Heroin And Fentanyl Addiction And Abuse
Heroin and Fentanyl are both powerful Opioid drugs that are extremely addictive and dangerous. Heroin is made from Morphine, which is made from the resin of poppy plants. It is refined from Morphine to become the addictive drug that can be injected, smoked, sniffed, or snorted. Sometimes Fentanyl is added to Heroin to increase potency, which is dangerous for the user because of Fentanyl strength. The Synthetic Opioid Fentanyl is intended to treat severe pain, like the kind after surgery, but it is also abused and has become responsible for many overdoses. Heroin and Fentanyl are drugs that can derail someone’s life; they can even claim it.
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Heroin was manufactured in 1898 by the Bayer pharmaceutical company as a treatment for Morphine addiction and tuberculosis. The intention of Heroin was to be a non-addictive substitute, but it ended up being more addictive than Morphine. Throughout the 1900s, Heroin addiction became a growing issue in the United States. Today, Heroin is a Schedule I drug; according to the federal government, it has no currently accepted medical use and a high potential for abuse. Its appearance varies, but it is usually seen as a white or brown powder or as a black and sticky substance called Black Tar Heroin.
When consumed, users start to feel the effects of Heroin very quickly. Injecting the drug into the bloodstream allows the user to feel the effects almost immediately, but this method of use presents unique dangers. Many people start by injecting into their forearms, but as veins become damaged or collapsed (or inflammation, infection, bruising, or lesions occur) users will have to start finding other places on the body to inject the drug. Other common areas used are the neck, hands, feet, face, and groin. Injecting drugs, especially Black Tar Heroin, puts users at risk for wound botulism. Wound botulism occurs when the germ Clostridium Botulinum gets into a wound and creates a toxin that causes muscle weakness, breathing difficulties, paralysis, and sometimes death. It is often seen in people who practice injecting drugs under the skin or into the muscles.
People use Heroin for the euphoric, pleasurable feeling they feel upon consuming the drug. Other effects that happen after using Heroin are a heavy feeling in the arms and legs, warm flushing of the skin, dry mouth, itching, clouded mental functioning, nausea and vomiting, and going back and forth between being conscious and unconscious. Long-term effects can develop after extended periods of use, such as lung complications, kidney and liver disease, sexual dysfunction, insomnia, depression, antisocial personality disorder, infection of the heart lining and valves, and abscesses.
With all of the negative side effects that come from using Heroin, it may be difficult for some to understand why someone would choose to keep using the drug. Once the body is used to Heroin, terrible withdrawal symptoms will occur if someone stops using it. These symptoms include diarrhea and vomiting, cold flashes, sleep problems, muscle and bone pain, restlessness, and uncontrollable leg movements. The more someone uses Heroin, the more of the drug they will have to take to get the same effects. Professional detox will make the process of quitting Heroin much more manageable and successful, followed by drug rehabilitation such as attending an inpatient treatment center.
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Fentanyl is classified as a Schedule II drug, “with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.” Although considered dangerous, Fentanyl is approved by the Food and Drug Administration (FDA) for use as an anesthetic and analgesic. Illegal distribution of the drug comes from both clandestine laboratories and theft from prescriptions. Fentanyl appears in many forms, including lozenges, tablets, nasal sprays, injectable formulations, and a powder. When abused, Fentanyl is taken orally, smoked, snorted, and injected.
Fentanyl produces a similar effect as Heroin, giving users a euphoric feeling quickly upon consuming the drug. Other effects include relaxation, pain relief, and sedation, as well as negative effects like nausea and vomiting, dizziness, drowsiness, confusion, urinary retention, and respiratory depression. Fentanyl is 50 times more potent than Heroin, making it easy to accidentally overdose from the powerful drug. The number of overdose deaths from Fentanyl have been increasing in recent years, with 2,666 deaths in 2011 to 31,335 deaths in 2018. One of the dangers of Fentanyl is that it is often added to Heroin without the user’s knowledge, leading them to take too much of the drug and overdose.
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Heroin And Fentanyl Distribution
The Heroin and Fentanyl markets are intertwined, according to the Drug Enforcement Administration’s (DEA) 2019 National Drug Threat Assessment. Both drugs disproportionately affect the Great Lakes and Northeast regions of America, with the majority of Heroin as well as Fentanyl being smuggled across the Southwest border from Mexican transnational criminal organizations. Drug traffickers mix Fentanyl in with white powder Heroin to stretch their supplies while giving users a potent product.
As traffickers mix Fentanyl into local Heroin supplies, they can charge a higher price for their product all while maintaining stable Heroin purity.
Mixing Fentanyl into Heroin puts users at a greater risk of overdose and death, especially when they are unaware that their Heroin contains Fentanyl. The largest Heroin markets in the United States are white powder markets in major Eastern cities. Smaller markets exist in Western cities, and many of them are Black Tar Heroin markets. The white powder Heroin markets are also the largest Fentanyl markets, as Fentanyl is both mixed into Heroin and sold as a stand-alone product. The presence of Fentanyl in these markets has resulted in a higher number of overdose deaths. The state of Delaware is an example of this, where Fentanyl was present in 72% of toxicology results for those who had overdosed in 2018. Fentanyl use and distribution is still increasing across the country, taking lives as it spreads.
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The Crisis Of Heroin And Fentanyl
A lethal dose of Heroin for an adult man is about 30 milligrams. The lethal dose of Fentanyl is only 3 milligrams. When someone goes to take their normal dose of Heroin, they are likely unaware that it has been mixed with Fentanyl and they are injecting a deadly concoction into their bodies. The drug Naloxone (Narcan) is meant to reverse Opioid overdoses and can be the difference between a person’s life and death. Naloxone works on Fentanyl, but it usually takes more doses of Naloxone to show results. This could be serious if someone has a limited amount of the drug and is unaware that their friend has even consumed Fentanyl. It is important to know the signs of an Opioid overdose so that medical treatment can be sought at the first signals.
The signs of an overdose are unconsciousness, a slow or erratic pulse, slow, erratic, or non-existent breathing, and choking sounds. They may appear pale and clammy, have blue or black lips and nails, and have a blue, purple, gray, or ashen skin tone. If they are awake, they will be unresponsive and unable to talk, have a limp body, and may vomit. Someone who is suspected of having an overdose should never be left alone, and professional treatment should be contacted immediately. The number of deaths involving Heroin in combination with Fentanyl have been increasing since 2014 and has become a major component of the Opioid epidemic.
Treatment For Heroin And Fentanyl Addiction
Overcoming an addiction to Heroin or Fentanyl is a difficult process that may take time. Methadone clinics offer people a safe, clean place to receive Methadone and Buprenorphine as part of their treatment for a Heroin addiction. If someone receives these medications and then uses Heroin or Fentanyl, the euphoric effects will be suppressed; this may motivate the user to stick to their treatment plan. These medications, as well as a variety of other therapies, are offered as part of inpatient or outpatient treatment programs. It is advised to detox under medical supervision to make the process easier and increase the odds of completing the detox. Contact a treatment provider for free today if you or a loved one is ready to take the steps to overcome an addiction.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience