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What’s the Difference Between Opium & Heroin?

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Apr 29, 2023 • 5 cited sources
dried poppy head

Opium and heroin are two opioids, with heroin being the more refined and potent of the two drugs. Heroin is also much more common. Opium is rarely used in the United States. 

Both heroin and opium are dangerous. Both drugs are highly addictive.

What Makes Opium & Heroin Different?

Opium and heroin are two opioids, but heroin is more refined.[1] Opium is essentially the “base” opioid, derived from the seeds of poppy plants. Heroin is made from morphine, which is itself produced through an extraction process involving opium resin or poppy straw. 

As a general rule, drugs that are “further refined” tend to be more potent. Put another way, heroin is therefore generally more potent than opium and may therefore be even more dangerous. 

What Are the Similarities Between Opium & Heroin?

Opium and heroin are both opioids. Because of this, they both have very similar effects, even if heroin is more potent.[2] 

These drugs act on opioid receptors in the body, activating them. This causes a variety of effects, including a surge of dopamine and euphoria. This surge of dopamine is part of what makes both drugs addictive. The brain and body essentially learn that the opioid use is rewarding through this increase in dopamine.[3]

Both drugs relieve pain and have at times been used historically for pain control. Heroin especially was once considered an extremely valuable drug in medicine, although doctors better understand the dangers of opioids now. When they are appropriate for a patient, doctors prescribe different opioids for pain relief. Heroin is currently a category I drug in the United States meaning it does not have any accepted medical use, and its risks outweigh its benefits. 

Both opium and heroin have a number of serious health risks, one of the most notable being their overdose potential. Opioids cause respiratory depression.[4] This can be fatal or lead to permanent brain damage. 

Does Either Opium or Heroin Have Legitimate Uses?

There are opioid derivatives that are used for pain control, including drugs like morphine, oxycodone and hydrocodone. Neither heroin or opium are generally considered to have legitimate uses in modern medicine in the United States. These drugs should be considered dangerous and avoided.

Does the Type of Opioid Misuse Affect Addiction Treatment?

Treatment for opioid use disorder (OUD) doesn’t usually vary much depending on the type of opioid a person uses. The ideal approach to treating dependence on any opioid – legal or illegal – is Medication for Addiction Treatment (MAT). MAT combines the use of medications, such as Suboxone or other buprenorphine-naloxone combination drugs, with cognitive behavioral therapy.[5] Reach out to us at Bicycle health to learn more.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. Opiates or Opioids — What's the Difference? Oregon Alcohol and Drug Policy Commission. Accessed March 2023.
  2. Opioids. Johns Hopkins Medicine. Accessed March 2023.
  3. The Neuroscience of Drug Reward and Addiction. Physiological Reviews. September 2019. Accessed March 2023.
  4. Understanding and Countering Opioid-Induced Respiratory Depression. British Journal of Pharmacology. June 2021. Accessed March 2023.
  5. Effective Treatments for Opioid Addiction. National Institute on Drug Abuse. November 2016. Accessed March 2023.
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