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Fentanyl Comparison Heroin Semi-synthetic opioid Highly addictive Illicit drug with no accepted medical use Manufactured in powder form Smoked, snorted or injected when abused Fast-acting and induces a short but intense rush Potential for rapid onset of overdose, resulting in life-threatening respiratory depression Often requires medical detox and opioid replacement therapy to clear the drug from the body safely, and prevent withdrawal symptoms and relapse Often requires comprehensive treatment for long-lasting recovery Fentanyl Synthetic opioid Highly addictive Available by prescription in several forms as a potent painkiller and also manufactured illicitly Manufactured as a pill, tablet, lozenge, patch, an injectable liquid, or powder Ingested, smoked, snorted or injected when abused Fast-acting and induces a brief but intense rush Lethal in microgram doses and can be absorbed through the skin by accidental contact Often requires medical detox and opioid replacement therapy to safely clear the drug from the body and prevent withdrawal symptoms and relapse Often requires comprehensive treatment for long-lasting recovery Getting Help for Opioid Addiction Both heroin and fentanyl are dangerous and potent opioids, and comprehensive substance abuse treatment is usually necessary to address addiction to these substances

Unlike urine testing, which measures metabolites filtered through the kidneys over time, oral fluid testing picks up parent drug compounds that transfer from the bloodstream into saliva almost immediately after use

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Totowa, NJ, Humana Press, pp 291304 Vachon L, Sulkowski A, Rich E