Are Painkillers Becoming a Gateway to Heroin?
Painkillers and Heroin: The Tale of Two Opiates
Opiate painkillers, available only with a prescription in the U.S., are extremely effective, but they can be both addictive and dangerous. Starting in the late 90s, widespread abuse of prescription painkillers began, and before long, reached epidemic proportions. In response to the sharply rising trend of abuse, addiction and overdose fatalities, the government began cracking down on doctors who over-prescribed painkillers and the infamous “pill-mills” that had begun to pop up around the country to fuel the supply. This response helped slow the growth of painkiller abuse, but it also squeezed the opiate market, leading to greater scarcity and higher prices. Suddenly faced with expensive pills that were becoming harder to come by, many painkiller addicts have instead turned to heroin for a faster, cheaper high.
So why do addicts choose heroin? Like hydrocodone and oxycodone, heroin is a derivative of opium. Specifically, it is synthesized from morphine. Heroin has a very similar chemical effect on the brain as painkillers and this effect allows a prescription pill addict to avoid withdrawals and experience a similar high. The similarities between heroin and prescription painkillers end there, however. Manufactured in home labs and sold on the black market, heroin isn’t regulated and is very often impure, with dose strength varying greatly from batch to batch. It isn’t unusual for one bad shipment of heroin to be responsible for a flood of overdoses and trips to hospital emergency rooms.
The Link Between Heroin and Prescription Painkiller Abuse
Several recent surveys illustrate the link between prescription drug and heroin use rates:
- The National Survey on Drug Use and Health reports the number of users admitting to abusing prescription painkillers dropped from 5.1 million to 4.5 million between 2010 and 2011.
- At the same time, the survey reports the number of heroin users rose from 119,000 in 2003 to 281,000 in 2011.
- Of the 39 states that reported data to the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2011, 30 reported a surge in heroin abuse rates.
- Nearly 80 percent of people who used heroin in 2012 had also abused prescription painkillers.
For officials trying to stop opiate drug abuse, the current situation is like being caught between a rock and a hard place. “It’s hard to talk about the heroin problem without talking about the prescription drug problem,” states Rafael Lemaitre, communications director of the White House Office of National Drug Control Policy. Health officials have found themselves trying to slow rising painkiller abuse rates without inadvertently fueling heroin use. Controlling the supply of a legal substance is one thing. Controlling opiate addiction is quite another, especially when a cheap illegal substance gets involved.
Despite health officials’ best efforts, the crackdown on prescription drug abuse has unfortunately led to an increase in heroin overdose and addiction rates. While the slight drop in prescription pill abuse rates is certainly a relief and a welcome reversal after nearly two decades, the corresponding rise in heroin abuse is cause for concern. It also shows yet another danger that these prescription painkillers present, now as a gateway drug to heroin, one of the nation’s most notorious street drugs.