Fentanyl and heroin are both considered opioid drugs that bind to receptors in the brain and reduce pain sensation. As an unintended result of use, these drugs both produce euphoric effects, which elevate pleasure and relaxation. Both substances are fast-acting and extremely potent, and both can be lethal in a single dose.
Heroin is a type of drug derived from morphine, which is a naturally occurring substance from the earth. The active ingredient goes through a process where it is removed from the seed of the opium poppy plant and is then distributed as a brown or white powder or as a black substance, which is known as black tar heroin. Heroin is illegal and has no accepted medical use in the United States and abroad. It is considered a Schedule I controlled substance by the Drug Enforcement Administration (DEA). The drug is usually smoked, injected, or snorted when it is abused.
Fentanyl is not natural, and it is a synthetic opioid similar to morphine. The National Institute on Drug Abuse (NIDA) warns that fentanyl is nearly 50 to 100 times stronger than morphine. The drug was initially synthesized as a potent analgesic, and it is sometimes used medically to treat severe chronic pain in those who have become opioid-tolerant or following surgery.
Unlike heroin, fentanyl does possess some accepted medical uses, and it is classified as a Schedule II controlled substance by the DEA. Schedule II drugs have a high potential for abuse and addiction, although they can be used medically.
Fentanyl is usually diverted from licit use to abuse, and it can be manufactured in clandestine labs. The drug is much cheaper and easier to make than heroin and will be commonly used as a cutting agent to make heroin more potent.
Fentanyl can be absorbed through our skin, which is dangerous because small doses are lethal. Prescription fentanyl comes in buccal and sublingual tablets, lozenges, transdermal patches, nasal or oral sprays, and as an injectable. Illegal fentanyl has been made into pills that look like other prescription medications, such as OxyContin and Norco.
Fatalities stemming from overdoses of heroin and fentanyl continue to rise. The Centers for Disease Control and Prevention (CDC) reports that nearly 30,000 American’s died in 2014 as a result of opioid overdose. Synthetic opioid overdose deaths doubled from 2013 to 2014, and fatal heroin overdoses quadrupled from 2002 to 2013.
Many people may not even know they are using a drug containing fentanyl because it is passed off as heroin. Fentanyl is much more potent than heroin, and someone who consumed the drug unknowingly can immediately overdose.
One of the leading causes of concern today is heroin being cut with fentanyl. As we mentioned above, an unsuspecting user can overdose immediately due to the sheer strength. Fentanyl is considered 50 times stronger than heroin and is used in those who have become opioid-tolerant to potent opiate drugs such as OxyContin, Dilaudid, or Opana.
Morphine: MedlinePlus Drug Information. (n.d.). from https://medlineplus.gov/druginfo/meds/a682133.html
Today's Heroin Epidemic. (2015, July 7). from https://www.cdc.gov/vitalsigns/heroin/
National Institute on Drug Abuse. (2016, June 6). Fentanyl. from https://www.drugabuse.gov/drugs-abuse/fentanyl
National Institute on Drug Abuse. (n.d.). Heroin. from https://www.drugabuse.gov/publications/drugfacts/heroin
Increases in Drug and Opioid Overdose Deaths – United States, 2000–2014. (n.d.). from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm