Fentanyl vs Heroin: What are the Differences?
Both heroin and fentanyl are opioids, which means that they work by binding very strongly to the opioid receptors found a person’s central nervous system. They are synthetic, which means they are man-made. As opioids, they are narcotics, which means they slow down bodily functions and ease pain. But there are important differences between them. Both are implicated in drug abuse, especially in the opioid epidemic that afflicted the United States in the first decades of the 21st century.
Both drugs easily cross the blood/brain barrier, a physiological system that evolved to keep toxins out of the central nervous system. People who take both drugs experience a rush of pleasure then sink into a placid, dreamy, largely pain-free state. Their breathing and digestion slow down, and their pupils constrict. Some people also experience nausea, vomiting or constipation.
History of Diamorphine
Heroin is derived from morphine and is also called diamorphine, diacetylmorphine, or morphine diacetate. Its chemical formula is C21H23NO5. The drug was synthesized for the first time in England by the chemist C.R. Alder Wright, but it didn’t become a popular drug of choice until it was re-discovered by Felix Hoffmann, a German chemist working for the Bayer company, the same company that brought the world aspirin. It was in Germany that diamorphine was given its new name as it made those who took it feel heroic. By 1895, it was a drug that could be bought over-the-counter as a cough suppressant, and for a time scientists really believed that it was non-addictive. This, they believed, made it superior to its parent drug morphine.
Diamorphine’s penchant for addiction and overdose is so great that it is now a Schedule I drug in the United States. This means that the risk for it to be abused is high, there is no safe way for a health professional to administer the drug, and the drug no longer serves any medical use. It most often comes as a brown or white powder.
History of Fentanyl
Fentanyl has a more recent history than diamorphine. It was made in 1960, but it wasn’t until 1968 that it was approved for use as a pain medication and as part of a formula for anesthesia. Unlike diamorphine, it is still allowed to be prescribed for pain relief and often comes in the form of a patch worn on the skin. It is also injected, used in nasal sprays, given in the form of lollipops or placed under the tongue to be slowly absorbed through the mucous membranes. Patients in the end stages of terminal cancer are given the drug, which is also spelled, to ease their pain.
Unlike diamorphine, fentanil is listed as a Schedule II drug in the United States. This means that even though it has a high potential for abuse, it does serve a purpose when it comes to medical treatment.
The time it takes for the body to eliminate fentanyl depends on how it is delivered. When it is delivered intravenously, the half-life ranges from 6 minutes to 16 hours. The half life when it is delivered intranasally is 6.5 hours, transdermally 20 to 27 hours, and if it is placed beneath the tongue, its half-life is 2.6 to 13.5 hours. By contrast, the elimination half-life of diamorphine is 2 to 3 minutes, and its effects last for 4 to 5 hours. Fentanyl’s bioavailability is very high when contrasted with diamorphine’s. When used as a patch, fentanyl’s bioavailability is 92 percent. On the other hand, diamorphine’s greatest bioavailability is about 60 percent.
Another difference in diamorphine and fentanyl is their respective strengths. Fentanyl, whose chemical formula is C22H28N2O, can be as much as 10,000 times as strong as diamorphine, and its very quick and powerful high comes with the risk of shutting down the user’s respiration. People who use diamorphine sold to them on the street may run the risk of fatal overdose if the drug is “cut” by even a small amount of fentanyl. Some people, especially children, suffer severe side effects simply from accidentally handling discarded fentanyl patches. Others believe they can dose themselves with the drug to relieve the chronic pain that comes with such conditions as arthritis or broken bones that have not healed well. This has caused deaths from fentanyl to spike 540 percent between 2013 and 2016 according to the National Institute on Drug Abuse.
Rehab and Detox
People who find that they are dependent on either fentanyl, diamorphine or both of them can avail themselves of detox and rehab. Some facilities are inpatient or outpatient, and the best not only help the patient through the rigors of opioid withdrawal, but give them the social and psychological support to face the world without the use of drugs.
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