Heroin and fentanyl are two of the most powerful and addictive drugs known to man. Both belong to the opioid drug class and work by reducing pain sensations and producing euphoria and pleasure. Although similar, there are a few key differences between the two.
What is Heroin?
Heroin is a semi-synthetic opioid that is derived from morphine. Morphine is a naturally occurring opioid that comes from the seed pod of the opium poppy plant. While morphine is approved by the U.S. Food and Drug Administration (FDA), heroin is illegal. It is a Schedule I Controlled Substance under the Drug Enforcement Administration’s (DEA) Controlled Substances Act and has no approved medicinal use.
In 1898, The Bayer Company introduced medical heroin as a pain reliever and cough suppressant. However, public health officials quickly discovered the addictive nature of this drug. In 1914, the Harrison Narcotics Act mandated that heroin could only be obtained via prescription, but in 1924, the drug was outlawed entirely as part of the Anti-Heroin Act.
Today, heroin is an illegal drug that is sold on the streets as a white or brown powder or as a black, sticky, tar-like substance known as “black tar heroin.” In 2022, about 1.1 million people ages 12 and older reported using heroin and 1.0 million were addicted to it. That same year, more than 9,000 people died from an overdose involving heroin.
Heroin has been a major component of the opioid crisis, but in recent years, heroin abuse, addiction, and overdoses have actually decreased. Unfortunately, this isn’t the good news it sounds like, because a more potent and addictive opioid has taken heroin’s place: fentanyl.
What is Fentanyl?
Fentanyl is a synthetic opioid that is similar to heroin and morphine, but it is 50 to 100 times stronger, respectively. Unlike heroin and morphine, fentanyl is man-made and not naturally-occurring.
Fentanyl was developed in 1959 and introduced in the 1960s as an intravenous anesthetic for pain. It is still used to treat severe pain following surgery or in opioid-tolerant individuals, such as cancer patients. Prescription fentanyl is available in several different forms and brand names, including:
- Transdermal patch (Duragesic)
- Lozenges (Actiq)
- Buccal tablets or film (Fentora, Onsolis)
- Nasal Spray (Lazanda, Instanyl, Nasalfent)
- Sublingual tablets (Abstral)
- Sublingual spray (Subsys)
- Injection (Sublimaze)
Pharmaceutical is highly regulated and is rarely involved in overdoses. However, illicitly-manufactured fentanyl, or IMF, is widely used recreationally. It typically comes in the form of a powder and may be sold by itself, pressed into counterfeit prescription pills, or mixed with other drugs like heroin.
A tiny amount of fentanyl can cause a life-threatening overdose. According to the DEA, 42% of pills they tested that had fentanyl in them contained a lethal dose. Fentanyl is so deadly and widespread that it is responsible for the majority of drug overdose deaths in the United States today. In 2021, more than 70,600 overdose deaths were attributed to synthetic opioids, primarily fentanyl.
Common Side Effects of Heroin and Fentanyl
Heroin and fentanyl are both opioid drugs that bind to opioid receptors in the brain. This causes reduced pain signals, euphoria, pleasure, and relaxation. Although fentanyl is more potent than heroin, both share many of the same side effects.
Common side effects include:
- Nausea and vomiting
- Constipation
- Drowsiness
- Confusion
- Weakness
- Flushed skin
- Dry mouth
- Headache
- Dizziness
- Fatigue
- Difficulty sleeping
- Itching
- Sweating
- Shallow breathing
- Decreased heart rate
- Respiratory depression
- Low blood pressure
- Slow heart rate
- Loss of consciousness
Symptoms of Opioid Overdose
While fentanyl is stronger and can result in an overdose in smaller amounts, heroin overdose can be deadly, too. Symptoms of overdose may include:
- Extreme drowsiness or inability to wake up
- Slow, shallow, or irregular breathing
- Pinpoint pupils
- Cold, clammy skin
- Bluish tint to lips or fingertips
- Slurred speech or confusion
- Loss of consciousness or unresponsiveness
- Weak pulse or low blood pressure
- Nausea or vomiting
- Seizures
If you suspect someone is experiencing an opioid overdose, it’s crucial to seek emergency medical help immediately by calling emergency services or taking them to the nearest emergency room. You can also administer naloxone (Narcan) if you have it.
Naloxone is an opioid antagonist that can reverse the effects of an opioid overdose. When it comes to fentanyl overdose, multiple doses of naloxone are sometimes needed.
Comparing Fentanyl vs. Heroin
Fentanyl and heroin share many similarities, including:
- Highly addictive
- Both are short-acting opioids
- May cause withdrawal symptoms if abruptly stopped
- Long-term effects of fentanyl and heroin addiction include damage to the respiratory and cardiovascular symptoms as well as infections, brain damage, and mental health problems
Key differences to highlight when comparing heroin vs fentanyl are:
- Fentanyl is available as a prescription opioid and is commonly prescribed for pain while heroin is illegal and has no approved medical use
- Fentanyl is significantly more potent and deadly than heroin
Find Treatment Now
Heroin and fentanyl are both highly addictive and powerful opioid drugs, and people struggling with addiction to either of them require comprehensive substance abuse treatment. Addiction treatment may include medically supervised detox, counseling, behavioral therapy, medications, and peer support. To learn more about addiction treatment or to get started with a confidential, risk-free assessment, please contact us today.
