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The Key Differences between Heroin and Fentanyl



Today, one of the biggest challenges that our country is facing is the opioid crisis. Topping in the list of the most abused opioids are heroin and fentanyl. According to the CDC, in 2016, close to 948,000 people above the age of 12 were using heroin. [1]. This means that 0.4 persons out of 100 in the U.S were on heroin.

The Heritage Foundation recently reported that more than 49,000 American lost their lives due to fentanyl in 2017. [2]. Both of the drugs bind to the brain’s opioid receptors when abused, and thus, resulting in feelings of relaxation and pleasure. They also work to reduce pain.

In this article, I’ll be discussing:

  • Heroin and fentanyl basics, i.e., the medical origins
  • The key differences between heroin and fentanyl
  • Side effects
  • The potential for overdosing including the symptoms
  • Addiction and dependence plus the opioid crisis

Heroin and fentanyl basics

Heroin has been around as a dangerous drug for quite some time, and persons who use it have pointed out, enjoying an effect called nodding. Nodding can be described as a drowsy state where one threads the thin line between consciousness and semi-consciousness. Fentanyl, on the other hand, is quite recent and has gained a lot of popularity in the last 5 or so years.

With the entry of fentanyl, which primarily comes from China according to the Heritage Foundation into the U.S., the number of opioid-related deaths has risen significantly. This is because as indicated in a recent CDC (Center for Disease Control) report, fentanyl is 50 to 100 times more potent than heroin. [3].

An averagely sized individual would need to take more than 30 milligrams of heroin for it to be deadly. As fentanyl is more potent, the same individual would only need to take 3 milligrams of it for it to be fatal.

The medical origins of heroin and fentanyl

Heroin is a derivative of morphine and was developed as medical scientists attempted to come up with a safer version of the painkiller. However, after a short time in the market in the early 1900s, its marketer Bayer was ordered to stop distributing it, and its use was outlawed. This was after the discovery of its addictive nature.

Today, doctors do prescribe fentanyl containing medication to treat severe pain. Some of the common prescription drugs that do contain fentanyl include Abstral, Fentora, and Actiq. There are also other chemical derivatives of fentanyl that are used in prescription drugs such as sufentanil, remifentanil, carfentanil, and alfentanil.

Differences between heroin and fentanyl

Here are the key differences between heroin and fentanyl:

1. Type of drug

Heroin is a semi-synthetic opioid, which means that it’s derived from synthesizing a natural substance; in this case, it’s morphine. Contrary to this, fentanyl is a synthetic opioid which is made through chemical processes. Chemically, fentanyl is similar to heroin and other derivatives of opium.

2. Legal status

Heroin is a Schedule I drug, and therefore, it’s illegal to have and also distribute. Fentanyl, on the other hand, is a Schedule II drug and can only be sold by licensed medical practitioners for use under a prescription. Despite these, it is illegal to have the medicine without a prescription or trade them with a license. The Drug Enforcement Agency has classified both heroin and fentanyl among the controlled substances.[4].

3. Origin

Heroin is a derivative of morphine, while fentanyl is purely human-made. Fentanyl is fully synthesized in a lab, and this is one of the reasons why it’s increasingly common these days plus it’s easy to manufacture. There are no sophisticated equipment’s required or lengthy process involved in the manufacture of fentanyl. This is unlike heroin, which consists of the growing of poppy and harvesting them.

4. Form

Heroin is a white or brown powder, while fentanyl can be in a pill, patch, liquid, or powder. No matter which form you take, either of these drugs is very dangerous.

5. Method of administration

Heroin can be abused by smoking, injecting, or snorting. For fentanyl, it can be administered via transdermal, sublingual, injected, snorted, or smoked.

6. Potency

Heroin is roughly two to three times more potent than morphine depending on its purity levels. On the other hand, fentanyl is more than 100 times more strong than morphine, this is according to the National Institute on Drug Abuse.

7. Street names

Heroin goes by several street names such as black tar, hell dust, Big H, Negra, horse, thunder, and smack. Fentanyl is known as china town, apache, tango, jackpot, cash, Goodfellas, and murder 8.

Side effects

Both heroin and fentanyl have severe side effects, which may lead to the deterioration of the health of the user after continued use.

Herein are the side effects of heroin:

  • A reduction in sexual urges
  • Confusion and difficulty in concentrating
  • Drowsiness
  • Slow or slurred speech
  • Reduced coordination of bodily functions
  • Constricted pupils
  • Dry mouth
  • Diminished appetite
  • Constricted pupils
  • Vomiting and nausea
  • Lowered blood pressure and heart rate

Here are the side effects of fentanyl:

  • Nausea and vomiting
  • Constipation which could quickly turn to chronic constipation
  • Sleepiness
  • Dry mouth
  • Adhesive reaction
  • Confusion and concentration difficulties
  • Constricted pupils
  • Weakness
  • Slowed breathing and low blood pressure

Potential for overdose

Generally, fentanyl has a higher potential for overdose as compared to heroin. This is primarily because there is a minimal difference between a therapeutic dose of fentanyl and a deadly dose. This high potential for overdose is what has made this opioid very dangerous. Many of its users don’t know how potent the drug really is and end up dosing like heroin. This results in an overdose and most of the time, death.

A deadly dose of fentanyl is 3 milligrams, while a fatal dose of heroin is 30 milligrams. Heroin has a lesser potential for overdose thanks to the high amounts needed to do so. As most abusers of fentanyl take it as a replacement to heroin and end up administering the same dose they are used to. You should know that some people also do overdose on heroin even though it takes much more effort to do so. Heroin is just as deadly as fentanyl when overdosed.

Here are the symptoms to check out for in a heroin overdose:

  • Nausea and vomiting
  • Excessive itching and sweating
  • Severely impaired concentration
  • Abnormally low body temperature
  • Slow and shallow breathing
  • Irregular heartbeat
  • A strong feeling to pass urine with no success in doing so
  • Unconsciousness

An overdose of heroin will result in death if the individual does not receive immediate medical attention. In this case, immediate attention is very vital as death can occur in a couple of minutes.

Naloxone or Narcan® is commonly used to combat the severe effects of a heroin overdose. Medical personnel, including ambulance officers, usually have it with them. Naloxone is available either as an intramuscular injection or nasal spray.

Here are the symptoms of a fentanyl overdose:

  • Muscle spasms
  • Hallucinations
  • Confusion and disorientation
  • Loss of motor function
  • Loss of body coordination
  • Pinpoint pupils
  • Irregular and shallow breathing
  • Slowed heart rate
  • Faint pulse
  • Loss of consciousness
  • Seizure

In the case of a fentanyl overdose, death can come fast, so the person has to be provided with medical attention as soon as possible. In this case, Naloxone can also be used to save the life of the victim.

Addiction and dependence

Fentanyl and heroin are both very addictive and are categorized as extremely addictive. This means that an individual can develop a dependence on them quite quickly. This is a result of the euphoric high that is synonymous with both of them. After a couple of times abusing the drugs, the brain will become conditioned to their presence in the body.

From this point on, the body will need the presence of the drugs for it to function optimally. When it gets to this point, the individual will not only be addicted to fentanyl or heroin but also dependent on them.

When a user of fentanyl or heroin becomes dependent, they are bound to experience severe side effects when the opioid wears off from their body. These severe side effects are what is referred to as withdrawal symptoms. These side effects include:

  • Depression
  • Agitation
  • Irritability
  • Anxiety
  • Insomnia

When these withdrawal symptoms set in, most individuals resort to taking the opioids to deal with them. Once they do, their body will resume to its normal functioning. Though this might seem like a solution, it’s not. The more the opioids are administered, the more the body builds a tolerance to them, and more will always be needed to get the same high. This could easily lead to overdose and death.

The opioid crisis

The opioid crisis which the country is facing at the moment is brought about by two main factors according to NIDA. These are:

  • Some doctors were prescribing fentanyl containing medicine to their patients over a long period. By the time the patient is done with the treatment, they are usually addicted to the opioid. Since they cannot access it via prescription anymore, most of them turn to buy it on the street
  • As fentanyl is comparatively cheaper than heroin, it’s used as a filler to heroin by drug barons. This increases the tolerance of an individual to heroin. Therefore, they have to opt for fentanyl to get the same high as before

References

[1] https://theridgeohio.com/the-difference-between-fentanyl-and-heroin/

[2] https://www.heritage.org/crime-and-justice/commentary/china-poisoning-america-fentanyl

[3] https://www.cdc.gov/drugoverdose/data/fentanyl.html

[4] https://ehs.mit.edu/site/biosafety/dea-controlled-substances

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