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Heroin has been the most popular illicit opioid for recreational use for decades, but fentanyl is relatively new in illicit markets, and it has made a huge impact in the last few years. You may already be aware that heroin overdoses and deaths are on the rise around the country, but that only tells part of the story. Many users are buying a variation of heroin that they’re not even aware of, which is a combination of heroin mixed with the synthetic opioid fentanyl. Fentanyl is estimated to be up to 100 times stronger than morphine, and the combination of heroin and fentanyl is incredibly dangerous. According to the Centers for Disease Control (CDC), opioid-related overdose deaths increased by 38.4% from 2019 to 2020, with the driving factor behind the rise in opioid overdose cases attributed to synthetic opioids such as fentanyl. This recent increase in overdose deaths highlights the continuing need for issues involving both addiction and fentanyl-laced drugs to be taken seriously .
But what’s the difference between these two opioids? How strong are they, and how easily can they cause a life-threatening overdose? Learn more here about heroin, fentanyl, and how they compare.
Comparing Heroin and Fentanyl: Similarities and Differences of the Opioids
Because both fentanyl and heroin are considered to be extremely addictive opioid drugs which can produce an intense and euphoric “high,” dependence can form quickly. Fentanyl and heroin are also both fast-acting drugs, but a person who uses them also builds tolerance quickly, meaning they have to take continuously larger doses to achieve the same euphoric high they did initially. The two drugs are commonly mixed by dealers to increase their profits while providing a cheaper high. According to the National Institute on Drug Abuse (NIDA), over half of all heroin overdoses in 2019 involved fentanyl-laced heroin. In 2016 alone, more than 19,000 opioid-related deaths were attributed primarily to fentanyl, according to statistics provided by the NIDA, showing a six-fold increase in deaths since 2010. Increasing cases of fentanyl being used as an additive to existing street drugs can make them much more lethal, and it is now more important than ever to seek professional medical treatment at a qualified facility for any underlying addictions that could potentially lead to one’s risk of exposure to fentanyl-laced drugs .
Although they are similar in many ways, the two drugs also have several distinct differences:
- illegally manufactured, semi-synthetic opioid derived from morphine with no accepted medical uses
- Injected, smoked, or snorted when abused
- Fast-acting drug that creates a short but intense high
- High potential for overdose, leading to fatal respiratory depression
- Highly addictive
- Requires medical detox and opioid replacement medications to safely remove the drug from the body
- Comprehensive treatment is ideal for long-term heroin addiction recovery
Users begin to feel the effects of heroin very quickly. Injecting the drug into the bloodstream allows the user to feel the effects almost immediately, but this method of use also presents unique dangers. Many users start by injecting heroin into their forearms, but as veins become damaged or collapsed (or inflammation, infection, bruising, or lesions become problematic) users will have to start finding other places on the body to inject the drug. Other common areas used are the neck, hands, feet, face, and groin.
With the negative side effects that come from using heroin, it may be difficult for some to understand why someone would choose to keep using the drug. Once the body is used to heroin, terrible withdrawal symptoms will occur if someone stops using it, and the longer someone uses heroin, the more of the drug they will have to take to get the same effects.
- Available both by prescription as a powerful painkiller and is also manufactured illegally
- May be used as a pill, patch, lozenge, tablet, injectable liquid, or powder
- Ingested, snorted, smoked, or injected when abused
- Fast-acting and creates a short but intense high
- Synthetic opioid
- Lethal in much smaller doses and can be absorbed through the skin and other contact
- Highly addictive
- Requires medical detox and opioid replacement medications to safely process the drug out of the body
- Comprehensive treatment is necessary for long-term recovery
Fentantyl is classified as a Schedule II drug with a high potential for abuse, with its use potentially leading to severe psychological or physical dependence over time. Although considered dangerous, fentanyl is approved by the U.S. Food and Drug Administration (FDA) for use as an anesthetic and analgesic.
The effects of fentanyl are similar in nature to heroin, and may include relaxation, pain relief, and sedation, as well as negative effects like nausea and vomiting, dizziness, drowsiness, confusion, urinary retention, and respiratory depression. Fentanyl is 50 times more potent than heroin, making it easy to accidentally overdose from the powerful drug .
The Dangers of Combining Fentanyl and Heroin
Fentanyl is a powerful synthetic opioid pain reliever that is medically prescribed to treat severe pain and is 50 times more potent than heroin and 100 times more potent than morphine. Pharmaceutical fentanyl is prescribed by doctors to treat patients suffering from severe pain, especially after surgery, for advanced-stage cancer, and as an anesthetic.
Fentanyl and other opioid drugs in its class work by binding to opioid receptors both in the Central Nervous System (CNS) and in the brain – the same areas of the brain that also control a person’s breathing rate. Because both drugs work as a depressant on the CNS, large enough doses can cause breathing to stop entirely, and this can be a substantial factor in increasing the risk of accidental overdose and death .
Heroin use on its own is already incredibly dangerous, but the addition of fentanyl significantly increases the risk of overdose and death. In many instances, the prescription opioid epidemic of the past decade has led to a significant increase in heroin addiction. This happens in part when other opioids become increasingly difficult to obtain, or if the cost of prescription opioids becomes prohibitive. To avoid withdrawal symptoms, some users will switch to heroin as a cheap, easily obtained substitute for other opioids.
Since most heroin addicts obtain the drug from dealers on the street, they may be unaware that the heroin they purchased is cut with fentanyl or may even be pure fentanyl itself. In most cases, it is impossible to detect the presence of fentanyl, especially when it is cut into counterfeit opioids or cocaine, as these are also white substances. However, because heroin has a yellowish tint, if a large amount of fentanyl has been cut into the heroin it might be detected. Understanding the dangers of heroin and fentanyl can help raise future awareness through youth-oriented education programs .
How Widespread is Fentanyl-Laced Heroin?
According to data from the Centers for Disease Control and Prevention (CDC), fentanyl is the leading contributor to the current drug overdose crisis in the U.S. and is involved in more than 40,000 of the 70,000 overdose deaths that were reported in 2017 alone.
Most recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl, which is distributed through illegal drug markets for its heroin-like effect. It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous.
According to a recent CDC report, deaths related to fentanyl increased by 30% in the year-long period between March 2020 and March 2021 alone. Synthetic drugs are often deadlier not only because of how potent they are but also because of the constantly changing ways in which they are blended into other substances which makes it difficult for people to know exactly what they are taking, but also the strength of the drug or drugs. Even in small doses, fentanyl can be deadly, and more than 150 people die every day from overdoses related to synthetic opioids such as fentanyl [5, 6].
There is Help for Opioid Addiction
Although overcoming heroin or opioid dependence requires time, patience, and perseverance, it is something that can be done. Individuals who are addicted to heroin or opioids should seek professional help to be able to safely quit these highly addictive drugs so they can avoid the effects of accidental exposure to fentanyl-laced heroin.
Nova Recovery Center provides evidence-based treatment methods, medication-assisted treatment as well as complementary therapies and aftercare services that can assist you or a loved one overcome addiction and begin a newfound life of sobriety. If you feel that you need help with an addiction and want to learn more about inpatient drug rehab in Austin or Houston, TX, please call Nova Recovery Center at (888) 427-4932 or contact us online today.
- Fentanyl Facts (cdc.gov)
- Overdose Death Rates | National Institute on Drug Abuse (NIDA) (nih.gov)
- Fentanyl vs. Heroin: An Opioid Comparison (americanaddictioncenters.org)
- Substances Laced with Fentanyl: How to Protect Loved Ones – Partnership to End Addiction (drugfree.org)
- Drug Overdose Deaths | CDC Injury Center
- Fentanyl (dea.gov)