Heroin Vs. Fentanyl, An Opioid Civil War

Opioids kill hundreds of thousands of people every year in our society. These drugs have started monopolizing the headlines. From the scientific studies done to the legislation and promises made by different government officials, there’s almost always a story in the headlines regarding the opioid epidemic world wide. Opioids like heroin and fentanyl are used everyday by those struggling with drug addiction, but they are also harming people in new and scary ways due to the lack of education about the drugs themselves – how to handle the drugs, not knowing the substance is even present in whatever stash of drugs the addict has, such as when a drug is cut with fentanyl or heroin – or a first responder’s unexpected encounter with the drug at a crime scene or an emergency scene. Everytime we read another story in the headlines it becomes more clear that the disturbing numbers of drug related health issues whether the person understood what they were getting themselves into or not, or the extremely disturbing number of fatal overdoses in the world are not going to stop climbing unless action is taken more aggressively.


The foundation of this epidemic is the prescription opioid scene. Here’s a few of the common opioid prescriptions that doctors give out.


  • codeine (only available in generic form)
  • fentanyl (Actiq, Duragesic, Fentora, Abstral, Onsolis)
  • hydrocodone (Hysingla ER, Zohydro ER)
  • hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
  • hydromorphone (Dilaudid, Exalgo)
  • meperidine (Demerol)
  • methadone (Dolophine, Methadose)
  • morphine (Kadian, MS Contin, Morphabond)
  • oxycodone (OxyContin, Oxaydo)
  • oxycodone and acetaminophen (Percocet, Roxicet)
  • oxycodone and naloxone


Countless prescription opioids are taken every year by people suffering from chronic pain or acute pain such as back trouble that maybe someone started experiencing due to a back injury from a construction job – a very innocuous reason to get some good pain pills. Nonetheless, the person suffering from that back pain easily becomes addicted because opioids ratchet up tolerance much faster than most drugs. As tolerance grows people end up taking more and more of the drug to get the same pain blocking, euphoric experience that they got the first time they took the drug. There is a very smooth pipeline that happens from prescription opioid use to the substantially more potent opioids like heroin and fentanyl. Though the epidemic holds its ground because of prescription pain blockers, it takes very little time before an addict finds that the prescription pills they are taking such as Oxycontin, or Vicodin don’t give them enough to meet their chemical dependence demands.


As the battle against opioids rages on, we have watched heroin destroy lives for years. For a very long time heroin has been the opioid that struck fear into the hearts of parents and the loved ones of addicts everywhere. But these days heroin is taking a backseat to fentanyl, in both the headlines and in the tragedies we see happening all across the world. Fentanyl, in fact is known to be up to fifty times more potent than heroin. Fentanyl has been used as a prescription drug but is generally only prescribed for the most dire of situations.


Heroin is the Old School Supervillain, Setting Up For a Comeback

Heroin, a narcotic analgesic, is a drug that has been the big man on campus, as it were, for years. It is, like all opioid drugs, a substance that alters a person’s mental state in a way that lessens pain, and causes the user to experience a feeling of contentment and calm while they are affected by the side effects of the dose they took.  

Heroin comes in a variety of different colors on a spectrum that ranges from stark white to a murky brown color. The shade of the drug tells the user something about the purity of their stash. The more white the drug, the purer the substance is, which is to say, the less it has been cut with other substances. Drug dealers cut heroin with all kinds of different types of elements in an effort to stretch the drug, therefore allowing them to make more money. This is a particularly dangerous practice for so many reasons.  One of the problems with this tendency of dealers is that when they cut the drug it is usually with some pretty dangerous drugs or substances.


Heroin is usually cut with:

  • Talcum powder
  • Rat poison
  • Baking soda
  • Caffeine
  • Flour
  • Fentanyl
  • Laundry Detergent


The killer fact is that users don’t usually know what has been mixed in their heroin, so they can’t necessarily pick between rat poison, laundry detergent, or almost worse – fentanyl. The fact doesn’t usually stop a person from using heroin because chemical dependence doesn’t allow for caring what kind of elements may be poisoning a user’s body, it only cares that it gets its fix.

In order to consume heroin people suffering from a drug addiction to the substance do all kinds of things to use it such as snorting it, injecting it and smoking the drug. These three methods of use come with each their own dangerous side effects. Snorting heroin can create severe respiratory problems. It removes the possibility of track marks on the body as an easily detectable way of telling of someone is using and abusing heroin and due to that fact, it is a method of use that is steadily on the rise with people struggling with a heroin addiction. Some users smoke the drug, a method also commonly called “chasing the dragon”.

This also removes the tell tale sign of track marks, but it can result in devastating medical problems. Respiratory complications are a standard side effect as the users pulmonary tissue deteriorates due this method of use. Of course the most commonly thought of way to administer the drug to oneself is via the method of injection. Injecting heroin can yes, cause track marks on the skin showing observers where the drug has been injected into the user’s body like battle scars. This use causes severe medical issues in the cardiovascular system such as blockages in blood vessels and the collapsing of veins.

These side effects of the way people consume the drug, and the horrific substances that are frequently added to heroin to stretch the drug pale in comparison to the danger of the drug itself, and are certainly not enough of a deterrent to keep people from trying the drug to begin with. The fact that most people, four out of five users, who try heroin are coming to it already addicted to opioids via the wide net of prescription opioid drugs. These users start with a prescription pain medication like vicodin, and then, in a desperate effort to find a drug that can pick up where their prescription medication left off, they fall into a habit with heroin. One might be surprised to know that that is not the end of the opioid journey. That is to say, if someone endures the heroin addiction long enough, without the worst consequences, a fatal overdose – their tolerance will eventually grow too substantial and they will require an even stronger opioid to give them the euphoria and contentment that they seek. Once this happens, fentanyl is there to take them to those well known landscapes of intoxication.


Many people never get to a stronger tolerance however, because heroin overdoses are far too common. The United States Center for Disease Control and Prevention reports that  “In 2016, nearly 948,000 people in the United States (12-years old or older) reported using heroin in the past year, which is an estimated rate of 0.4 per 100 persons.  And in 2015, 81,326 emergency department visits occurred for unintentional, heroin-related poisonings in America, which is an estimated rate of almost 26 per 100,000 people.”


Opioids in The Age of Fentanyl

Fentanyl first showed up on the United States drug scene in the 1960’s. It started as a drug given to a patient via injection as an anesthetic, or mind altering medication, in medical situations that were usually surgical in nature. Like almost all drugs, when fentanyl became more available to the general public with the option to administer it via a patch, the problem really started to pop up. When a drug is more accessible and is able to be administered at home rather than in a hospital or doctor’s office, or clinic of some kind, it automatically becomes much more difficult to regulate.  With the dawn of the 1990s fentanyl patches became more ubiquitous. Patches allowed for transdermal use of fentanyl. These days a person struggling from addiction to opioids can find the drug in a common tablet form, sublingual sprays and tablets, lollipop form, nasal spray, and transdermal patches to the public via prescription or on the street as well. It has claimed the lives of many and came into public spotlight through the death of superstars Michael Jackson and more recently, Prince.


The United States Center for Disease Control and Prevention reports that even though fentanyl is used as a pharmaceutical to manage severe pain like the type of pain someone may suffer after a major surgery, or used as an anesthetic before surgery to “knock someone out”, the majority of deaths due to opioid consumption have been, perhaps obviously, when people use the drug illicitly. The opioid narcotic analgesic is more powerful than most people seeking out illicit drug experiences can really comprehend. Usually, in fact, users have no idea what they are getting themselves into.


“Most of the increases in fentanyl deaths over the last three years do not involve prescription fentanyl but are related to illicitly-made fentanyl that is being mixed with or sold as heroin—with or without the users’ knowledge and increasing as counterfeit pills. In July 2016, the Drug Enforcement Administration (DEA) issued a new nationwide report indicating hundreds of thousands of counterfeit prescription pills have been entering the U.S. drug market since 2014, some containing deadly amounts of fentanyl and fentanyl analogs. The current fentanyl crisis continues to expand in size and scope across the United States”


Fentanyl’s power can be easily proven through the fact that very recently it was used by the state government of Nebraska as a means to carry out a state sanctioned death sentence. It’s the first time Fentanyl has been used in this way and for this purpose. Coincidentally it is also the first death sentence carried out for the state of Nebraska in years. This is likely due to the controversy that stalled many state death sentences around the country. Medications used to lethally inject inmates were found to torture inmates for substantial periods of time before they ultimately killed them, or failed at taking their life all together. It should be a sign of how menacing this drug is that a state like Nebraska decided to reverse its pause on death penalty activities because it was able to trust in the strength of fentanyl to effectively kill a person.


Don’t Be Fooled, Fentanyl and Heroin are On The Same Side

Pitting the two drugs, heroin and fentanyl, against each other, asking which opioid is taking more lives than the other is the wrong question to ask. The world should be asking, how do we stop opioids all together. The two opioids work together in the prescription to illicit drug overdose pipeline to take a horrifying number of human lives. They are different steps in the same opioid collision course to fatal overdose. Even as fentanyl is the drug in the spotlight these days, based on studies and reports coming out as well as information commonly known about opioids, we can be sure that one opioid leeds to another.

The number of opioid prescription pain killers out there is high and continues to grow. Therefore it is only a matter of time until the people who are right now developing an addiction to the opioid prescription in their medicine cabinets fall into step with the next point on the terrible journey of their opioid addictions. Just as we should never underestimate drugs like oxycodone and hydrocodone, we must also remember that even while fentanyl takes up so much space in the news these days, that heroin is just below the surface, as if planning its next move. Heroin is frequently mixed with fentanyl and the two together are a terrifying combination. Fentanyl is also frequently mixed with other drugs. Both substances are highly dangerous in their own right.  Each drug needs to be considered a high danger to society, and to public health as a whole.


FHE Health – The Treatment Superhero to Your Opioid Supervillain

FHE Health boasts the best halfway houses in Florida where a patient can get the kind of care they need to deal with their opioid addiction, or treatment for whatever kind of chemical dependence they suffer from. The deerfield beach halfway houses offer superior amenities because FHE knows that if our patients are taken care of and don’t have to worry about their everyday needs, they will be more able to focus on the very hard work of medical detox and the, sometimes intense emotional work that comes along with our programs at deerfield beach rehab. Our licensed medical staff and qualified therapists are there to support every patient through their individual process of detoxification and rehabilitation. The staff will help patients through the symptoms that come along with opioid addiction withdrawal and will help them learn the vital life skills necessary for living a brand new sober way of  living. Florida is focusing more and more on making sure its citizens who are suffering from the complications of opioid addiction have more options and funding for treatment. Likewise, so are the medical insurances that cover individuals in the state and across the country. Call your insurance today to see if you qualify for coverage of treatment for substance use disorder. No one should have to be a statistic.

This is your chance to get clean and manage your addiction. If you have questions about how to navigate the sometimes confusing world of substance abuse recovery, call FHE Health today and we can answer your questions.


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