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BetahydroxythiofentanylBetahydroxythiofentanyl, often written as β-Hydroxythiofentanyl, is an opioid analgesic drug and analogue of the powerful painkiller fentanyl. Drug analogues are drugs that have a similar basic structure to the parent drug compound, but with a slight modification.

The fentanyl analogues all belong to the same class of drugs as morphine, heroin, oxycodon and heroin. Most of them can be used as direct substitutes of heroin by opiate addicts. Fentanyl and its related analogue drugs bind strongly to the μ-opioid receptor in a similar fashion to heroin, producing a similar high. This is why they have a history as drugs of abuse.

There are a number of crucial differences between fentanyl analogues such as Betahydroxythiofentanyl and more traditional opiate drugs like heroin that make them arguably more dangerous than heroin.

First of all fentanyl analogues tend to be many times more powerful than morphine or heroin. Betahydroxythiofentanyl is no exception. There are unverifiable reports of it being a stronger drug than fentanyl itself. At the very least then it will be 100 times as potent as heroin. This means it takes at least 100 times less Betahydroxythiofentanyl to kill by overdose. A dose of pure Betahydroxythiofentanyl that might look like a few grains of salt could be enough to kill. It is easy to see then why fentanyl analogues are such dangerous recreational compounds.

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This danger is compound by a number of other factors. Most importantly is one of the most notorious side effects of these drugs. They are known to cause respiratory depression at lower doses relative to the euphoria or “high” they produce. Respiratory depression is the most deadly side effect of any opiate or opioid drug like morphine, heroin or oxycodon. At high doses of these drugs, breathing will become laboured, and the user will feel as if they are continually short of breath. This is a sure sign that too much drug has been administered. Of course fentanyl and its analogues produce less euphoria relative to the “high” then users tend to be pushing towards the higher doses and putting themselves at risk. They are chasing the high and this is very dangerous with fentanyl analogues.

At higher doses as the breathing mechanism becomes further suppressed, less oxygen reaches the brain and vital organs. The drug user may find their thinking becoming cloudy, and may experience small blackouts. A dose slightly higher than this again will cause them to black out. Their lungs and diaphragm are now heavily suppressed. Not enough oxygen is entering the body. Another side effect of the drug is vomiting. This is the final killer blow. They lose consciousness in an upright position, whilst the stomach is forced to expel its contents. The vomit will run back in to an unresponsive and heavily suppressed respiratory system. Now they will easily die from asphyxiation, drowning helplessly in their own vomit.

This has been the fate of many opiate addicts in the USA and Estonia where fentanyl analogues have reached the black market in a large way.