Background: The terms opioid and narcotic are often used interchangeably by healthcare providers. The purpose of this study was to compare understanding narcotics vs. opioids. Methods: A convenience sample of English-speaking women (n=188), aged 2145years, seeking care at a primary care clinic were asked (1) What is an opioid/narcotic? (2) Give an example of an opioid/narcotic? (3) Why does someone take an opioid/narcotic? and (4) What happens when someone takes an opioid/narcotic for a long time? Responses were recorded verbatim by a research assistant and then coded independently by two investigators. Results: More than half of respondents (55.9%) responded don't know to all 4 opioid questions, while just 3.2% responded don't know to all 4 narcotic questions (P<0.01). Most women were unfamiliar with the term opioid (76.3%) and did not know why someone would take an opioid (68.8%). About two-thirds of respondents were able to give an example of a narcotic (64.2%) and knew the consequences of long-term narcotic use (63.2%). Conclusions: While more women were more familiar with narcotic, many identified negative connotations with this term. Future research should explore how to improve patient understanding and attitudes regarding both the terms opioids and narcotics.