Was sind Opiate? Wirkung, Nutzen & Risiken

What are opiates?

Opiates are natural substances extracted from the opium poppy (Papaver somniferum). These substances are among the oldest known painkillers and have been used medicinally for centuries. They act directly on the central nervous system, where they activate certain receptors that are responsible for the perception of pain. By binding to these receptors, opiates block the transmission of pain signals to the brain and thus effectively relieve pain. Well-known opiates such as morphine and codeine are among the strongest natural painkillers and play a particularly important role in modern pain therapy, as they are often used for pain that cannot be treated with other means. However, due to their strong effect, opiates also carry the risk of addiction, 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 difference between them. While "opiates" only includes natural substances derived directly from the opium poppy (such as morphine and codeine), the term "opioids" is broader and includes all substances that can bind to the opiate receptors in the body. This also includes synthetic and semi-synthetic substances such as fentanyl, oxycodone or methadone. These synthetic opioids are often much stronger than natural opiates and their effects can be specifically adjusted, which makes them particularly valuable for medical purposes, but also more risky. Due to the widespread use of synthetic opioids in medicine, the term "opioids" is often preferred to describe the entire class of these substances.

Which drugs are opiates?

Some of the best-known drugs containing natural opiates are morphine and codeine, both of which have important applications in pain therapy. Morphine is mainly used to treat severe, acute pain, for example after surgery or in cancer. Its analgesic effect is intense and relatively long-lasting, which makes it particularly useful for chronic pain. Codeine, on the other hand, is often used as an ingredient in cough suppressants and weaker painkillers, as it has less of an analgesic effect and causes fewer side effects than morphine. Opium, which is obtained from the dried milky sap of the opium poppy, also contains a mixture of natural opiates and was historically used as a painkiller. Nowadays, however, pure opium is rare in modern medicine, as isolated active ingredients such as morphine or synthetic alternatives have a more specific effect and can be dosed in a more controlled manner.

The body's own opiates: endorphins and their effect

An interesting aspect of opiate research is the discovery that our body itself produces opiate-like substances. These so-called endorphins are the body's own painkillers and bind to the same receptors as opiates and opioids. They are released during certain activities, such as sport, stress, laughter or intense emotional moments, and provide a natural high and reduce the sensation of pain. This phenomenon is also described as a "runner's high", when people experience a strong sense of well-being after long running sessions. Endorphins are part of our body's natural pain defense system and show that pain perception and well-being are closely linked. The understanding of endogenous opiates has also influenced the development of synthetic painkillers that aim to mimic these natural processes.

Opiates as painkillers: when and why they are used

Opiates are particularly important in modern medicine when it comes to treating severe or chronic pain that cannot be sufficiently alleviated by conventional painkillers. Typical areas of application are cancer pain, post-operative pain and certain chronic pain syndromes. Opiates are often used in cancer patients when the pain severely impairs their everyday life and significantly reduces their quality of life. They can also help to alleviate acute pain after serious operations so that patients can recover better. Opiates can also be an option in pain therapy for chronic pain that does not respond to other medications, but usually only under strict medical supervision in order to minimize side effects and the risk of addiction. The 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 analgesic effects, opiates also have numerous side effects that can be problematic, especially with prolonged use. The most common side effects include nausea, constipation, fatigue and in some cases a slowing of breathing, known as respiratory depression. This respiratory depression is particularly dangerous in cases of overdose and can be fatal in the worst cases. There is also a considerable risk of developing physical and psychological dependence with prolonged use. The body becomes accustomed to the substances so that higher doses are required to achieve the same effect - a process known as tolerance formation. If consumption is stopped abruptly, severe withdrawal symptoms can occur, which manifest themselves in restlessness, sleep disorders, sweating and pain. For this reason, the use of opiates is carefully considered and usually only prescribed if the benefits outweigh the potential risks.

Opiates as drugs: abuse and dependence

A particular risk associated with opiates is abuse, which poses a serious danger, especially with potent variants such as heroin. Heroin is made from morphine and is one of the best-known illegal opiates. Due to its strong and rapid effect, it quickly leads to addiction and has driven millions of people worldwide into addiction. Abuse of opiates can have serious health consequences, including rapid deterioration of physical health, organ failure and a high risk of overdose, especially if the purity and dosage of the substances are uncontrolled. In many countries, the abuse of prescription opiates has also become a serious problem, as the availability of these drugs sometimes inadvertently encourages the development of addiction. Addiction to opiates is difficult to overcome and usually requires a combination of drug support, therapy and social support.