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What Is the Difference Between Narcotics and Opioids?

Table of Contents

Both narcotics and opioids are painkillers. Some people use the terms interchangeably. But technically, some narcotics aren't opioids at all.

Doctors overwhelmingly agree that they should use plain language when speaking to patients. There is a lot of jargon in the healthcare world; some studies show that doctors use up to 70 terms their patients don't understand in a single visit![1]

Here's what you should know about the terms narcotic and opioid.  

What Are Narcotics?

A narcotic is a painkiller. The term narcotic comes from the Greek word for stupor, and the original term referred to anything that could dull senses and therefore relieve pain.[2]

These days, because the vast majority of pain medications are opioids, some people use the term “opioids” and narcotics” synonymously although technically narcotic is a more broad term that refers to any painkiller, opioid or nonopioid.[3]

Plenty of non-opioid medications exist, including ibuprofen, acetaminophen, and aspirin.[4] Some people find that these medications are enough to quell pain, while others may require narcotic medication.

If your doctor proposes treating your pain with a narcotic, it's best to ask for clarification. Ask your doctor about the risks and benefits of any treatment for pain. 

What Are Opioids?

Opioids are a type of narcotic painkiller that are derived from the poppy plant or synthesized in a lab. Natural versions (like opium or heroin) come from poppy plants, while lab-created versions (like Vicodin) are synthesized. [5]

Opioids are powerful, and they can be helpful for people in a great deal of acute pain.[6] But they are also associated with significant problems, including overdose deaths and physical dependence. [5]

Differences Between Opioids & Narcotics 

To some people, there is no difference between an opioid and a narcotic. Your doctor may use these terms interchangeably. However, technically opioids are a subclass of narcotics, as described above. 

Who Determines What Drugs Are Legal? 

The Controlled Substances Act, enforced by the Drug Enforcement Administration, places substances into schedules.[7] In general, the lower the number on the schedule, the more dangerous the substance is thought to be.

When officials determine drug schedules, they consider these aspects of the drug:[7]

  • Potential for abuse 
  • Scientific value 
  • Research background 
  • History of abuse 
  • Significance of abuse 
  • Risk to public health 
  • Dependence potential 
  • Relation to other controlled drugs

Opioids appear at almost every level within the schedule. Over-the-counter drugs with a limited amount of codeine are Schedule V drugs, while substances like heroin are Schedule I. Non-opioid narcotics are typically Schedule V drugs.[8]

Sources

  1. Eradicating Jargon-Oblivion: A Proposed Classification System of Medical Jargon. Journal of General Internal Medicine. https://link.springer.com/article/10.1007/s11606-019-05526-1. November 2019. Accessed June 2022.
  2. Drug Fact Sheet. Department of Justice Drug Enforcement Administration. https://www.dea.gov/sites/default/files/2020-06/Narcotics-2020.pdf. 2020. Accessed June 2022.
  3. Narcotic. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/narcotic. Accessed June 2022.
  4. Non-Opioid Treatment. American Society of Anesthesiologists. https://www.asahq.org/madeforthismoment/pain-management/non-opioid-treatment/. Accessed June 2022.
  5. Opioids. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/opioids. Accessed June 2022.
  6. Opioid Medications. U.S. Food and Drug Administration. https://www.fda.gov/drugs/information-drug-class/opioid-medications. March 2021. Accessed June 2022.
  7. The Controlled Substances Act. United States Drug Enforcement Administration. https://www.dea.gov/drug-information/csa. Accessed June 2022. 
  8. List of Controlled Substances. U.S. Department of Justice Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/schedules/. Accessed June 2022.

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 she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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