodiazepines, other CNS depressants |
| Typical Dose | 15–30 mg every 4 hours as needed for pain | Started at a lower dosage, increased under medical supervision until adequate pain relief is achieved |
What is Opioids?
Opioids and opiates both refer to drugs used primarily to treat acute and chronic pain. Opiates are naturally occurring substances derived directly from the opium poppy plant, including morphine and codeine. The term "opioid" was originally used for synthetic opiates, such as hydrocodone and oxycodone. However, today "opioid" is a term used for the entire family of opiates including natural, synthetic and semi-synthetic.
Medical professionals began using opioids in medicine due to their effectiveness at relieving pain. They work by binding to opioid receptors in your brain, spinal cord, and other areas of your body which reduces feelings of pain. These drugs can also produce a sense of well-being or euphoria depending on the specific drug utilized since they affect the areas of brains responsible for reward.
Though effective at reducing pain, opioids have high potential for addiction due to their influence on dopamine levels - a neurotransmitter associated with pleasure sensations - leading to increased tolerance over time if not managed carefully under medical supervision.
What conditions is Opioids approved to treat?
Both opioids and opiates are approved for the treatment of severe pain conditions:
- Acute, such as post-surgical or injury-related
- Chronic, in cases where non-opioid alternatives are not effective
- Cancer-related pain.
Some specific opioids like methadone and buprenorphine are also used in opioid use disorder management to reduce withdrawal symptoms and cravings.
How does Opioids help with these illnesses?
Opioids are a category of drugs that includes substances derived synthetically, semi-synthetically or naturally from the opium poppy plant. They work in the body by binding to opioid receptors located primarily in the brain and spinal cord. By activating these receptors, opioids can inhibit pain signals from reaching the brain, thereby reducing sensations of pain. Opiates on the other hand refer specifically to natural alkaloids found in the resin of the opium poppy such as morphine and codeine.
Both opioids and opiates play a critical role in managing severe acute pain and chronic pain conditions unresponsive to other medications. However, they also have potential for misuse due to their euphoric effects which can lead to dependence over time. Thus, while these drugs can dramatically improve quality of life for individuals suffering from intense pain, they must be used under careful medical supervision.
What is Opiates?
Opiates, a group of drugs that includes morphine and codeine, are derived directly from the resin of the opium poppy. These substances have been used for centuries due to their effective pain-relieving and euphoria-inducing properties. Opiates work by binding to opioid receptors in the brain and other parts of the body, reducing perception of pain while also triggering a release of dopamine - leading to feelings of pleasure or relaxation. Because opiates are naturally derived, they were among some of the earliest analgesics (pain relievers) available in medical practice.
However, opiates can be habit-forming if misused due to their pleasurable effects – but when used responsibly under professional supervision they remain an important tool in managing severe pain conditions. Common side-effects include constipation, drowsiness and dependence with long term use; yet these side-effects tend not to cause sedation or induce weight gain as is common with certain types of antidepressants like SSRIs such as Prozac.
What conditions is Opiates approved to treat?
Opiates are a group of drugs that derive directly from the opium poppy plant. They have been used for centuries to treat pain and other conditions due to their potent analgesic effects. Some types of medical conditions for which opiates might be prescribed include:
- Severe acute (short-term) pain, such as post-surgical pain or severe injury
- Chronic (long-term) pain in cases where non-opioid treatments are insufficient
- Palliative care, to ease suffering at the end of life
How does Opiates help with these illnesses?
Opiates, derived directly from the opium poppy plant, play significant roles in many processes in the body. They primarily interact with opioid receptors located in the brain and spinal cord to reduce pain sensations, creating a sense of euphoria that can often lead to misuse or addiction. Opiates like morphine and codeine have been widely used for their analgesic properties.
Unlike opioids — which refer to any substance (natural or synthetic) that binds to opioid receptors — opiates are not synthetic; they're natural alkaloids found in the resin of the opium poppy. The effect on endorphin levels by opiates is similar to how Wellbutrin affects norepinephrine levels: it increases them, thereby alleviating some symptoms such as severe chronic pain.
While opioids include a broader category encompassing synthetics like fentanyl and semi-synthetics like oxycodone, when a patient requires potent relief from severe acute pain naturally rather than chemically synthesized drugs, they might be prescribed an opiate instead.
How effective are both Opioids and Opiates?
Both opioids and opiates have been used extensively in the management of pain, with a history that spans hundreds of years. Opioids is an umbrella term which includes both natural opiates (such as morphine and codeine) derived from the opium poppy, as well semi-synthetic variations (like hydrocodone and oxycodone), and fully synthetic versions (fentanyl, methadone). They were initially developed to provide effective pain relief for moderate to severe acute or chronic pain.
Opioids work by binding to specific proteins called opioid receptors found in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs bind to their receptors they reduce the perception of pain. A 2010 clinical trial showed no significant difference between morphine (an opiate) and fentanyl (a synthetic opioid) when used for postoperative analgesia.
A review published in The Journal of Pain Research has concluded that opioids are indeed effective at alleviating different types of pain but due caution should be exercised because their side effect profile is not favorable over many other classes of medication; constipation being one common side effect among others. Furthermore opioids are highly addictive substances causing physical dependence even when taken under medical supervision.
A meta-analysis indicated that while opioids may be more powerful than non-opioid alternatives for immediate pain relief due their potent action on opioid receptors throughout our nervous system; however long-term use can result in tolerance meaning increasingly higher doses are required for same level of efficacy which increases risk factor for addiction making them a second- or third-line treatment option after non-opioid alternatives like NSAIDs.
Nonetheless, despite inherent risks associated with usage especially around dependency issues; thanks to modern pharmacology advancements such as slow-release formulations there’s increasing evidence supporting appropriate use particularly chronic cancer related pains where less potent options fail providing much needed relief improving patient's quality life significantly.
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At what dose is Opioids typically prescribed?
Dosages of opioids can vary widely, but are typically prescribed at the lowest effective dose to manage pain and minimize side effects. For example, oral dosages of morphine (an opioid) range from 15–30 mg every 4 hours as needed for pain. Studies have indicated that careful dosage titration is necessary and depends on the patient's previous exposure to opioids. Children and adolescents may be started on lower doses depending upon their weight, age, and overall health status. In either population, dosage can be increased gradually if there is no adequate response or relief of symptoms. The maximum dosage varies among different opioids and should not be exceeded under any circumstance without medical supervision.
For opiates like codeine (a naturally occurring opiate), the typical oral starting dose for adults is 15-60 mg every 4-6 hours as needed for pain relief; children would be given a proportionately smaller dose based on their body weight. As with opioids, the optimal dose will depend on individual factors such as type/severity of pain, prior use/dependence/tolerance to opiates or other analgesics etc., so it always needs close monitoring by a healthcare provider.
At what dose is Opiates typically prescribed?
Opiate treatment, such as morphine or codeine, is generally started at a lower dosage which can vary significantly based on the specific drug and the patient's pain level. The dose can then be increased under medical supervision until adequate pain relief is achieved. Doses are typically spaced 4-6 hours apart depending on the formulation and specific medication used. Maximum dosages will depend upon several factors including tolerance to opiates, severity of pain and overall health status of the patient. As with all potent medications, careful monitoring by a healthcare provider is essential during opiate therapy to ensure safety and efficacy while minimizing potential risks such as addiction or overdose. Always follow your doctor's instructions when taking opiates for pain management.
What are the most common side effects for Opioids?
Common side effects associated with both opioids and opiates include:
- Drowsiness/sleepiness
- Mental fog or confusion
- Nausea, vomiting
- Constipation
- Itching or rash
- Dry mouth
- Sweating
- Miosis (constriction of the pupil)
- Decreased libido (sex drive), erectile dysfunction in men
- Respiratory depression (slowed breathing)
More severe side effects can also occur, including dependency and addiction. If you experience any distressing symptoms while taking these medications, it is crucial to seek immediate medical attention.
Are there any potential serious side effects for Opioids?
Opioids and opiates both have the potential to cause serious side effects, including:
- Thoughts of suicide or self-harm
- Signs of allergic reaction such as difficulty breathing, swelling in your face or throat, hives
- Skin reactions: fever, sore throat, burning sensation in eyes; severe skin pain followed by a red or purple rash that blisters and peels
- Vision issues: blurred vision, tunnel vision, eye pain/swelling; seeing halos around lights
- Cardiovascular issues: fast/irregular heartbeats (palpitations), fluttering sensation in chest; shortness of breath leading to dizziness (feeling like you might faint)
- Low sodium levels - symptoms can include headache/confusion/slurred speech/severe weakness/vomiting/incoordination/unsteadiness
- Severe nervous system response – rigid muscles/high fever/sweating/confusion/fast or uneven heartbeat/tremors/fainting.
In addition to these symptoms which are common to both opioids and opiates due to their similar nature and effect on the central nervous system. It is important that if any signs of an opioid overdose occur such as extreme drowsiness/slow breathing/extreme pupil constriction/cold/clammy skin/faint heart rate/muscle weakness that emergency medical attention is sought immediately.
What are the most common side effects for Opiates?
Opiates, which are derived directly from the opium poppy plant, can cause a range of side effects. These include:
- Dry mouth and throat
- Constipation or other gastrointestinal problems such as nausea or loss of appetite
- Sleep disturbances like insomnia
- Sweating excessively
- Feeling anxious or restless
- Confusion or disorientation
- Potential skin rashes
- Unexplained weight loss
Additionally, opiates can lead to frequent urination, headaches, dizziness and muscle or joint discomfort. It is essential to remember that these symptoms may vary in severity among different individuals and should be discussed with your healthcare provider if persistent.
Are there any potential serious side effects for Opiates?
Opiates, while effective for pain relief, can carry a risk of serious side effects. If you or someone taking opiates experiences any of the following symptoms, immediate medical attention is required:
- Difficulty breathing or shallow breaths
- Severe drowsiness or inability to wake up
- Hives or rash
- Swelling in your face, lips, tongue, or throat indicating severe allergic reaction
- Unusual changes in mood and behavior such as agitation, hallucinations or confusion
- Convulsions (seizures)
- Severe constipation
- Nausea and vomiting that doesn't stop
- Extreme fatigue with loss of coordination causing balance problems
Remember that misuse of these drugs can lead to dependence and addiction. Always follow your doctor's instructions when using opiates for pain management.
Contraindications for Opioids and Opiates?
Like Wellbutrin and Prozac, opioids and opiates can also exacerbate certain symptoms. They can increase feelings of depression or anxiety in some individuals. If your mood worsens significantly, or you experience suicidal thoughts while on these medications, it's crucial to get medical help right away.
Neither opioids nor opiates should be taken if you are using or have recently stopped using monoamine oxidase (MAO) inhibitors. It is essential that you inform your physician about all the drugs you are currently taking; MAOIs require approximately 5 weeks to leave your body completely in order to avert dangerous interactions with opioids and opiates.
Remember that usage of both opioid and opiate medications carries a high risk for dependence and addiction due to their potent pain-relieving effects. Hence, they must always be used cautiously under professional supervision. Never attempt self-medication with these substances as the consequences can be severe.
How much do Opioids and Opiates cost?
For the brand name versions of these drugs:
- The price for a month's supply (30 tablets) of OxyContin, a popular opioid, is around $380. This works out to approximately $13/day if you are using 40 mg per day.
- A full month's supply of morphine sulfate ER, an opiate, costs roughly between $50-$200 depending upon the dosage and brand. Even at higher dosages like 60 mg per day, this can work out to be less than OxyContin with prices falling in the range of about $1.66 - $6.66/day.
Thus, if you are on a higher dose (i.e., more than 40mg), then Morphine sulfate ER may be less expensive on a per-day treatment basis compared to OxyContin.
For generic versions of opioids and opiates, costs are significantly lower:
- Oxycodone HCL (10 mg tablets) is available in packs starting from 30 tablets up to larger quantities. Costs can vary drastically based on insurance coverage but typically fall within the range of ~$0.67 - ~$2 per tablet.
- Generic morphine sulfate ER ranges in cost from about $0.33 - ~$3 per tablet based on strength and quantity purchased.
Remember that while cost is one factor when choosing medication options, it should not dictate your decision entirely – always consult with your healthcare provider for personalized advice appropriate for your needs and health status.
Popularity of Opioids and Opiates
Opioids, a broad category of drugs including synthetic and semi-synthetic substances, were estimated to have been prescribed to about 153 million people in the US in 2020. Opioids accounted for around 58% of pain management prescriptions in the US. However, it appears to be most commonly used class of analgesics despite their high potential for addiction and overdose. The prescription rate for opioids has been generally decreasing since its peak in 2012 due to increasing awareness about opioid addiction crisis.
On the other hand, opiates which are natural products derived directly from opium plant like morphine and codeine were prescribed to approximately 13 million people in the USA during 2020. In terms of overall painkiller prescriptions across the country, opiates make up just under a modest percentage compared largely due their lower potency than many synthetic opioids as well as concerns over dependency issues associated with them. The prevalence flow is quite stable over time but there has been a slight decrease noticed recently because of stringent regulatory control.
Conclusion
Both opioids and opiates have a long-standing record of usage in patients suffering from moderate to severe pain, with numerous clinical studies indicating their effectiveness. Both classes of drugs work by binding to opioid receptors in the brain, reducing the perception of pain. The terms are often used interchangeably, but there is a distinction: opiates refer specifically to natural substances derived directly from the opium poppy plant, like morphine and codeine; while opioids include not only these natural substances but also semi-synthetic derivatives such as hydrocodone and oxycodone, as well as fully synthetic versions like fentanyl.
Prescription decisions between these two drug classes depend on various factors including the type and severity of pain experienced by the patient. While both are effective for managing acute postoperative or cancer-related pains, they should be used judiciously due to potential side effects which can include constipation, drowsiness, nausea/vomiting and respiratory depression.
Addiction risk is substantial with both opiates and opioids due to their high potential for dependence. Therefore it's crucial that patients under treatment closely monitor their reactions especially when starting treatment or changing doses - any signs suggestive of developing addiction should prompt immediate medical attention.
The availability in generic form represents significant cost savings for many patients who must pay out-of-pocket costs — although this varies depending on specific medication within each class.
In summary: while opioids' broader range includes more potent options than typical opiates (which might make them preferable for severe pain), each has its place based on individualized assessment considering factors like kind/intensity of pain alongside patient's overall health status plus other concurrent medications being taken.