Fentanyl vs Heroin

Fentanyl vs Heroin

Authored by Defining Wellness    Reviewed by Dr. John Elgin Wilkaitis    Last Updated: August 17th, 2021


Dr. John Elgin Wilkaitis Medical Reviewer
Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

Fentanyl and heroin are two very similar and highly addictive drugs. Though these two drugs are frequently confused, there are some distinct differences between them. Understanding the differences between heroin and fentanyl can help you stay safe and get appropriate treatment for an opioid use disorder.

A Quick Overview of the Differences Between Fentanyl and Heroin

Though fentanyl and heroin are both opioids, there are a lot of things that make fentanyl and heroin different from each other. We will get into all of these distinctions in more detail later on in this guide. However, if you are just curious about the basic differences between the two drugs, here is what you need to know.

• Fentanyl is a synthetic, man-made drug, while heroin is derived from plants.
• Fentanyl is a legal, prescription drug, while heroin is illegal and not prescribed for treating healthcare problems.
• Heroin is more frequently abused than fentanyl, with over 948,000 people using heroin each year.
• Fentanyl is much stronger than heroin, so even a few milligrams can cause a deadly overdose.
• Fentanyl is often mixed into other drugs as a cutting agent, so more people take fentanyl accidentally.
• There are more options available for heroin use disorder treatment.
• Heroin has been around for decades, so there is more awareness about heroin addiction.

What Are Fentanyl and Heroin?

Fentanyl and heroin are both a type of opioid. Opioids are a class of drug that affect the opioid receptors in the brain. Though opioids do have some legitimate uses as painkillers, they are also one of the most frequently abused types of drugs. When a person takes opioids, they experience euphoria, relaxation, sleepiness, and mental fog. Opioids are a very powerful substance, so they can be quite dangerous. In addition to being addictive, opioids can also cause deadly overdoses by slowing your breathing and heart rate.

Heroin is a type of opioid that is made from a concentrated form of poppy plants. It is available as a whitish brown powder or a sticky black goo, and heroin can be snorted, smoked, or injected. Meanwhile, fentanyl is a synthetic opioid produced in pharmaceutical labs. It is most widely available in pill or powder form, but fentanyl can also be made into a nasal spray, stick-on patch, or a substance for injection.

The Legality and Availability of Fentanyl and Heroin

One of the major differences between the two drugs is their legality and intended uses. Both fentanyl and heroin are controlled substances. However, heroin is a Schedule I controlled substance while fentanyl is a Schedule II controlled substance. This means that heroin is always illegal while fentanyl is legal as long as a doctor prescribes it.

Fentanyl does have many medical uses. It was created to provide pain relief for cancer patients and others with chronic pain that cannot be handled with usual painkillers. Meanwhile, heroin is never used as a prescription drug. If you are caught with heroin or fentanyl without a prescription, the consequences will be more severe for heroin. Due to the way different states classify drug laws, some states may not penalize possession of fentanyl as severely as they penalize heroin possession.

The differences in legality and usage have led to some differences in availability. For many years, fentanyl was an obscure prescription drug while heroin was a common street drug people could purchase from dealers. However, starting in the mid-2010s, there was a massive surge in fentanyl availability as illegal drug manufacturers started to learn how to make it. More and more people started abusing fentanyl, and now both heroin and fentanyl can be found in most illicit drug markets.

The Effects of Fentanyl and Heroin

Fentanyl and heroin have fairly similar effects. Some habitual users might report a slight difference in the “vibe” or feel of the drug, but from a medical perspective, their impacts are quite similar. Common mental and physical effects include:

• Drowsiness
• Mental confusion
• Euphoria
• Dizziness
• Relaxation
• Nausea
• Constipation
• Constricted pupils
• Slow, shallow breaths
• Dry mouth
• Stomach pain
• Difficulty urinating

Which Drug Is Easier to Overdose On?

The main difference between fentanyl and heroin is that fentanyl is far stronger than heroin. Since fentanyl is a synthetically produced opioid, it ends up being way more potent. According to the CDC, fentanyl is 100 times more potent than morphine. This becomes a major problem when people are using fentanyl without direction from a doctor.

Both fentanyl and heroin can cause an overdose through the same mechanism. The drug relaxes your body so much that your heart can stop beating and your lungs can stop breathing. However, fentanyl does this a lot faster. The exact lethal dosage for any opioid will vary depending on a user’s weight, metabolism, and opioid tolerance. For the average user, around 30 milligrams of heroin, or a very small spoonful, is enough to kill a person. For fentanyl, just 2 milligrams, or a few small grains of pure fentanyl, is enough to be deadly.

The very low lethal dose for fentanyl makes it extremely easy to overdose accidentally. A person who just slightly miscalculates their dose can end up overdosing quickly. Another dangerous issue is that fentanyl is often mixed with other drugs. Due to its potency, it is cost effective for drug dealers to dilute other drugs and add a bit of fentanyl to mask the dilution. This can mean a person ends up with cocaine, meth, prescription pills, or other drugs that are tainted with fentanyl. In the past five years alone, there has been a massive surge in overdoses due to accidental fentanyl consumption. Fentanyl is currently the most common type of drug involved in drug overdose deaths.

Is Fentanyl or Heroin More Addictive?

Fentanyl and heroin interact with the brain in somewhat similar ways. They bind to the areas of your brain that control your pain and emotions. When you use either fentanyl or heroin multiple times, your brain starts to compensate for the drug. It will produce less of certain essential chemicals, so your body will start to crave the drug as an attempt to restore balanced neurotransmitter levels. This leads to physical dependency and addiction.

It is hard to classify the addictiveness of various drugs. However, opioids are generally considered one of the most addictive categories of drugs. Unlike some other illegal substances, opioids are so addictive that you can develop a craving for the drug after just one use. So far, there have not been any serious medical studies on the addictiveness of fentanyl versus heroin. However, anecdotal evidence suggests that some people may find fentanyl to be more addictive.

The reason fentanyl often feels more addictive is due to the difficulty with dosing. Since the drug is so powerful, even a small amount has a big effect. People using fentanyl instead of heroin are more likely to accidentally take higher doses. Taking a higher dose of any substance impacts your brain more and makes addiction more likely. Therefore, it is no surprise that more and more people are dealing with fentanyl addiction.

Treatment Options for Fentanyl and Heroin

Both fentanyl and heroin addiction are a type of opioid use disorder. Treatment is fairly similar, but those who have a fentanyl addiction may need to look a little harder for the right care. There are plenty of rehab centers that offer treatment programs for heroin addiction. However, since fentanyl addiction only became common a few years ago, there is less awareness about the issue. You can still get plenty of great help with prescription opioid abuse treatment, but there might not be as much fentanyl-focused content in the treatment program.

Regardless of whether you are dealing with fentanyl or heroin use problems, treatment for opioid use disorders falls into three categories.

Heroin and Fentanyl Withdrawal Care

The first type of care you might want to consider is withdrawal care. Withdrawal happens when you quit using a drug abruptly after taking it for a while. Since your body no longer knows how to function without the drug, you can get physically ill. Opioid withdrawal often causes issues like vomiting, intense joint pain, anxiety, and difficulty sleeping. Heroin withdrawal typically starts a little sooner than fentanyl. Especially if you take a slower-acting form of fentanyl like Duragesic, fentanyl withdrawal might not set in for around 24 hours. Meanwhile, heroin withdrawal can start in as little as six hours.

Withdrawal can be very physically intense. In many cases, you feel so miserable that it is hard to stay committed to sobriety. An opioid detox center and opioid withdrawal care can help. They provide specialized care to help you get through the worst withdrawal cravings. In addition to medications for things like vomiting or insomnia, withdrawal care will also monitor you closely to ensure you do not experience serious side effects.

Heroin and Fentanyl Addiction Counselling

One of the most essential parts of addiction treatment is counseling and therapy. These treatments consist of you sitting down and talking with a trained professional. In addition to speaking with your therapist, you might have group therapy where you talk with fellow opioid addiction sufferers. This provides a valuable form of support and care.

This part of treatment is almost identical for heroin and fentanyl users. Heroin users might find more people they have a connection with in group chat, but fentanyl users will still find a lot to identify with in other people who use opioids. Therapy for both types of addiction will focus on helping clients identify drug use triggers and come up with healthy ways of avoiding cravings. It can give you the tools you need to overcome past trauma and reduce drug-seeking behaviors.

Medication-Assisted Treatment for Fentanyl and Heroin Addiction

Another helpful option for managing opioid use disorders is medication-assisted treatment. This is a type of care that involves giving clients a dosage of a mild, very slow-acting opioid. The most common drug is methadone, but buprenorphine is also becoming a popular choice. These drugs provide just enough opioid effects to prevent withdrawal or cravings, but they do not cause intense highs or addictive behavior.

This treatment is most commonly used for managing heroin use disorders. However, more and more healthcare providers are starting to realize it can also be used for fentanyl use disorders. This means it is possible to find some rehab centers that offer medication-assisted treatment for people struggling with fentanyl. Though medication-assisted treatment is not ideal for every case, it can help manage both heroin and fentanyl addictions.

Defining Wellness Centers Is Here to Help

Whether you struggle with heroin abuse, fentanyl abuse, or both, there is hope. At Defining Wellness Centers, our innovative treatment options can address the unique needs of clients who use heroin or fentanyl. Our approach combines the latest research with healthy living to create an environment where you can heal and recover. To get started on the path to recovery, call us today to ask about our treatment options.

Family-owned and operated, Defining Wellness Centers is a true labor of love. My wife Robin and I, along with our children, are deeply passionate about wellness, mental health and addiction treatment.

We are a family, dedicated to helping other families. We created Defining Wellness with two central goals in mind: to share our love, understanding and compassion with clients and to utilize the best health and wellness modalities available today to treat addiction.

Our programs are built on a foundation of proven, evidence-based therapeutic techniques combined with cutting-edge bio-technological treatments, fitness and experiential learning. Our end goal is to provide the support and tools necessary for people become their best selves through emotional wellness and balance.