Is Heroin More Dangerous Than Other Opiates?

Is heroin more dangerous than other opiates? This doesn\’t have a simple answer, but in many ways, it probably is. When misused, all opiates and opioids are potentially dangerous, but heroin does pose risks beyond those of pharmaceutical opioid drugs.

Opiate or Opioid?

Although the terms opioid and opiate are often used interchangeably, they are not the same. An opiate is an alkaloid substance naturally present in the opium poppy, which is known as Somniferum papaver. Examples of these would be codeine and morphine. Heroin is an opioid. This means that it has opiate-like actions in the brain and body. Opioids are synthetic or semi-synthetic substances that may or may not be derived from opium. Some, such as fentanyl and methadone, are entirely synthetic. Others, like kratom, come from a plant not botanically related to the opium poppy. However, heroin is indeed an opium poppy derivative. To avoid confusion, this article will use the term opioid to refer to both opiates and opioids.

What is Heroin?

It\’s a semi-synthetic morphine analog, or chemical cousin, produced through a relatively simple chemical reaction process called acetylation. The chemicals needed to make heroin, such as acetic anhydride, are strictly controlled within the chemical market industry. If you\’re not a legitimate laboratory or school, you\’re not going to legally be able to get acetic anhydride.

Heroin was once freely available without a prescription. It was in all sorts of proprietary patent medicines primarily intended to treat cough, pain and diarrhea. In the nineteenth century and before, it was actually one of the very few medicines that actually worked. Heroin could be purchased over the counter in a general store or through the mail. Morphine, amphetamine, barbiturates, cocaine and marijuana were all freely available, too. In 1914, the Harrison Narcotic Act put an end to the over-the-counter purchase of opioids. However, the Act just required a prescription, which at the time was really not that hard to get.

A few years later, Prohibition forbid the sale and consumption of most alcoholic beverages, but people got whiskey prescriptions for medical use all the time. In 1937, the Marihuana Tax Act placed taxes on the substance but didn\’t criminalize it. States began passing laws to ban it. In 1970, the federal government placed all cannabis products in Schedule I, both outlawing and criminalizing its use at the federal level, where it remains to this very day. Substances in Schedule I have no accepted medical use. Heroin is a Schedule I drug in the United States, but it does have legal uses in some other countries. Heroin is roughly twice as strong as the morphine it\’s synthesized from.

Problems with Heroin

When compared with legal prescription opioids, even those which are much stronger, heroin is dangerous in that there is no way to be sure what the strength is. You can\’t tell by looking. It could be very powerful or very weak and still look the same. There are test strips that can tell you if it\’s heroin or not, but they can\’t tell you how strong it is or what else may be in it. With a prescription drug, as long as it\’s not counterfeit, at least you can be sure of its strength and purity. A legitimate prescription opioid isn\’t going to kill you with contaminants or other substances that shouldn\’t be there. Of course, overdoses still often happen, but this is because of carelessness and ignorance and not due to the drug itself.


Another major safety issue with heroin on the market today is that it\’s often cut with fentanyl. Worse, it may be cut with super-powerful fentanyl analogs like carfentanil, which is some tens of thousands times stronger than fentanyl. Even fentanyl itself is some 30 to 50 times stronger than heroin. With that kind of potency, overdoses can happen easily. Again, there are test strips available that will reveal if fentanyl is present in a particular sample of heroin or not. However, these test strips cannot tell you how much is there, so their usefulness is limited. Fentanyl is cheap and increases dealers\’ profits considerably, but few, if any, know how to properly cut heroin with fentanyl. This takes tremendous skill and knowledge not likely possessed by the average heroin street dealer.

Injection Dangers

Finally, heroin is more dangerous than many other opioids because it\’s commonly injected. Although heroin can be ingested both nasally and orally, the rush so desired by many users only comes with intravenous injection. Injecting a nonsterile substance into a vein can cause serious bacterial infections like endocarditis. This affects the heart and can be fatal.

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