Fentanyl vs Heroin
Heroin and fentanyl are both opioids, but they’re different drugs. Heroin is made from morphine, while fentanyl is fully synthetic and much more potent. Illicit fentanyl has also become increasingly common in the drug supply, where it may be mixed with or sold in place of heroin.
In 2024, fentanyl was identified as a cause of death in 3,224 cases across Florida, compared with 63 deaths involving heroin as a cause. In the Tampa Medical Examiner District, which covers Hillsborough County, fentanyl caused 236 deaths compared with nine involving heroin. At Clean Recovery Centers, we help people understand the changing risks of opioid use and find support when they’re ready. Below, we’ll look at how fentanyl and heroin differ, why fentanyl has become so common in the illicit drug supply, and what treatment can look like.
What Are Fentanyl and Heroin?
Heroin and fentanyl are both opioids and are often used recreationally. They produce euphoric effects followed by drowsiness and dizziness. Heroin is a semisynthetic opioid made from morphine, while fentanyl is fully synthetic. This contributes to their potency and the way they affect the body. Heroin and fentanyl have both contributed to overdose fatalities as well as non-fatal overdose incidents throughout the world.
Fentanyl and Heroin: The Similarities
Heroin is made from morphine, which comes from the opium poppy. Fentanyl is produced synthetically and does not come from the poppy plant. Common ways that heroin and fentanyl are used include injecting, snorting, swallowing, or smoking. Both substances can come in a powder form or liquid when added to water. Each substance produces the same effects, but it takes less fentanyl than heroin to produce the desired effect. Common side effects of both include:
- Dry mouth
- Flushing of the face and neck
- Rush of euphoria
- Nausea
- Itching
- Sweating
- Drowsiness
- Nodding in and out of consciousness
Both heroin and fentanyl work by affecting the central nervous system. Systems such as breathing become slowed, and can stop altogether. This results in an overdose, which can be life-threatening. Naloxone, commonly known by the brand name Narcan, can temporarily reverse an opioid overdose. Give naloxone if an opioid overdose is suspected, call 911, and give additional doses if the person does not respond within two to three minutes.
As the body becomes dependent on either heroin or fentanyl, withdrawal will occur between uses. Heroin and fentanyl withdrawal can be unpleasant, and mental health may become compromised. It is always advised to seek a medical detox facility when trying to stop heroin or fentanyl use as professionals can monitor and manage your symptoms. If you are withdrawing on your own and have thoughts of self-harm or suicide, seek medical help immediately.
Fentanyl and Heroin: The Differences
Although both are opioids, fentanyl and heroin do have differences. Fentanyl is a much stronger opioid, often 50 times more potent than heroin. This makes fentanyl more likely to cause an overdose. In many instances of fentanyl, the person does not know the substance has fentanyl present. There are test strips available to check if a substance has been mixed with fentanyl. Typically, heroin is not used as a cutting agent whereas fentanyl is commonly seen.
Another key difference between heroin and fentanyl is that heroin is completely illicit. Most fentanyl seen on the streets is also illicit, however, there are prescription versions that are used for chronic pain management. This is typically seen in cancer patients or those recovering from extensive surgery. Prescription fentanyl comes in a variety of forms including lozenges, patches, injectable solutions, and pills. Illicit fentanyl and heroin are not regulated by any government agency, such as the Food and Drug Administration (FDA). Prescription fentanyl is FDA-approved and used under medical supervision, but it can still cause physical dependence and carries serious risks if it is not taken as prescribed.
Fentanyl and Heroin Overdoses
Overdosing on fentanyl or heroin is a medical emergency and should be treated with urgency. During an opioid overdose, breathing can become dangerously slow or stop. This can lower oxygen levels and allow carbon dioxide to build up in the blood, which can lead to brain or organ damage and death. Hypoxia is when not enough oxygen is circulating in the blood. This causes organs to shut down and potentially fail, leading to damage. Hypercarbia is when too much carbon dioxide is present in the blood. Both of these conditions lead to lasting organ damage and possible death. If an overdose of heroin, fentanyl, or both is suspected, call for help immediately. Give naloxone if it is available, call 911, and provide rescue breathing or CPR if needed and you know how. Stay with the person until emergency help arrives. Be honest about all substances taken so the medical professionals can treat them accordingly.
Fentanyl Addiction vs Heroin Addiction: Are They Treated the Same?
As fentanyl and heroin are both opioids, addiction treatment will be similar. However, every person is different, and no two addiction stories are the same. While therapies and skill-building classes are large components of treatment, some will respond to different therapies better than others. It is important to offer a range of therapy methods so that each person can find what works for them. Mental health also plays a role in addiction, and different conditions will require different treatments. Some may need medications while others respond to coping techniques. Recovery from fentanyl or heroin addiction will have similarities, but highlighting the differences between each person will make the most difference.
In some cases, medication may be used to treat fentanyl or heroin addiction. Medications for opioid use disorder, including buprenorphine and methadone, can reduce withdrawal symptoms and cravings and lower the risk of overdose. These medications can be used as part of ongoing treatment for both heroin and fentanyl use disorders.
Seeking Treatment for Opioid Addiction in Hillsborough County, FL
Opioids like fentanyl and heroin can seem to take over your life, often before you realize it. Living in fear of possibly overdosing is no way to get through life. Thankfully, treatment options for fentanyl addiction and counseling for heroin use disorder are out there and is the first step toward a new life. Opioid detox can be uncomfortable, but professionals will be there every step of the way to ensure your safety. After detox is complete, therapy and coping skill classes will begin. These will help you understand the root causes of your addiction and provide you with the tools needed for a successful recovery. Fentanyl and heroin addiction do not have to be permanent, all it takes is the first step today.
Clean Recovery Centers is here to guide you through leaving opioids behind and beginning your recovery. Each of our locations offers housing that has been certified by the Florida Association of Recovery Residences (FARR). You will never have to worry about a safe place to stay while you heal your body and mind. Call us today at (888) 330-2532 to learn more about our opioid addiction treatment.
Get Clean. Live Clean. Stay Clean.
FAQs
- Is street heroin always contaminated with fentanyl now?
No. Not every sample sold as heroin contains fentanyl, but fentanyl has become extremely common in the illicit opioid supply. In 2024, fentanyl was the primary drug in 73% of DEA-tested samples that contained both heroin and fentanyl. Because there’s no reliable way to tell what a street drug contains by looking at it, any illicit opioid can carry a risk of unexpected fentanyl exposure. DEA - How do acute withdrawal symptoms differ in severity between heroin and fentanyl detox?
Heroin and fentanyl withdrawal can both cause muscle aches, nausea, diarrhea, sweating, anxiety, sleep problems, and strong cravings. Research suggests fentanyl withdrawal may be more severe or last longer for some people, although the experience varies from person to person. Medical support and medications for opioid use disorder, such as buprenorphine or methadone, can help manage withdrawal and support continued recovery. PubMed Central (PMC)
