What are opiates?
What are opiates?
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What are opiates?
Opiates are natural substances derived from the opium poppy (Papaver somniferum). These compounds are among the oldest known painkillers and have been used in medicine for centuries. They act directly on the central nervous system, where they activate specific receptors responsible for pain perception. By binding to these receptors, opiates block the transmission of pain signals to the brain, effectively relieving pain. Well-known opiates such as morphine and codeine are among the most potent natural painkillers and play a particularly important role in modern pain management, as they are often used for pain that cannot be treated with other medications. However, due to their strong effects, opiates also carry a risk of dependence, which is why their use is usually strictly regulated.
Difference between opiates and opioids
Although the terms "opiates" and "opioids" are often used interchangeably, there is an important distinction between them. "Opiates" refers exclusively to natural substances that are directly derived from the opium poppy, such as morphine and codeine. In contrast, the term "opioids" is broader and includes all substances that can bind to the opiate receptors in the body. This also covers synthetic and semi-synthetic compounds like fentanyl, oxycodone, or methadone. These synthetic opioids are often much more potent than natural opiates and can be specifically tailored in their effects, making them particularly valuable for medical purposes, but also more risky. Because synthetic opioids are widely used in medicine, the term "opioids" is often preferred to describe this entire class of substances.
Which medications belong to the opiates?
Some of the best-known medications containing natural opiates are morphine and codeine, both of which play important roles in pain management. Morphine is primarily used to treat severe, acute pain, such as after surgery or in cancer patients. Its pain-relieving effects are intense and relatively long-lasting, making it especially useful for chronic pain. Codeine, on the other hand, is often included in cough suppressants and milder painkillers, as it has a weaker analgesic effect and causes fewer side effects than morphine. Opium, which is obtained from the dried latex of the opium poppy, also contains a mixture of natural opiates and was historically used as a painkiller. Today, pure opium is rarely used in modern medicine, as isolated active ingredients like morphine or synthetic alternatives are more targeted and can be dosed more precisely.
Natural opiates: Endorphins and their effects
An interesting aspect of opiate research is the discovery that our bodies produce their own opiate-like substances. These so-called endorphins are the body's natural painkillers and bind to the same receptors as opiates and opioids. They are released during certain activities, such as exercise, stress, laughter, or intense emotional moments, creating a natural sense of euphoria and reducing the perception of pain. This phenomenon is also described as the "runner’s high," when people experience a strong sense of well-being after long runs. Endorphins are part of the body's natural pain defense system and demonstrate that pain perception and well-being are closely linked. Understanding the body’s own opiates has also influenced the development of synthetic painkillers, which aim to mimic these natural processes.
Opiates as painkillers: When and why they are used
Opiates play a particularly important role in modern medicine when it comes to treating severe or chronic pain that cannot be adequately relieved by conventional painkillers. Typical areas of use include cancer pain, postoperative pain, and certain chronic pain syndromes. For cancer patients, opiates are often used when pain significantly interferes with daily life and greatly reduces quality of life. They can also help relieve acute pain after major surgeries, allowing patients to recover more comfortably. In pain management for chronic pain that does not respond to other medications, opiates may also be an option, but usually only under strict medical supervision to minimize side effects and the risk of dependence. Dosage is carefully adjusted and often combined with other painkillers to keep the amount of opiates as low as possible.
Risks and side effects of opiates
Despite their pain-relieving effects, opiates also have numerous side effects that can be particularly problematic with long-term use. The most common side effects include nausea, constipation, fatigue, and in some cases, slowed breathing, known as respiratory depression. This respiratory depression is especially dangerous in cases of overdose and can be fatal in the worst case. In addition, prolonged use carries a significant risk of developing physical and psychological dependence. The body becomes accustomed to the substances, so higher doses are needed to achieve the same effects—a process known as tolerance. If use is stopped abruptly, severe withdrawal symptoms may occur, such as restlessness, insomnia, sweating, and pain. For this reason, the use of opiates is carefully considered and usually prescribed only when the benefits outweigh the potential risks.
Opiates as a Drug: Abuse and Addiction
A particular risk associated with opiates is misuse, which poses a serious danger especially with potent variants such as heroin. Heroin is produced from morphine and is one of the most well-known illegal opiates. Due to its strong and rapid effects, it quickly leads to dependence and has driven millions of people worldwide into addiction. The misuse of opiates can have severe health consequences, including a rapid decline in physical health, organ failure, and a high risk of overdose, especially when the purity and dosage of the substances are uncontrolled. In many countries, the misuse of prescription opiates has also become a serious problem, as the availability of these medications can unintentionally contribute to the development of dependencies. Opiate dependence is difficult to overcome and usually requires a combination of medical support, therapy, and social assistance.