Fentanyl vs. Heroin: An Opioid Comparison

Heroin vs Fentanyl

Heroin and fentanyl are both opioid drugs that bind to opioid receptors in the brain, reducing pain sensations and elevating pleasure and relaxation. Both are extremely potent, fast-acting, and can be lethal in as little as one dose.

Fentanyl vs. Heroin

Heroin is derived from morphine, which is a natural substance that is removed from the seed of the opium poppy plant. Heroin is distributed as a white or brown powder, or as a black, tacky substance known as “black tar” heroin. It is classified as an illegal drug with no accepted medicinal uses in the United States (Schedule I controlled substance) by the Drug Enforcement Administration (DEA). It is typically injected, smoked, or snorted when abused.

Fentanyl is a synthetic (manmade) opioid that is similar to morphine; however, the National Institute on Drug Abuse (NIDA) warns that it is 50-100 times more potent than morphine. The chemical structure of fentanyl is slightly different from that of heroin. Fentanyl was originally synthesized as a powerful analgesic (pain reliever), and it is still used medically to treat severe pain following surgery or for chronic pain in people who are opioid-tolerant, which means that other painkillers aren’t as effective. Unlike heroin, fentanyl does have some accepted medicinal uses, so it is classified as a Schedule II controlled substance by the DEA. Schedule II drugs still have a very high potential for abuse and addiction despite their specific medical uses.

Fentanyl is diverted from licit uses for abuse, and it is also manufactured in clandestine laboratories. Fentanyl is cheaper and easier to obtain than heroin and is often used as a cutting agent or filler for heroin.

Fentanyl can be absorbed through the skin and be lethal in very small doses, as little as 0.25 milligrams, CNN warns. Prescription fentanyl comes in lozenges, buccal and sublingual tablets, nasal or oral sprays, as an injectable, and in a transdermal patch form. When abused, fentanyl patches may be sucked on, chewed, inserted into the body, or the gel can be scraped off the patches and injected. Tablets may be ingested or crushed and snorted, smoked, or injected. Illegal fentanyl may be made into pills to look like other prescription opioid medications like Norco, be manufactured in powder form, or put on blotter paper to be placed under the tongue.Don’t wait. Call us now.Our admissions navigators are available to help 24/7 to discuss treatment.Why call us?Fentanyl vs. Heroin

Comparing Heroin & Fentanyl


  • Illegal drug with no accepted medical uses
  • Manufactured in powder form
  • Injected, smoked, or snorted when abused
  • Fast-acting and creates a short but intense rush
  • Semi-synthetic opioid
  • Potential for rapid onset of overdose, leading to fatal respiratory depression
  • Highly addictive
  • Often requires medical detox and opioid replacement medications to safely process the drug out of the body
  • Comprehensive treatment ideal for long-term recovery


  • Available by prescription as a powerful painkiller and also manufactured illegally
  • Manufactured as a pill, patch, lozenge, tablet, injectable liquid, and powder
  • Ingested, snorted, smoked, or injected when abused
  • Fast-acting and creates a short but intense rush
  • Synthetic opioid
  • Lethal in much smaller doses and can be absorbed through the skin and incidental contact
  • Highly addictive
  • Often requires medical detox and opioid replacement medications to safely process the drug out of the body
  • Comprehensive treatment ideal for long-term recovery

Dependence and Addiction

Both fentanyl and heroin are considered to be extremely addictive drugs. They can produce an intense and euphoric “high,” and dependence can form quickly. Once the brain becomes used to the presence of an opioid drug, the body will require the drug in order to function optimally. Significant withdrawal symptoms can occur when the drug wears off. These effects include depression, anxiety, irritability, agitation, insomnia, and physical symptoms similar to those experienced with the flu. It may seem better to just keep taking the drug than deal with these painful withdrawal symptoms, and this can quickly lead to an inability to control how much and how often the drug is taken. Compulsive drug use caused by altered brain chemistry as the result of regular drug abuse is the definition of addiction.

The American Society of Addiction Medicine (ASAM) publishes that nearly a quarter of people who use heroin will suffer from opioid addiction, and over 2.5 million Americans battled addiction to opioids in 2015.

Both fentanyl and heroin are dangerous and powerful opioid drugs, and comprehensive addiction treatment is needed to address addiction to these substances. There are several medications that are FDA-approved to treat opioid dependence (suboxone, methadone, buprenorphine, naltrexone), and these pharmaceutical tools, combined with behavioral therapies, are often beneficial in managing the cravings and withdrawal symptoms of either substance.

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