Fentanyl and heroin are among the most dangerous opioids, as evident from the fact that they are both key players in the opioid crisis plaguing the United States. While they both have similar effects and share a high potential for addiction, fentanyl is much more potent than heroin.
This article will compare fentanyl vs. heroin in terms of chemical composition, cost, overdose risks, and more to help you better understand the risks associated with both substances.
What Is Fentanyl, and How Does It Work?
Fentanyl is an exceptionally potent synthetic opioid. Originally developed in 1959 for intraoperative anesthesia, it is also approved for medical use as an analgesic. It is most commonly prescribed for severe pain, such as that resulting from injuries, that cannot be controlled with non-opioid painkillers like acetaminophen.
Fentanyl comes in numerous forms, including:
- Lozenges (Actiq®)
- Injections (Sublimaze®)
- Buccal tablets (Fentora®)
- Transdermal patches (Duragesic®)
- Sublingual tablets (Abstral®) and sprays (Subsys®)
Fentanyl works by binding to the opioid receptors in the central nervous system (CNS), thereby blocking pain signals. It also produces intense euphoric effects by triggering a surge of dopamine in the brain, increasing the risk of opioid abuse.
Due to its extraordinarily high potency and low cost, fentanyl became a popular street drug in the 2010s, leading to the third wave of the U.S. opioid epidemic. Some of its street names include Dance Fever, Fire, Jackpot, Murder 8, and Apache.
Although fentanyl is a prescription medication, it is often obtained illegally. Illicit fentanyl is an incredibly potent opioid, and even small amounts can be deadly. One of its greatest dangers is that it’s often laced with other drugs, such as heroin, cocaine, or counterfeit pills, without the user’s knowledge. This makes it nearly impossible to know the strength or contents of what someone is taking, significantly increasing the risk of overdose. Fentanyl is sometimes mixed with other dangerous substances like xylazine, a tranquilizer, further complicating treatment for overdose and often leading to fatal outcomes.
The importance of taking fentanyl strictly as prescribed cannot be overstated. Abusing it (i.e., taking it in any way other than prescribed, such as in higher doses) significantly increases the risk of fentanyl addiction, overdose, and death.
What Is Heroin, and How Does It Work?
Heroin—also known as diamorphine and diacetylmorphine—is a potent, rapidly acting, and highly addictive semi-synthetic opioid drug. It is a tar-like substance, brown or white powder, or off-white granules that can be smoked, injected, or snorted.
As an illicit opioid, heroin has not been FDA-approved for any medical use and cannot be obtained legally. Its street names include Dope, H, Junk, and Brown Sugar. Heroin is often cut with other substances—including fentanyl, veterinary anesthetic xylazine, or even rat poison—to intensify its effects and reduce costs, further increasing the risk of opioid overdose.
Heroin works in much the same way as other opioids. It attaches to opioid receptors and induces strong euphoric and relaxing feelings by stimulating dopamine release. While the onset and duration of its effects depend on the method of consumption, they are usually fast and short-lived.
Heroin played a pivotal role in the second wave of the U.S. opioid epidemic, with thousands of Americans dependent on prescription opioids turning to it once they could no longer obtain their drugs legally. In 2013, nearly 80% of recent heroin users reported prior misuse of prescription pain medications.
Now that we’ve covered the basics, it’s time to explore fentanyl vs. heroin differences.
Key Differences Between Fentanyl vs. Heroin
The key difference between fentanyl vs. heroin lies in their potency, as fentanyl is up to 50 times more potent than heroin. Moreover, heroin is an illicit drug, whereas fentanyl is approved for certain medicinal purposes. Nonetheless, it is also manufactured and distributed illegally, which means its potency and purity may vary widely.
Here’s a detailed breakdown of the differences in fentanyl vs. heroin effectiveness, chemical composition, addictiveness, cost, and overdose risks:
Fentanyl vs. Heroin Effectiveness
Fentanyl is an analgesic. Although heroin alters the perception of pain by interacting with the same receptors as other opioids, including fentanyl, it has no legitimate uses in the United States and most other countries.
However, in some places, diamorphine (heroin) can be prescribed to treat certain medical conditions.
A survey by researchers from King’s College London found that many British medical practitioners regard diamorphine as a useful drug and mainly prescribe it for post-operative pain, palliative care, myocardial infarction, and pulmonary edema. Still, more research is needed to understand its uses and applications in clinical settings.
Fentanyl vs. Heroin Chemical Composition
The main difference in the chemical compositions of fentanyl vs. heroin is that fentanyl is a synthetic opioid, whereas heroin is semi-synthetic.
In other words, fentanyl (molecular formula C22H28N2O) is an entirely human-made piperidine opioid. Meanwhile, heroin (molecular formula C21H23NO5) is created by synthesizing morphine, an opioid alkaloid that naturally occurs in the opium poppy plant.
Fentanyl vs. Heroin Addictiveness
Fentanyl and heroin addiction is a risk anyone taking these drugs faces. They both affect brain chemistry and rapidly produce rewarding effects, contributing to a high potential for dependence and addiction.
Although fentanyl is classified as a Schedule II controlled substance, whereas heroin is treated as a Schedule I controlled substance, it doesn’t mean that fentanyl is less addictive than heroin. It can cause dependence and addiction, especially if used for a prolonged time or abused.
Fentanyl vs. Heroin Cost
When it comes to fentanyl vs. heroin cost, keep in mind that you can only obtain fentanyl legally by prescription. The cost of pharmaceutical fentanyl largely depends on the prescription strength and the type of fentanyl prescribed. Generic drugs are always cheaper than those sold under a brand name, and they are often covered by insurance.
Fentanyl has lower production costs than heroin, which is why heroin and other illicit opioids are often laced with fentanyl to reduce costs and enhance their effects. You should never buy opioids or other drugs illicitly, as it considerably increases the risk of a potentially life-threatening overdose.
Fentanyl vs. Heroin Overdose
Both fentanyl and heroin carry a considerable risk for opioid overdose. Given that fentanyl is significantly more potent than heroin, however, it’s safe to say that it exposes users to an even higher risk of overdose than heroin. Due to its extreme potency, fentanyl is only prescribed for opioid-tolerant patients in most cases.
Moreover, fentanyl overdoses have claimed far more lives over the past two decades than those involving heroin.
For comparison, close to 156,000 Americans lost their lives to a heroin overdose between 2000 and 2022. Meanwhile, nearly 74,000 Americans died of fentanyl overdose in 2022 alone.
Next, let’s explore the side effects of fentanyl vs. heroin.
Fentanyl vs. Heroin Side Effects
Fentanyl and heroin have similar side effect profiles, with their most common side effects being:
- Nausea
- Vomiting
- Itchy skin
- Confusion
- Dry mouth
- Drowsiness
- Constipation
- Lightheadedness
Fentanyl and heroin can cause serious adverse effects, such as respiratory depression, even at low doses. Taking these drugs can also impair your cognition and reaction time, making it dangerous to drive or operate heavy machinery.
Importantly, using fentanyl or heroin for a prolonged time increases the risk of:
- Tolerance
- Opioid dependence
- Opioid use disorder (OUD)
- Hormonal imbalances
- Fertility issues
- Organ damage
- Opioid overdose
- Death
Injecting fentanyl or heroin can also make you vulnerable to bloodborne diseases, such as HIV/AIDS.
Opioid abuse, including taking fentanyl and heroin together or mixing them with other drugs, further increases the risk of adverse effects.
On that note, let’s look into fentanyl vs. heroin drug interactions.
Fentanyl and Heroin Drug Interactions
Fentanyl and heroin may interact with the following drugs:
- Alcohol
- Sedatives
- Antibiotics
- Other opioids
- Antipsychotics
- Antihistamines
- Muscle relaxers
- Antidepressants
- Benzodiazepines
This list of fentanyl and heroin drug interactions is by no means extensive. To minimize the risk of respiratory depression, overdose, and other adverse effects, you should never mix opioids with other drugs without your doctor’s approval.
Furthermore, mixing fentanyl or heroin with cocaine and other stimulants has become increasingly popular in recent years. This dangerous form of polysubstance abuse, known as speedballing, is driving the fourth wave of the opioid epidemic.
This drug combination is extremely dangerous, as opioids and stimulants have opposite effects, which may overwhelm the CNS. Speedballing amplifies the risk of adverse effects associated with both substances, such as seizures, paranoia, respiratory failure, overdose, and more.
Other Risk Factors of Fentanyl and Heroin
Certain medical conditions may enhance the risks associated with fentanyl and heroin use, including:
- Head injury
- Liver disease
- Heart disease
- Opioid allergy
- Kidney disease
- Respiratory issues
- Blood pressure problems
- Substance use disorders (SUDs)
Using opioids during pregnancy can negatively affect the health of the mother and the fetus, increasing the risk of neonatal abstinence syndrome (NAS), maternal death, congenital disabilities, and other adverse effects.
If you are pregnant, nursing, or planning to have a baby while taking fentanyl or heroin, discuss your options with your doctor.
Physical Dependence and Addiction to Opioids
Physical dependence and addiction to opioids are distinct conditions, even though they often co-occur. However, you can be dependent on opioids without being addicted to them.
Since opioids alter brain chemistry, anyone taking them for an extended time can become dependent. Opioid dependence refers to the physical reliance on opioids; opioid-dependent people have to take them to feel and function normally.
Meanwhile, opioid addiction is predominantly psychological and characterized by an overwhelming urge to take opioids. Those addicted lose control of their impulses and struggle to quit, even when opioid use causes significant problems in their lives, such as job loss or relationship strain.
If left untreated, opioid dependence can turn into an addiction. Therefore, it’s of utmost importance to seek professional help for opioid dependence.
Signs and Symptoms of Opioid Dependence
Opioid dependence is marked by two signs: tolerance and opioid withdrawal symptoms, which occur upon drug discontinuation.
If you take fentanyl or heroin repeatedly, your brain will eventually stop producing endorphins. Instead, it will create more and more opioid receptors, leading to tolerance. In other words, you will need larger doses to achieve the same effects as before.
In addition to that, opioid-dependent people experience withdrawal symptoms, such as cravings, muscle aches, fever, and so forth, once they attempt to quit the drug or reduce their dosage. Since these symptoms can be very uncomfortable and downright unbearable, many people continue taking opioids just to avoid them.
If you’re struggling with opioid dependence or addiction, know that it is never too late to return to an opioid-free life. The right opioid addiction treatment can help you break free from opioid dependence safely, quickly, and effectively.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is an ultra-modern opioid dependence treatment that has helped nearly 25,000 people worldwide achieve a lasting recovery within a matter of days—the average hospital stay for ANR patients lasts only 36 hours!
Developed by Dr. Andre Waismann, ANR stands out as the only treatment that addresses the root of opioid dependence by repairing the endorphin-receptor system. As such, it boasts an unmatched success rate. Since it restores the brain to its pre-addiction state, ANR allows patients to forget cravings and the fear of relapse.
At ANR Clinic, patient safety is our top priority, which is why each patient receives a personalized treatment plan. Tailoring the treatment to the patient’s unique needs and medical history not only negates the risk of complications but also makes the procedure safe for virtually everyone—even those with co-occurring health conditions.
Moreover, ANR treatment is carried out in an ICU setting of fully accredited hospitals by a team of highly experienced and compassionate healthcare professionals, including anesthesiologists and critical care physicians.
Eager to return to a life without fentanyl or heroin dependence? Contact us today and book a free, 100% confidential consultation!
Key Takeaways
Let’s summarize the key points we covered today:
- Fentanyl is a potent synthetic opioid used to treat severe pain with a high potential for addiction.
- Heroin is a semi-synthetic opioid that has not been approved for medical use in most countries, including the United States.
- Fentanyl is significantly stronger than heroin; using it as prescribed is of utmost importance, as it can cause an overdose even at very low doses.
- ANR is a revolutionary treatment that can help you conquer fentanyl or heroin dependence by re-regulating the endorphin-receptor system.
Fentanyl vs. Heroin FAQ
Fentanyl is popular because of its potency. Since it is not only very potent but also relatively easy and cheap to manufacture, it has become popular on the streets and is often used to adulterate other illicit drugs.
Fentanyl and heroin should not be mixed under any circumstances. Taking them together can have fatal consequences; it tremendously increases the risk of respiratory depression, opioid addiction, overdose, and death, among other adverse effects.
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