Heroin is a drug that’s front and center in the opioid epidemic taking place in the U.S. right now. Heroin is powerful, inexpensive and relatively easy to obtain, and is used by many people who are addicted to opioids.
Also relevant to the heroin and opioid epidemic in the U.S. is synthetic heroin. Below is an overview of what synthetic heroin is and how to identify it.
There are only a few natural opiates that are used in medical settings, including morphine. Opium (a naturally occurring opiate) was used for medical reasons at one point but it is no longer used in clinical settings. Morphine and codeine are controlled substances in the U.S., which means only a qualified medical professional can prescribe them for pain relief.
Codeine is typically more commonly abused than morphine because it’s easier to get and it’s available as a prescription cough syrup. Other opioid drugs include methadone, fentanyl, oxycodone, hydrocodone, and heroin.
Heroin is one of the most widely abused of all opioid drugs. It’s made from morphine and then synthesized. Once someone takes heroin, it converts back into morphine in their brain before binding to the opioid receptors.
As cases of opioid addiction have become more prevalent over the years, there has been a rise in something called synthetic heroin. Synthetic heroin is an umbrella term which most often refers to drugs like Dilaudid or hydromorphone. Fentanyl is another drug that is commonly referred to as synthetic heroin. Fentanyl is incredibly powerful and often causes people to overdose after taking it. Fentanyl is so powerful that it can be dangerous to people who touch it or accidentally inhale it.
Fentanyl is an opioid pain medication that is considered to be 50 times more potent than heroin, but in many ways mimics the effects of morphine. Fentanyl was first introduced as a pain reliever for palliative care, but it’s since become one of the most widely used synthetic opioids. People may knowingly take fentanyl because of the powerful and rapid effects it can deliver, but they may also accidentally take it.
For example, so-called synthetic heroin is often mixed with heroin or is sold as a different medicine than what it really is. It’s led to many overdose deaths in recent years. Combining even just a small percent of fentanyl with heroin greatly decreases the amount of oxygen to the brain, which contributes to fentanyl overdose deaths.
Carfentanil is also often called synthetic heroin, and this is a derivative of fentanyl. Carfentanil is 100 times more powerful than fentanyl, meaning it’s 10,000 times more potent than morphine. It’s used to sedate large animals like elephants, and it doesn’t have approved human uses. It’s incredibly powerful and when veterinarians use it, they have to wear protective clothing.
Even in people with a tolerance for opioids, an amount of carfentanil the size of a salt grain can lead to overdose and death.
For example, the synthetic heroin name might just be used to refer to prescription opioids that act on the central nervous system in a way that’s similar to heroin, or it can be used to refer to incredibly powerful and completely synthetic substances like fentanyl and carfentanil. Because synthetic heroin leads to depression of the central nervous system and respiratory system, the use of this drug can cause breathing to stop.
In some cases, the synthetic heroin name may even be used to refer to methadone, which acts somewhat like an opioid but is designed to help people stop using heroin and other opioids.
There is also something called China White that’s relevant to the discussion of synthetic heroin. China White is a name that refers to derivatives of fentanyl. It’s similar to heroin and morphine but much more potent, and the overdoses that occur with China White are very difficult to treat. China White often contains a variety of substances including fentanyl as well as heroin and cocaine in many cases.
Synthetic heroin can look very much like conventional heroin, which is what makes it so dangerous and often deadly.
Synthetic heroin tightly binds to the brain’s opioid receptors. If someone overdoses on synthetic heroin, several doses of Narcan (naloxone) may be needed to reverse the drug’s effects.
Butterfield, Michelle. “P.E.I. Police Photo Shows Just How Little Fentanyl And Carfentanil It Takes To Kill.” Huffington Post, 2017. Accessed February 2019.
Centers for Disease Control and Prevention. “Synthetic Opioid Overdose Data.” Last updated December 18, 2018. Accessed February 14, 2019.
Koyyalagunta, Dhanalakshmi. “Chapter 113 – Opioid Analgesics.” Pain Management. Volume 2. 2007. 939-964.
Mars SG., Bourgois P, Karandinos G, Montero F, Ciccarone, Daniel. “Research paper: “Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting”. International Journal of Drug Policy. March 2014 25(2):257-266.
- Volkow, F. Collins. “The role of science in addressing the opioid crisis.” NEJM, 377 (2017), pp. 391-394.
PubChem. “Carfentanil.” (n.d.) Accessed February 14, 2019.
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