# data[].attributes.body
Fentanyl is a synthetic narcotic that was created as a pain management, as it works as an anesthetic. It is reported to be more potent than morphine. Fentanyl can be used legally as prescribed to treat post surgery pain or for those who are tolerant to opioids. Fentanyl is considered a synthetic drug because it is man made in laboratories. It does not rely on the opium poppy for production. It is derived from an organic compound called Piperidine. The basic molecules in Fentynal can be manipulated to create different potencies. When used illicitly, Fentanyl is deadly as there is no regulation. Whether used legally or not, Fentynal is highly addictive.

# data[].attributes.attachment_link.readable_text
The Basics of Heroin and Fentanyl

Heroin is derived from morphine, which is a natural substance that is removed from the seed of the opium poppy plant. Heroin is distributed as a white or brown powder, or as a black, tacky substance known as "black tar" heroin. It is classified as an illegal drug with no accepted medicinal uses in the United States (Schedule I controlled substance) by the Drug Enforcement Administration (DEA). It is typically injected, smoked, or snorted when abused.

Fentanyl is a synthetic (manmade) opioid that is similar to morphine; however, the National Institute on Drug Abuse (NIDA) warns that it is 50-100 times more potent than morphine. The chemical structure of fentanyl is slightly different from that of heroin. Fentanyl was originally synthesized as a powerful analgesic (pain reliever), and it is still used medically to treat severe pain following surgery or for chronic pain in people who are opioid-tolerant, which means that other painkillers aren't as effective. Unlike heroin, fentanyl does have some accepted medicinal uses, so it is classified as a Schedule II controlled substance by the DEA. Schedule II drugs still have a very high potential for abuse and addiction despite their specific medical uses.

Fentanyl is diverted from licit uses for abuse, and it is also manufactured in clandestine laboratories. Fentanyl is cheaper and easier to obtain than heroin and is often used as a cutting agent or filler for heroin.

Fentanyl can be absorbed through the skin and be lethal in very small doses, as little as 0.25 milligrams, CNN warns. Prescription fentanyl comes in lozenges, buccal and sublingual tablets, nasal or oral sprays, as an injectable, and in a transdermal patch form. When abused, fentanyl patches may be sucked on, chewed, inserted into the body, or the gel can be scraped off the patches and injected. Tablets may be ingested or crushed and snorted, smoked, or injected. Illegal fentanyl may be made into pills to look like other prescription opioid medications like Norco, be manufactured in powder form, or put on blotter paper to be placed under the tongue.

Overdose Potential and Side Effects

Overdose fatalities involving heroin or fentanyl are rising. The Centers for Disease Control and Prevention (CDC) reports that close to 30,000 Americans died from an opioid overdose in 2014. Overdose deaths from synthetic opioids like fentanyl nearly doubled from 2013 to 2014, and heroin overdose fatalities quadrupled from 2002 to 2013, the CDC publishes.

People may not even realize that the drug they are taking contains fentanyl, as it is often passed off as pure heroin. Fentanyl is more potent than heroin and can therefore cause a toxic buildup and lead to overdose faster and in lower doses. An opioid overdose becomes dangerous when breathing is slowed too much. Pulse also slows, body temperature drops, and individuals often become mentally confused, drowsy, and lethargic. Pinpoint pupils and potential loss of consciousness are further indicators of an opioid overdose.

Overdose on either fentanyl or heroin has the potential to be life-threatening, and overdoses on both substances can be reversed with the swift administration of the opioid antagonist naloxone (Narcan). Since fentanyl is more powerful in lower doses than heroin, it may take several doses of Narcan to reverse the toxic side effects.

Both heroin and fentanyl can cause long-term damage to the respiratory and cardiovascular systems as well as lead to potential brain damage and cognitive defects. Injecting these drugs increases the risk for contracting an infectious disease like hepatitis and HIV/AIDS and for collapsed veins, scarring and track marks, and skin abscesses.

Dependence and Addiction

Both fentanyl and heroin are considered to be extremely addictive drugs. They can produce an intense and euphoric "high," and dependence can form quickly. Once the brain becomes used to the presence of an opioid drug, the body will require the drug in order to function optimally. Significant withdrawal symptoms can occur when the drug wears off. These effects include depression, anxiety, irritability, agitation, insomnia, and physical symptoms similar to those experienced with the flu. It may seem better to just keep taking the drug than deal with these painful withdrawal symptoms, and this can quickly lead to an inability to control how much and how often the drug is taken. Compulsive drug use caused by altered brain chemistry as the result of regular drug abuse is the definition of addiction.

The American Society of Addiction Medicine (ASAM) publishes that nearly a quarter of people who use heroin will suffer from opioid addiction, and over 2.5 million Americans battled addiction to opioids in 2015.

Both fentanyl and heroin are dangerous and powerful opioid drugs, and comprehensive addiction treatment is needed to address addiction to these substances. There are several medications that are FDA-approved to treat opioid dependence (methadone, buprenorphine, naltrexone), and these pharmaceutical tools, combined with behavioral therapies, are often beneficial in managing the cravings and withdrawal symptoms of either substance.

Since both fentanyl and heroin are both short-acting opioid drugs, they may be replaced with a longer-acting opioid during detox and addiction treatment. Neither heroin nor fentanyl should ever be stopped cold turkey. An opioid withdrawal medication is often given and then slowly tapered off to to minimize withdrawal symptoms and cravings. Treatment for opioid addiction is similar for addiction to either fentanyl and heroin, often beginning with medical detox and followed with a complete care plan that addresses both the emotional and physical aspects of the disease.

Quick Comparison between Fentanyl and Heroin

Heroin

Illegal drug with no accepted medical uses

Manufactured in powder form

Injected, smoked, or snorted when abused

Fast-acting and creates a short but intense rush

Semi-synthetic opioid

Potential for rapid onset of overdose, leading to fatal respiratory depression

Highly addictive

Often requires medical detox and opioid replacement medications to safely process the drug out of the body

Comprehensive treatment ideal for long-term recovery

Fentanyl

Available by prescription as a powerful painkiller and also manufactured illegally

Manufactured as a pill, patch, lozenge, tablet, injectable liquid, and powder

Ingested, snorted, smoked, or injected when abused

Fast-acting and creates a short but intense rush

Synthetic opioid

Lethal in much smaller doses and can be absorbed through the skin and incidental contact

Highly addictive

Often requires medical detox and opioid replacement medications to safely process the drug out of the body

Comprehensive treatment ideal for long-term recovery

# data[].attributes.attachment_link.title
Fentanyl vs. Heroin: The Similarities and Differences Between Two Powerful Opioids

# data[].attributes.attachment_link.description
Heroin is derived from morphine, which is a natural substance that is removed from the seed of the opium poppy plant. Heroin is distributed as a white or brown powder, or as a black, tacky substance known as "black tar" heroin.

# data[].attributes.body
Impact on the body: Fentanyl causes respiratory depression, decreases heart rate and blood pressure, causes constipation, nausea, dizziness, delirium, vomiting, blurred vision, and cardiac and respiratory arrest. Other side effects include seizures and hallucinations.
Impact psychologically: euphoria, relaxation, reduced pain, similar to heroine.

# data[].attributes.attachment_link.readable_text
You've likely heard of fentanyl and that it's a huge part of this country's drug crisis. But to fully understand why it's so deadly and why this country's drug epidemic is worse than it's ever been, you have to meet the parents of Alex Gertsch.

When the wind blows, there is both comfort and sadness for Dena and Shane Gertsch.

To speak about their son is agonizing, but they are enduring in order to save others.

"He was the center of our life," Dena said. "He was our only child and just everything was centered around him and trying to make sure he had a good, happy life."

Alex, 25, was a talented musician, a creative and kind soul.

"He had a smile that would light up a room and just kind, compassionate...," Shane cried.

Addiction is a horrible thing. Alex fought it and went to rehab. He was clean for eight months until he had a moment of weakness, his parents shared.

That moment of weakness was the beginning of a torturous education for these grieving parents. It was Alex's own father who found his body - and his cellphone.

"We were able to gain access to his phone, be able to see that our son's searching for the code words where he could find drugs on Craigslist.

Suddenly, at his fingertips, there was entry into that sinister world, no longer hiding in the shadows, but arrogantly out in the open.

Right there, during the interview, Dena plugs in the same codes and up pop the pushers.

Dena read one of the posts, "I'm offering sets and half sets of authentic white china plates. These plates are among the most prized ever distributed in America..."

That was only part of what they learned. The rest came after the autopsy.

"Our son's toxicology report came back with 100 percent fentanyl, nothing else in his system, pure fentanyl," Shane said.

In the DEA's secret lab, forensic chemist Dean Kirby said fentanyl is so potent and inexpensive, counterfeiters mix it in place of other, more expensive drugs. Touching it, breathing it or ingesting a minuscule amount can kill you.

"It takes two milligrams enough to kill a person, especially someone who's not tolerant in any way to taking those kinds of medications, so that's very small compared to a dosage of let's say heroin," he said.

And that's what happened to Alex. He wanted heroin, which is 50 times less powerful. Through Craigslist, he found someone named Stixx and texted him.

"You in stock with roofing tar?"

Stixx texted back that he's all out but he does have "china white."

It's likely Alex never knew what he was getting.

Fentanyl is a large part of what is killing 200 people a day in our country. It's produced in China and what's mindboggling is that it's often just mailed to the U.S.

The Gertschs ask the obvious question: Why?

"There seems like sometimes common sense should come into play," Shane said. "If there are all of these packages coming in from China with a similar look, shape and feel, maybe that's where we make an exception."

And Craigslist and social media platforms, why aren't these billion-dollar companies doing more to protect people?

"They will invest the money for algorithms and for data mining to market and sell for profit. What about using some of that same technology or same focus to help with social change," Shane said.

Alex was also a writer. One of his poems is inscribed on a wind chime at their home.

"Sometimes we think that it's Alex, like he's trying to send us a message," Dena shared.

"If he's out there watching us, he wouldn't want us to be sad every day -- it's hard not to," Shane said. "But he would want us to do what we can to potentially, hopefully help some other families from going through what we are going through."

Dena and Shane say the one bright spot in their story is the DEA's fusion task force. Investigators tracked down that dealer named Stixx and he now faces 20 years in prison. But no matter what happens to him, nothing will ease the pain of losing their one and only child, Alex.

# data[].attributes.attachment_link.title
Parents speak out about losing son to fentanyl overdose

# data[].attributes.attachment_link.description
You've likely heard of fentanyl and that it's a huge part of this country's drug crisis. But to fully understand why it's so deadly and why this country's drug epidemic is worse than it's ever been, you have to meet the parents of Alex Gertsch.

# data[].attributes.body
There have been 28,466 deaths related to synthetic opioids (mainly Fentanyl) since 1999. From 2007-2017 there was a 12.9% increase. It is estimated that 10% of people that are prescribed opiates become addicted. It is difficult to calculate as some do not know if Fentanyl is contained in certain batches of illicit drugs. In 2008, more than 20,179 people were treated in the ER due to Fentanyl.

# data[].attributes.attachment_link.title
Overdose Death Rates | National Institute on Drug Abuse

# data[].attributes.attachment_link.description
The U.S. government does not track death rates for every drug. However, the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention collects information on deaths involving many of the more commonly used drugs available through 2020 at a searchable database, ca…