How do prescription opioids lead to heroin use? The answer to that question is one that every American can benefit from knowing, in light of distressingly high rates of addiction to painkillers in this country.
Heroin is a highly addictive drug that’s made from morphine, which is a natural substance that’s taken from the sap of opium poppy plants. It’s recognized as being one of the hardest drugs to quit and comes with a slew of serious side effects like insomnia, infections of the heart’s lining and valves, and liver and kidney disease.
It may be difficult to understand how someone could go from swallowing prescription pills to using an intravenous drug like heroin. While opioid use doesn’t directly lead to heroin use, research indicates that misusing prescription opioids may open the door to heroin use. In some cases, users report switching to heroin because it’s cheaper and easier to get than prescription opioids.
How Do Opioids Work?
While we tend to think of opioid addiction as a 21st-century problem, the truth is that opioids have been used for thousands of years, and their addictive properties have been recognized for hundreds.
In some cases, prescription opioids are made directly from the opium poppy plant, and in others, synthetic forms are created in a lab. Whether they’re natural or synthetic, they’re used because they contain chemicals that are effective in relaxing muscles and relieving pain. They are usually prescribed for moderate to severe pain and occasionally for diarrhea and coughing.
Opioids are absorbed through the gastrointestinal tract and attach to the opiate receptors in the brain, spinal cord, and other areas of the body. When that happens, the brain no longer perceives pain. The cause of the pain is still there, but the user no longer feels it.
Some of the most common prescription opioids include:
- Fentanyl
- Codeine
- Morphine, like Kadian and Avinza
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin, Percocet)
- Oxymorphone (Opana)
The Link Between Regulating Opioids and Heroin Use
In the 1990s, pharmaceutical companies sang the praises of opioids and assured the medical community that patients couldn’t become addicted to these effective pain relievers. As a result, healthcare providers began to prescribe opioid pain relievers at an increased rate. As this happened, opioid overdose rates also increased.
In the last two decades, drug overdose deaths involving prescription opioids have increased dramatically. In 2017, over 47,000 Americans died from opioid overdoses, including prescription opioids, heroin, and illegally manufactured fentanyl. That same year, it was reported that about 1.7 million Americans lived with substance use disorders related to prescription opioid pain relievers.
In response, some regions of the country have cut down on opioid-related deaths by putting drug take-back programs in place, making sure that patients aren’t getting prescriptions for opioids from multiple doctors and supporting the development of opioid pain relievers that are less habit-forming and less likely to be abused.
While progress has been made in reducing prescription opioid deaths, overdose deaths related to heroin have been on the rise since 2007. In 2014, the CDC reported 10,574 heroin deaths in the country, which is five times the number reported in 2002.
The relationship between prescription opioid abuse and heroin use is still being studied. Both of these substances are in the opioid drug category and overlap in a lot of ways, and for some people, prescription opioid use paves the way towards heroin addiction. According to the National Institute on Drug Abuse, 75 percent of those who abuse opioids reported that the first opioid that they used was a prescription drug. Another study showed the incidence of heroin initiation was 19 times higher among those who reported that they’d misused prescription opioids versus those who didn’t.
As tighter regulations have impacted how accessible prescription opioids are, many people have found themselves cut off from their legal suppliers— the doctors who write the scripts. Those who rely on higher than their prescribed doses have a harder time getting enough of the drug to achieve the desired effects. As a result, some users turn to heroin.
Heroin: Same High, Greater Accessibility
Prescription opioids may be harder to get, but heroin, which has similar chemical properties and effects on the body, is cheap and readily available. According to a recent study of heroin users in the Chicago metropolitan area, prescription opioid use is one of three pathways to heroin use. While only about four percent of prescription opioid users make the leap to heroin, numerous studies have suggested that about 94 percent of those people switch from prescription opioids to heroin because it’s more available, more affordable, and provides a better high.
Most people who use prescription opioids as directed and under the doctor’s supervision don’t go on to develop an addiction to more potent drugs like heroin. However, somewhere between 20 percent and 30 percent of people using opioids misuse them by taking them in a way or dose other than directed, taking someone else’s prescription medication, or taking the medication to get high. For these people, suddenly being cut off from their supply can result in unpleasant withdrawal symptoms like muscle aches, nausea and vomiting, blurry vision, and anxiety. To avoid withdrawal symptoms and to continue experiencing an opioid’s desired effects, some users seek out heroin.
The Opioid Crisis Is Far from Over
There’s no doubt that communities that have tackled the opioid crisis are seeing positive results. Among the 38 states that publish prescription opioid overdose death data, none experienced a significant increase in deaths between 2017 and 2018, and 17 states saw a decline.
Even so, the pipeline from prescription opioids to heroin still exists. As late as 2017, there were nearly 58 opioid prescriptions written for every 100 Americans. More than 17 percent of Americans had at least one opioid prescription filled, with the average patient getting 3.4 opioid prescriptions. The number of days per prescription is also increasing, averaging 18 days in 2017 compared to 13 days in 2006.
There’s a direct correlation between the prevalence and duration of opioid use and the likelihood of misuse. As long as opioids continue to be prescribed at a high rate, users will develop substance use disorders and addictions to these drugs.
Seeking Treatment for Opioid and Heroin Addiction
Misuse of prescription opioids and heroin affects more than two million Americans and about 15 million people globally every year. Drug overdoses are now a leading cause of death among Americans under age 50, with opioids accounting for over half of these deaths.
Anyone who takes opioids is at risk of developing an addiction, regardless of age, income level, and education level. These drugs are highly habit-forming, mainly because of how they activate the brain’s reward center to reduce pain and increase feelings of pleasure. Addiction can take years to form, or it may happen quickly, depending on genetic, psychological, and environmental factors.
For those who are living with opioid addiction, professional help is generally necessary. In most cases, treatment for prescription opioid and heroin addiction involves a detox period, withdrawal treatment, and long-term care. Many users successfully end their opioid addiction with a combination of medication-assisted treatment and therapy, and for most, it’s a life-long journey. If you’re living with opioid addiction, contact FHE Health for immediate help by calling 844-970-1777.
