Talk:Opiate

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 August 2018 and 7 December 2018. Further details are available on the course page. Student editor(s): Dschaefer5326 (article contribs). Actually, the broadest term is "opioid", which is any substance, natural or synthetic, that behaves like morphine in the body. The term "opiate" is generally understood to mean only those opioids that occur naturally, or are derived from them. Examples of opioids that would not be opiates are the synthetics fentanyl and methadone.

This would be a fairly major revision, so what do others think about making it? --Phil Karn

Go for it. Only opioids in my opinion are really a class of chemical compounds that show affinity to opioid receptors. Kpjas

I know that opiates are much more readily available from the seed pod and other parts of the straw than they are from the seed. I would recommend changing the text to reflect this by replacing "seed" with "seed-pod" in the article. -- Morelos jejje

Heroin

Heroin is not a natural occurring alkaloid, so is not an opiate. There can be some confusion between the words opiate and opioid, but there is not in a voice about opiates. There is yet a large heroin and a opioid voice, so I have removed the heroin part here.

Heroin is not classified as an opioid (eg. oxycodone or hydromorphone). It is an "opiate". It is a pro-drug for the systemic delivery of morphine, nothing more. Morphine is converted into "heroin" through a very simple process and in vivo, it is reverted back into morphine. Their chemical structures are identical execpt for the two acetyl groups attached. Their pharmacology is also identical. Do you know why? Because it is morphine that does the work, while the acetyl groups act as some sort of propeller. It doesn't take much brainpower to figure this out, really. TheGoodSon

Of course heroin is an opioid. An opioid is anything that acts on the opioid receptors (has morphine-like action), including all opiates. However, an opiate is an alkaloid naturally occurring in the opium poppy, which heroin is not. Heroin is derived from morphine, but oxycodone and hydrocodone are derived from codeine or thebaine, and that doesn't make them opiates. They're called semisynthetic opioids, as is heroin. Your references do not state anywhere that heroin is an opiate or that it's not an opioid. The term "opiate" is sometimes used in place of "opioid" (where someone would even class a completely synthetic opioid like pethidine as an "opiate") in casual use, but Wikipedia should be technically correct.

OK, I just looked at a couple online medical dictionaries (http://cancerweb.ncl.ac.uk/omd/ and http://www.nlm.nih.gov/medlineplus/mplusdictionary.html). Apparently "opioid" traditionally didn't encompass the opium alkaloids (I wonder if it encompassed endogenous compounds with morphine-like action, but maybe they hadn't been discovered yet), and "opiate" is used in a broader sense. At any rate, I want to reiterate that this is a discussion of semantics, and has nothing to do with the fact that heroin is a prodrug. And I personally think that the definition of "opioid" that says "anything that acts on the opioid receptors" and the definition of "opiate" as "an alkaloid naturally occurring in opium" are more precise and avoid a lot of ambiguity about semisynthetics, endogenous opioids, etc. and whether "derived from opium" means "separated out of opium" or "chemically derived from an opium alkaloid". Or (perhaps better) we could talk about the two definitions and what each encompasses. But there's no reason to single out heroin. --Galaxiaad 14:30, 21 August 2007 (UTC)

Hi Galaxiaad, I am going to have to disagree with you. There is a very good reason to single out heroin (vs. oxycodone, hydrocodone or other "semi-synthetics"). You have to understand that the conversion of codeine into hydrocodone is very sophisticated and complex, unlike the conversion of morphine into heroin. What happens with the codeine (in it's conversion into hydrocodone), is that the codeine is broken down and it's chemical structure is significantly altered. If you took a look at all the "semi-synthetic" opioids, you'd notice that they are all very similar in structure (oxycodone and hydrocodone are very similar to codeine; while hydromorphone and oxymorphone are much more similar to morphine). Using morphine to get hydromorphone, is again, very complex and sophisticated. The morphine molecule is significantly altered. Getting diamorphine (out of morphine) is a very simple process that can be done at home by amateurs (if one had freebase morphine). All it requires is some acetic acid and heat and that's it. The morphine molecule is NOT changed one bit, but two acetyl groups attach themselves to morphine - making it more lipid soluble (which is why it delivers more morphine to the brain, faster). So, there is a significant difference between oxycodone, hydrocodone, and other semi-synthetics vs heroin. First, neither of the former are prodrugs (you may be able to make a case for oxycodone, as it is metabolised into oxymorphone, which plays a small role in the analgesic efficacy of oxycodone). Second, the chemical structures of the semi-synthetics are vastly different from each other and their parent drugs (be it codeine or morphine). Heroin, however, has the exact chemical structure as morphine does, except for the two acetyl groups. Numerous studies have been done on the similarities between heroin and morphine. In fact, you can find one in the morphine article.

I would, however, like to say that, you are right in saying that heroin is not an alkaloid. It's not, but because of it's chemical structure and similarities to morphine (both pharmacologically and chemically), it is often considered to be an opiate, as opposed to opioid. In which semi-synthetic opioid does morphine itself play such a role in alleviating pain, suffering, etc as it does with heroin? None! TheGoodSon —The preceding signed but undated comment was added at 04:26, August 22, 2007 (UTC).

I still don't agree with you. I wish someone else would weigh in on this discussion... or maybe sometime soon I'll try and rewrite those parts highlighting the controversy about terminology. Again, if you actually have any references saying that because heroin is so similar to morphine (something I don't disagree with), it's considered an opiate, that would really help your case. --Galaxiaad 15:15, 23 August 2007 (UTC)

I am in total agreement with Galaxiaad. Lets make this nice and simple. What does the SCIENTIFIC community define an opiate as? An alkaloid present in the Papaver somniferum plant. This article begins by defining an opiate as "...any of the narcotic alkaloids found in opium.". So far so good. So lets run a little test to see if heroin is an opiate. To make this simpler lets use the chemical name, diacetylmorphine. Alright here we go, is morphine an opiate? YES. Is codeine an opiate? YES. Is diacetylmorphine a pro-drug of morphine? YES. Is diacetylmorphine any of the following: morphine, codeine, thebaine, oripavine, or papaverine? NO. That is a negative. Unequivocally No! Has diacetylmorphine EVER been found the opium poppy? NO! For the last time, please god don't make me ever have to discuss again, NO! Diacetylmorphine "heroin" has never been found in the resin or plant material of the opium poppy. Therefor it can tap dance all around the god damn universe, it has never been and will never be an opiate. This is so simple it's making me want to blow my brains out. This is like black and white. Heroin is not an alkaloid found in opium, therefor by definition it is not an opiate. Diacetylmorphine != morphine, it can change into morphine all it wants, that doesn't make the original chemical change as well. That is the nature of time. Diacetylmorphine becoming morphine doesn't mean that it was morphine to begin with. Now please, I've gone on way longer than was needed (hopefully). So please just follow the rules of science and stop trying to call heroin an opiate. In the next day or so I will remove the significant mentions of heroin from this article. Along with the casual non encyclopedic tone. Remember, addiction potential is non quantifiable. Therefor, "highly addictive" is meaningless. Unfortunately that's not all. Remember, here on wikipedia you must cite sources for data such as this: "with as little as three days usage resulting in withdrawal symptoms when use is terminated". Who says a physical dependence can form in as little as three days? What dosages were used when this was tested? Who were the test subjects? Was a double blind conducted? Without citing a source that provides this kind of information (and hopefully much much more) the claim that a physical dependence can form in three days is absolutely useless. There is one more part that must be addressed (pretty much making the whole section a problem):

"The fact that heroin is so widely and destructively abused, however, has to date made the regulatory commissions of most countries loath to appear to give heroin any legitimacy by allowing any medical uses."

The first problem is the claim that heroin widely used, citing a source that had done a study on percentage of heroin users in a number of populations would provide far more information and provide credibility. The second is the implication that the majority of recreational heroin use is destructive. Although not said directly it is implied. The problem with an attempt to claim that the majority or even a significant amount of heroin use is destructive is that responsible users of heroin do not advertise there presence. Due to its illegality in the majority of the world, it is only those who experience negative consequences from heroin use that are seen by the public, researchers, or law enforcement. This makes any claim to destructive effects of heroin hard to defend without careful study. Third, the use of the word abuse or abused does not reflect a NPOV. It is far simpler to either say "use" or use one of those handy adjectives to change it to reflect a specific circumstance. For example, "John buys one 20 bag of heroin a week. On Friday night every week John uses his heroin. Gary buys one 40 bag of heroin every day. His heroin use has become problematic, he is now having trouble paying rent." Or "Kens destructive use of heroin has resulted in the loss of his car, apartment, and job." Now we are simply describing what has happened rather than passing judgment.

Fourth and almost last. The use of the word loath is really tough to use in an encyclopedia. To loath something is to dislike it to the highest degree. To loath a person is to be hostile to every aspect of their being. In some cases loath implies disgust, sometimes even a physical response to said disgust, such as nausea. Loath is such a strong word that it is my opinion that the only accurate use of the word can be by the individual experiencing the loathing. Using it to another parties reaction is almost impossible. Finally (yes it's true), by claiming that the resistance to allowing medical use of heroin in many areas is due to a desire to avoid granting it "legitimacy" causes a whole host of problems. First you must provide an area that said medical use provides legitimacy for. Does it give legitimacy to its medical use? If so, then any worry about granting legitimacy to its medical use is unfounded, as the medical use would only occur if it did in fact have legitimate medical uses. If the concern is that medical use will grant legitimacy to general use, how does either allowing or disallowing a particular use grant legitimacy? It is the positive and negative effects that grant legitimacy, not simply public opinion or the opinion of a regulatory committee. If one is examining recreational use, it has already attained legitimacy. Legitimate is defined as "being exactly as purposed : neither spurious nor false". So lets look at recreational use. Is the recreational user using heroin for its enjoyable effects? Yes, that is the definition of recreational use. Therefor its purpose in that situation is to produce pleasure. Making its use legitimate.

SO! If you subject yourself to reading this entire diatribe I hope that it is clear now why heroin is not an opi opiates.

Should someone choose to return this article to its previous state I fear that this must be taken to the higher authorities. It does NOT matter what you believe heroin should be classified as. The fact of the matter is that under the rules established by the scientific and medical communities for the classification of compounds as either opiates, opioids, semi-synthetic opioids, or fully synthetic opioids; heroin IS NOT AN OPIATE. Wikipedia is not for opinion it is for fact.

Foolishben 08:33, 27 September 2007 (UTC)

I'm sorry to say there is yet another problem that was not addressed. This claim made in the Overview: "Codeine, morphine and heroin metabolites are so similar, that it is impossible to distinguish whether heroin, codeine or morphine has been taken when low concentrations of opioids are found in the urine.", is completely false. Heroin is metabolized into 3-monoacetylmorphine and morphine, codeine is metabolized into morphine. The only reason morphine or codeine could not be distinguished from heroin is that the amounts used were to small for a measurable amount of 3-MAM to be present in the test subjects urine. This cannot be used to support the false claim that heroin is for all intents and purposes identical to morphine, or that heroin is an opiate. Science has ruled. HEROIN IS NOT AN OPIATE. Stop messing with this page.

I just edited the Overview section rather heavily, which was necessary due to typos and general unreadability. I also took pains to distinguish between naturally occurring OPIATES and synthetic OPIODS. It appears that some who have edited this page assume that their own use of the substances in question makes them authorities, which they clearly are not. I believe that most editors who are concerned with medical and scientific accuracy in this article will find my edits to be satisfactory. And, one final suggestion: we should leave the discussion of the precise metabolic pathway heroin takes upon administration to the heroin page and agree to abide by the established conventions for distinguishing between natural and synthetic opium products. R0m23 (talk) 21:35, 29 May 2008 (UTC)

This is an old discussion, but what none of the people in this discussion do is CITE THEIR SOURCES. I'm perfectly willing to accept that heroin is not an opiate, but for God's sake CITE!!! I'm not even clear about whether opiates are a subset of opioids or vice versa, or if they are two entirely separate classifications. Foolishben in particular is ranting and raving about this with no appeal to authority other than his own. I'm not going to contact him now as I'm not making any changes, but please people, in the future, back up what you say with references. They can even be incorrect!!! Just something other than "I say it's scientific, so it's authoritative." Cuvtixo (talk) 15:01, 1 April 2017 (UTC)

Reference 6 does not support statement about morphine-induced pulmonary edema

Statement: "Although uncommon, reports of morphine-induced pulmonary edema are not unheard of.[6]" Reference 6: Wang WS, Chiou TJ, Hsieh RK, Liu JH, Yen CC, Chen PM (Oct 1997). "Lethal acute pulmonary edema following intravenous naloxone in a patient received unrelated bone marrow transplantation". Zhonghua Yi Xue Za Zhi (Taipei) 60 (4): 219–23. PMID 9439052.

Reference 6 does not support statement about morphine-induced pulmonary edema. Instead, reference 6 is about naloxone-induced pulmonary edema.

-- Meesther

Clarification with regard to thebaine

While thebaine is indeed a minor component of opium, this compound is not primarily obtained from opium but from P. bracteatum or more recently from special cultivars of P. somniferum for legal extraction directly from plant biomass. I needed to clarify this, since thebaine does not participate in the narcotic effect of opium, and is not a main constituent thereof. Since, these are potent pharmacological agents under international control, correct statements are imperative to avoid confusion and misinterpretations. — Preceding unsigned comment added by Osterluzei (talk • contribs) 02:03, 13 February 2011 (UTC)

Clairification

Thebaine is one of the alkaloids present in opium. The relative amount, or usual commercial source, is irrelevant. It is, has been, and always be an opiate. — Preceding unsigned comment added by 75.73.1.89 (talk) 06:18, 23 April 2013 (UTC)

Copyright problems

This article was tagged for copy-paste concerns. Evaluation shows that content entered in May 2007 duplicates content from poppies.org which is, unfortunately, not compatibly licensed with Wikipedia (see their terms of service). Other content added by this contributor may need to be checked for copying. Any assistance in rewriting the article to remove this material by interested editors would be much appreciated, since otherwise it may simply need to be excised. --Moonriddengirl ^(talk) 00:42, 11 March 2012 (UTC)

Article could use a major overhaul

This article is in sorry shape. The article does not even mention the cardinal effects of opiates (euphoria, analgesia, sedation, resp. depression etc.); the bulk of the content is contained in the section about individual alkaloids and is often not even relevant, eg. the first thing noted about morphine is that it does not cause pulmonary edema as often as heroin. This is true but hardly the first thing worth noting abour morphine ("Morphine is the principle active in opium, and is the gold standard by which all other narcotics are measured" would be a good one, etc.).

This is a fairly important article given the crucial importance of opiates in medicine; by comparison, look at Morphine! That article arguably has more information about opiates in general in it than this article does itself! IforgotAboutSemiProtection (talk) 00:48, 30 June 2012 (UTC)

Opioid is pretty thorough. Maybe that's what you're looking for?CrocodilesAreForWimps (talk) 04:37, 13 February 2013 (UTC)

As above... Conflicting definitions of opioid.

It appears that you folks are aware of the conflicting definitions of opioid here and in the opioid article. Here opioids include opiates; there opioids are exclusive of opiates. Here morphine is an opioid; there morphine isn't an opioid. Both definitions exist as do editors' opinions. Neither definition is wrong. However Wikipedia needs to settle on a consistent definition. I learned the inclusive definition but the exclusive definition might reduce ambiguity. Nonetheless I believe the most common accepted use needs to be considered.

I sense the editors here and there may be as different as the definitions. This central issue needs to be discussed and here and at the opioid article talk page and resolved by a common consensus. To use a bad pun, you need to get on the same page. Box73 (talk) 11:26, 4 October 2015 (UTC)

I address this under the Heroin section of this Talk page. I think it worthwhile to repeat CITE YOUR SOURCES! Right here on the Talk page. The common accepted use isn't really an issue to discuss at this point, because editors are bickering over these definitions with no references here. If we have conflicting definitions that are cited, we can then debate which source is more authoritative. And this doesn't include arguing that one definition is more "scientific". That's a moot point if you don't have a citation. Cuvtixo (talk) 15:08, 1 April 2017 (UTC)

Winnner! Just found a good one on the Opioid page. Hemmings, Hugh C.; Egan, Talmage D. (2013). Pharmacology and Physiology for Anesthesia: Foundations and Clinical Application: Expert Consult - Online and Print. Elsevier Health Sciences. p. 253. ISBN 1437716792. "Opiate is the older term classically used in pharmacology to mean a drug derived from opium. Opioid, a more modern term, is used to designate all substances, both natural and synthetic, that bind to opioid receptors (including antagonists).

Okay, I looked at the Opioid page and judged it to be more authoritative, and newer, citing scientific publications rather than just a definition from an online dictionary. As well changing the introduction I find the former definition differentiating passage here confusing as well as too lecturing or chastising in tone. Note a big problem there, although a scientific book is cited, is that it extensively defines "opioid", when this article is about "opiates", which are simply a subset of opioids, as admitted to in the passage. Several not-opiate opioids are mentioned and linked to articles. Such definitions should be moved to Opioid, rather than reverting here, or included in a new article about Synthetic and/or Semisynthetic Opioids. If it simply defined opiates further there would be no issue. Cuvtixo (talk) 15:54, 1 April 2017 (UTC) For clarification: apparently "opioid" used to strictly be synthetic chemicals not derived (or directly derived) from opium. Opiate was for those that were derived from opium. There were (and still are) differences of opinion whether "semi-synthetic" substances like heroin should belong to one or the other category. Recently, it seems opioid is being used for all; derived from poppies, semi-synthetic and synthetic. https://www.naabt.org/education/opiates_opioids.cfm Opiates are drugs derived from opium. At one time "opioids" referred to synthetic opiates only (drugs created to emulate opium, however different chemically). Now the term Opioid is used for the entire family of opiates including natural, synthetic and semi-synthetic. http://detoxanswers.com/.../opiate-vs-opioid-what-is-the-difference-between-opiate-and-opi... Sep 5, 2016 - An opiate is a substance derived from the poppy plant (which contains opium). Opiates are sometimes called "natural" since the active ... http://opium.com/derivatives/opiate-vs-opioid-whats-difference/ Opiate vs. Opioid. Opiates or opiate drugs originate from naturally-occurring alkaloids found in the opium poppy plant. ... Opiate drug types include heroin, opium, morphine and codeine. Both opiates and opioids are in some way derived from opium. Cuvtixo (talk) 16:50, 1 April 2017 (UTC)