There has been a surge in demand for opioids in recent times.
This has led to the increased prevalence and availability of dangerous illicit street drugs like heroin and fentanyl.
The American Society of Addiction Medicine (ASAM) estimates that approximately 25% of people who use heroin will develop opioid dependence.
In 2017 in the UK, almost 60,000 people started treatment for opioid dependence, which at the time was 35% of the total number of people starting treatment for opioid dependence in the entire European Union.
The prevalence of opioid abuse in the United States also makes for grim reading. In 2015, over 2.5 million Americans were addicted to opioids.
The death rate due to opioid analgesic drugs like heroin and heroin laced fentanyl has been increasing rapidly over the past 20 years.
According to the Center for Disease Control (CDC), these drugs were responsible for 33,091 deaths in the US in 2015 alone.
The increased use of synthetic and semi-synthetic opioids has become a public health threat of increasing concern.
Heroin, also known as diacetylmorphine, is a semisynthetic opioid drug made from opium-derived morphine.
Although heroin is made from the naturally occurring opium poppy plant, it is considered semi-synthetic because the morphine used to make it is chemically processed.
Heroin differs from morphine only slightly. The presence of the acetyl group in heroin allows it to enter the brain much quicker than morphine.
This rapid onset of action is responsible for the “rush” associated with heroin use.
Once heroin enters the brain, it is synthesized to form morphine. Similar to morphine, heroin binds to opioid receptors in the brain called Mu opioid receptors (MORs).
MORs are responsible for the regulation of a wide range of bodily functions including stress, temperature, respiration, endocrine activity, gastrointestinal activity, memory, mood, and motivation.
Heroin is mostly distributed in three different forms:
Black tar heroin is largely produced in Mexico, brown heroin most often comes from Southwest Asia and white heroin from Southeast Asia.
Heroin can be administered in three different ways:
Heroin has several other names that it is referred to on the street that are used to divert attention and confuse law enforcement, family members, and teachers.
Popular street names for heroin include:
To discover more about heroin and its devastating effects, talk to our team on 0800 140 4690
Fentanyl is a synthetic opioid that is 50 – 100 times more potent than heroin.
There are two types of fentanyl: pharmaceutical fentanyl used to treat pain, and illicit fentanyl used on the streets for its pleasurable effects.
Like heroin, fentanyl mostly binds to MORs and initiates effects synonymous with heroin use as a consequence, despite their slight difference in chemical structure.
Fentanyl is mostly found in street heroin, particularly white powder heroin, added because of its low production cost and ability to create a more intense high for users.
The presence of fentanyl in heroin increases the opioid-like effect, but in so doing, makes it considerably more dangerous.
Fentanyl is also found in counterfeit OxyContin tablets, with some studies reporting its presence in up to 89% of seized tablets.
Fentanyl has also been detected in methylenedioxymethamphetamine (MDMA), counterfeit alprazolam (Xanax), and acetaminophen-hydrocodone (Norco).
Illegal fentanyl has also been sold as a powder, on blotter paper, in eye droppers, and in nasal sprays.
Unfortunately, most people who die from a fentanyl-related overdose are unaware that they have ingested the drug.
As a consequence, fentanyl is playing a central role in the increasing number of opioid-related deaths.
The serious overdose risk posed by fentanyl is largely due to its high potency and intense opioid-like effects, most notably severe depression and respiration difficulties.
As of 2015, synthetic opioids cause more deaths from overdose than heroin in the U.S.
Fentanyl, which can be deadly in small doses, is now the most common drug detected in cases of both fatal and non-fatal overdose across the U.S., both of which are continually on the rise.
Illicit fentanyl is typically administered in the following ways:
Like heroin, fentanyl has several street names which include:
In the U.S., heroin is an illicit schedule 1 drug. Schedule 1 drugs are considered to have no accepted medical use and a high potential for abuse.
Possession of heroin in the U.S. may carry a punishment of no more than 1 year imprisonment or a fine of no less than $1,500, or both.
The severity of punishment may be determined by drug quantity and intent to sell.
In the U.K., heroin is classified as a class A, schedule 2 drug.
Interestingly, heroin can be prescribed in the U.K. as a treatment for opioid dependence, however, it very rarely is.
It is illegal to possess heroin in the U.K. without a prescription, and only licensed pharmacists can supply or produce the drug.
Illegal possession of heroin in the U.K. carries a maximum sentence of 7 years’ imprisonment, an unlimited fine, or both.
Illegal supply and production of heroin in the U.K. carries a maximum sentence of life in prison, an unlimited fine, or both.
Fentanyl is considered to have medical utility, and is, therefore, classified as a schedule II drug that can be prescribed for medical purposes.
This is despite its high potential for abuse, dependence and overdose.
Fentanyl can be used during surgery and is in fact the most commonly used drug to induce analgesia during surgical procedures.
Fentanyl is also used to induce anaesthesia for patients undergoing heart surgery or for patients with heart failure.
Fentanyl can also be prescribed to treat severe pain in cancer patients who are already using opioid medication for underlying enduring pain.
In addition, it is prescribed to people with moderate to severe pain who require 24-hour pain-relieving medication.
Medical fentanyl can be prescribed in several forms, including:
The transdermal fentanyl patch is prescribed to people with chronic pain who require continuous delivery of the drug to effectively manage their condition.
Notably, physicians can only prescribe the fentanyl patch to people who have already developed a tolerance to another opioid medication.
Over the past 30 years, fentanyl has become an increasingly important medication in the treatment of pain
This is largely due to some of its desirable qualities that have led to its increased medical application.
These may include:
Would you like to learn more about fentanyl? Call us today on 0800 140 4690
Immediately after injecting heroin or fentanyl, users experience a “rush” of pleasurable feelings, characterised by intense sensations of happiness and euphoria.
Experienced mental effects are similar but less intense when opioids are administered using alternative methods such as oral or nasal, because it takes much longer for them to reach the brain.
The temporary pleasant effects of heroin and fentanyl help to improve mood and manage distress.
However, these effects are short-lived, and continued heroin or fentanyl abuse aggravates emotional and physical distress over time.
Short-term mental effects of heroin and fentanyl include:
Heroin and fentanyl abuse can cause several physical effects in addition to the above-mentioned mental effects
For instance, breathing becomes shallow and users may go in and out of drowsiness in a phenomenon called “being on the nod”.
Short-term physical effects of heroin and fentanyl include:
Heroin and fentanyl overdoses have the potential to be life-threatening. In fact, approximately 150 people die from opioid-related overdose every day.
Worldwide, 375,000 deaths every year are related to opioid use, with more than 30% of these deaths due to overdose.
Overdose deaths from fentanyl and other synthetic opioids more than doubled between 2012 and 2014.
It is estimated that over 40% of all these deaths were fentanyl-related.
The World Health Health Organisation estimates that approximately 115,000 people died of opioid overdose in 2017.
Nonfatal overdoses are substantially more common than fatal overdoses and occur in much greater frequency.
Over 30,000 people died from an opioid-related overdose in 2014 in the United States alone.
In that same year, opioids accounted for 60% of all drug overdose deaths.
Research conducted by the CDC illustrates that both heroin and fentanyl are the two most involved drugs in opioid-related deaths.
Opioid overdoses are caused by severely slowed breathing or a complete stop to breathing altogether.
Slowed respiration can cause hypoxia, a condition whereby the body’s tissues are starved of oxygen.
Opioid-induced hypoxia can lead to coma, serious brain damage, or death.
Signs of a heroin or fentanyl overdose may include:
Opioid overdose is an emergency situation and immediate medical attention should be provided.
Initial steps taken to care for someone who has overdosed include ringing emergency services, protecting the airway, maintaining breathing,and maintaining blood circulation.
At the same time, preparations should be made to swiftly administer the opioid antagonist drug naloxone.
Naloxone, which comes in nasal spray form under the names Narcan and Kloxxado, blocks and reverses the effects of heroin and fentanyl.
Naloxone can also be administered via the following routes:
The effectiveness of naloxone depends on the type of opioid used and how much was taken.
In the case of a fentanyl overdose, naloxone, which is typically effective for just 90 minutes at a time, may need to be administered multiple times to reverse toxic effects.
People who are administered naloxone should be carefully monitored for two hours after the final dose has been administered to ensure breathing remains stable.
Some states in the U.S. have made it legal for people without a prescription to purchase naloxone for the purpose of saving a person’s life.
Drugs can be tested for the presence of fentanyl by using fentanyl strips.
It is very difficult to effectively detect the presence of fentanyl in drugs without using these strips.
Test strips, which can be the difference between life and death, are very affordable and typically produce results in less than 5 minutes.
However, caution should still be taken even in the event of a negative test. Strips may not be effective in terms of detecting more harmful fentanyl analogues like carfentanil.
Healing oneself from an addiction to heroin can be mentally tasking, and is often a quite long and laborious road.
However, treatment options available today make the recovery process an awful lot easier than it otherwise might be.
If a person wants to receive treatment for their heroin addiction, they have two options: inpatient treatment or outpatient treatment.
Of the two options, inpatient treatment is recommended due to its higher success rate. Some of the main features of both inpatient and outpatient treatment are outlined below.
If you would like to learn more about rehab treatment for heroin addiction, give our team a call on 0800 140 4690
Medications used to treat heroin addiction help to lessen the challenging effects of withdrawal, prevent relapse, and ultimately make the recovery process considerably easier for patients.
The use of medications to treat opioid use disorders has been shown to reduce the risk of opioid-related fatal overdoses by up to 50%.
Medications for heroin addiction include:
If you believe that you or a loved one may be at risk of addiction to heroin or fentanyl, reach out to us today.
Our expert team have many years of experience helping addiction sufferers find the perfect treatment for their needs.
Whether you would like to begin the recovery process or just learn more about the disease of addiction, we are here to help.
Call us today on 0800 140 4690 and begin your journey towards sobriety.
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
