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Why Synthetic Heroin Is More Deadly Than Heroin

We all take our chances when we use any drug—legal or illegal, over-the-counter, or prescription. But one of the real risks of taking street drugs is not knowing exactly what you’re getting or how powerful it is. It is not always known how pure the street substance is or isn’t. And that’s definitely the case with synthetic heroin.


Synthetic heroin can be several things, but none of it is real heroin, the illegal opiate drug made from morphine that is taken from the seed pod of the Asian opium poppy plant. Synthetic heroin is a man-made opioid drug. It contains no opium, which is one way it differs from real heroin. So, in other words, real heroin, which comes from a plant, is replaced by man-made analogs that are more addictive, deadly, and harder to track down.

The term synthetic heroin could refer to a combination of natural heroin that’s been mixed with fentanyl, an opioid that is similar to morphine but 50 to 100 times stronger than morphine, according to the National Institute on Drug Abuse. When fentanyl is prescribed to relieve pain in safe dosages, it can be effective. According to data from the U.S. Centers for Disease Control and Prevention, the 700-plus fentanyl-related overdoses that occurred between 2013 and 2015 is mostly linked to fentanyl that was not produced by a pharmaceutical company.

Synthetic heroin also can refer to a substance that is mislabeled as “heroin” but is entirely made up of nothing but fentanyl, or the animal sedative carfentanil, a derivative of fentanyl. The list of opioids that also could fall under the synthetic heroin label include:

  • Hydromorphone (brand name Dilaudid)
  • Methadone
  • Tramadol
  • Pethidine


According to the DEA’s 2018 report on the heroin threat in the United States, several states started to report spikes in overdose deaths due to fentanyl and its analog acetyl-fentanyl in late 2013. It writes in the report, “Fentanyl is much stronger than heroin and can cause even experienced users to overdose. Between 2013 and 2014, there was a 79 percent increase in deaths related to synthetic opioids, the category under which fentanyl falls. There were 5,544 synthetic-opioid-related deaths in 2014, and the true number is most likely higher because of non-standardized reporting and because many coroners’ offices and state crime laboratories initially did not test for fentanyl or its analogs unless given a specific reason to do so.”


As dangerous as they are, there are several reasons why synthetic drug use is popular. The most common one is that people seek these potent substances because they’re potent and the highs last longer. According to, more than 200 synthetic drug compounds have been identified. Many of them are made abroad in other countries and then smuggled inside the United States. The site lists anxiety, aggressive behavior, paranoia, seizures, loss of consciousness, nausea, vomiting, coma, and death as effects that result from synthetic drug use.

Brookings explains in its April 2018 article titled, “How Synthetic Opioids Can Radically Change Global Illegal Drug Markets and Foreign Policy,” why the synthetic opioid trade appeals to the people who participate in it. Making synthetic opioids requires a smaller labor force, it reports, and it takes far less work than cultivating the poppy plant and collecting its resin for heroin. Brookings also writes that because less labor is required, it also means the benefits of production are lower in poor areas. Synthetic drugs also can be produced just about anywhere, meaning any place is ripe for opportunity.

In a March 2018 press release, the CDC reported that drug overdoses killed 63,632 Americans in 2016. “Nearly two-thirds of these deaths (66 percent) involved a prescription or illicit opioid,” it said.

According to its analysis of 2016 U.S. drug overdose data, “The recent increases in drug overdose deaths are driven by continued sharp increases in deaths involving synthetic opioids other than methadone, such as illicitly manufactured fentanyl (IMF).”

The synthetic class of drugs, which are also known as designer drugs, includes:

Synthetic marijuana. This is not real marijuana and it is also known as cannabinoids. It is known on the streets as K2 and Spice. reports that there are about 90 different synthetic marijuana chemical compounds.

Synthetic LSD. This drug, a phenethylamine, is said to mimic the effects of actual LSD and causes hallucinations and paranoia. Street names for it include “N-Bomb” and “Smiles.”

Synthetic stimulants. These are popularly known as “bath salts” or “Molly.” They are also called cathinones and mimic the effects of MDMA or ecstasy.

Synthetic PCP. This synthetic compound, known as MXE or Methoxamine, mimics the effects of PCP (phencyclidine). Delusions, a sense of detachment, and psychosis are effects of using this drug.

When it comes to synthetic heroin, there are a few more things to know.

It Is Hard to Tell Synthetic Heroin From Real Heroin

The appearance of synthetic heroin makes it tricky to identify, which is why so many people are not aware that they have used it. A powder that looks like heroin could have been cut or laced with fentanyl or another synthetic opioid. A person buying prescription pills off the streets with a certain label actually could be buying another substance entirely.

The practice of cutting synthetic heroin with fentanyl and other harmful substances increases profits for sellers in the illicit market because it increases their drug supply. But for users who get ahold of these cut batches of drugs only increase their chance of overdosing. The substance is in part stronger because some dealers may not have the equipment to measure out levels of the drug that could result in an overdose. Illegally made fentanyl also can be unpredictable as the pharmaceutical version of it.

Synthetic Heroin Is More Addictive Than Heroin

Natural heroin is a strong, addictive drug in its own right. The substance can be eaten, smoked, snorted, or injected for the highs it brings. Users report feeling an immediate, intense, and pleasurable rush as the drug enters the brain and returns to its morphine state. Regular heroin use is quickly habit-forming, and chronic heroin use results in addiction for most people. However, an addiction to synthetic heroin, which, again, might not be heroin at all, presents a different set of challenges. It’s already difficult to end addiction to heroin. But synthetic heroin is another battle altogether and a person can have an even tougher time ending their dependence on that drug.

Synthetic Heroin May Not Respond Well to Overdose-Reversal Drugs

Synthetic heroin and other synthetic opioid drugs are stronger than natural heroin, which means life-saving overdose agents like naloxone aren’t as effective. Multiple doses may be required to bring around a person who has overdosed, and as an August 2017 Bloomberg article notes, multiple applications of overdose-reversal agents can drain health care resources.

“Hospitals and emergency-services agencies across the U.S. are confronting higher bills for the chemical compound that can block the effects of painkillers and heroin, as super-strong synthetic opioids like fentanyl and carfentanil grow increasingly popular,” the article says. “Not only are more doses of the remedy often required, prices for some brands of naloxone have been ticking up.”

According to the report, the National Association of EMS Physicians says the number of people who receive more than one dose of naloxone has grown more than 25 percent since 2012.

The fact that these overdose-reversal medications may not work as well, if at all, makes synthetic heroin more lethal and dangerous. If one does overdose on a substance that has been passed off as heroin but isn’t, the person could die. They also can have a harder time ending their addiction.


The name “China White” emerges when synthetic heroin comes up. The designer drug China White, a fat-soluble pain reliever, is said to be stronger than morphine, heroin, or fentanyl. It also is said to last much longer than any of these drugs.

China White has been described as a heroin-like drug that actually is a derivative of fentanyl. But Dr. Wilfredo Lopez-Ojeda, a biomedical sciences professor at the University of Central Florida, told that the substance popularly known as China White doesn’t exist. He explained, “What gave rise to China White is a mixture of the original fentanyl with perhaps some residues of heroin and maybe some cocaine, then they started referring to it as a more pure product. But the truth is such a thing doesn’t exist.”

Despite this, China White’s side effects are reported to be deadlier and harder to identify. “People high on the drug who enter emergency room may seem like they’re overdosing on heroin or another opioid, but the symptoms are more complicated because fentanyl derivatives are far more powerful,” the publication reports.


Whether it’s heroin, synthetic heroin, or any other addictive substance, dependence on a drug jeopardizes everything—health, relationships, income, well-being, and more. Battling addiction can be difficult without professional help from trained addiction specialists, but that’s what Pathway to Hope is here for. We can help you.

Pathway to Hope, a Delphi Behavioral Health Group facility, specializes in helping people who are battling substance addiction, whether that substance is legal or illegal. We focus on the roots of your addiction and mental health condition and help you or your loved one start healing from substance abuse and give you the tools to leave it behind for good.

If you or someone you know is struggling with drug abuse, call Pathway to Hope at (855) 757-2128 today or contact us online, so we can help you find the right treatment program. Don’t delay. If you need addiction treatment, now is the time to make that important step for your health and your life.


Elysia Richardson

Elysia L. Richardson is a writer and editor at Delphi Behavioral Health Group.

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