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Synthetic and Semi-Synthetic Opioids: Types and Effects

Synthetic and Semi-Synthetic Opioids: Types and Effects

Synthetic and semi-synthetic opioids are made from the extracts of the opium poppy plant. Here, we break down how they differ, their uses, and associated risks.

In 2021, 107,622 Americans lost their lives to a drug overdose. Of these, opioid overdose was responsible for more than 70,000 deaths. For context, this is roughly twice the number of accidental casualties each year!

Unfortunately, doctor prescriptions are the major reason for the current state of the opioid epidemic that affects 2.7 million people. Research shows 4 out of 5 opioid use disorders begin with a prescription opioid. This is unsurprising given that 43% of all doctor prescriptions in the U.S. contain opioids. In other countries, this number is almost twice that. 

This article will dissect two types of opioids, synthetic and semi-synthetic, as well as answer all of your questions about them. Read on to learn more. 

What are Opioids and How do they Work?

Opioids are a medication class that structurally resembles the natural plant derivatives of the poppy plant (Papaver somniferum). They act by binding to specific receptors (in the brain and spinal cord) and suppressing signal transmissions between different parts of the body. This is how opioids relieve pain and cause feelings of euphoria. 

The Types of Opioids

types of opioids

What is the Difference Between Opiates and Opioids?

Although most people use the terms opiates and opioids interchangeably, they are not the same. 

Opiates refers only to the naturally occurring opioid products. While opioids is a broad term that includes opiates and synthetic/semi-synthetic opioids.

Are Opioids Legal in the United States?

Only healthcare practitioners licensed with the Drug Enforcement Administration (DEA) can prescribe opioids in the United States. 

The DEA classifies opioids into five groups (called schedules) based on their addiction potential. These are:

  • Schedule I: These have the highest potential for misuse and addiction. Schedule I opioids have no medicinal use. Examples include: heroin,, methaqualone.
  • Schedule II: These have a lower addiction risk than schedule I opioids and doctors can prescribe them for medical use when necessary. Examples include: fentanyl, oxycodone, hydromorphone, meperidine, morphine, and methadone.
  • Schedule III: These are safer to use than schedule II opioids. An example is benzphetamine, Buprenorphine (Suboxone).
  • Schedule IV: This includes the analgesic tramadol.
  • Schedule V: These are the safest opioids with the lowest addictive potential. An example is codeine. 

Synthetic Opioid Uses

The following synthetic opioids are FDA-approved for medical use:

  • Fentanyl (Sublimaze): Doctors can use fentanyl as an anesthetic agent for complicated surgical procedures and to relieve pain associated with advanced stage cancer. 
  • Methadone (Dolophine): This is FDA-approved to treat Opioid Use Disorder (OUD).
  • Tramadol (Ultram): Physicians can prescribe tramadol on a short-term basis for moderate to severe pain.

Semi-Synthetic Opioid Uses

Most semi-synthetic opioids (with the exception of buprenorphine) are FDA-approved as pain medications. Buprenorphine, on the other hand, is an effective treatment for Opioid Use Disorder (OUD). 

Here is a list of all FDA-approved semi-synthetic opioids:

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The Dangers of Synthetic and Semi-Synthetic Opioids

Given their addictive potential, opioids (and opiates) are potentially dangerous medications. Users will usually go through three stages if they misuse opioids. These are:

  • Stage 1 (Tolerance): As users continue to take opioids to relieve pain, they need to take increasing dosages to achieve the same results. This is because continuous opioid use alters the brain chemistry requiring greater doses of opioids to achieve the same effect. 
  • Stage 2 (Dependence): Regular opioid misuse, without medical supervision, eventually leads to dependence. This refers to the compelling drive to use opioids regardless of its consequences on overall wellbeing. 
  • Stage 3 (Addiction): This refers to a compulsive and irresistible urge to continue to use opioids. Like any other chronic disease, addiction often involves cycles of relapse and remission. If left untreated, it can be fatal

Other Side Effects

Other side effects of opioids

Confidant Health Uses Evidence-Based, Medication-Assisted Treatments to Help you Combat Opioid Use Disorder

Confidant health — a state of the art virtual clinic — combines the most effective medications with behavioral therapy to help you overcome Opioid Use Disorder (OUD). So you can get the help you need, without leaving the comfort of your house.

Begin your treatment by getting in touch with one of our experts today!

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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