Can Prescription Opioid Abuse Lead To Heroin Abuse?

Prescription Opioid Pain Medication abuse has led to increased Heroin Abuse and accidental deaths in recent years in the USA and the problem is so prevelant that it is considered a public health crisis.  The emerging data in this trend is cause for great concern with the increased number of heroin use doubling from 2005 to 2012.  Even more alarming is adolescent (12 – 17 years old) addiction.  In 2014 close to a half million adolescents used prescription pain medication that was accessible from their parent’s medicine cabinet or friends.

During the early 2000s the death from heroin abuse stayed at a constant level, but with the increased prescription of opioid pain relievers around 2005 also saw a rise in the use of heroin and its victims, Heroin deaths doubled in 5 years time.  Today it is estimated that 78 people die daily in the United States of some form of an opioid overdose.

Opioid pain relievers are extremely addictive and when an addict is faced with the lack of supply or the cost of obtaining prescription pain medications are too difficult to obtain or costly the option for an addict is heroin.  Heroin is easy to obtain, is available in rural areas now but, because it is not regulated is often mixed with extremely dangerous opioids such as fentanyl.  Fentanyl is estimated to be 50 times stronger than pure heroin.  Prince died of an accidental overdose of fentanyl.

Overdose is the leading cause of accidental death.  Heroin use is extremely risky business not only because the drug manufacturing has no quality control but is also linked to HIV, hepatitis C and other blood borne diseases due to sharing needles and paraphernalia.

Prescription drugs, when used as prescribed, are safe and effective. However, when abused they can be harmful and become addictive. More than 80% of painkillers in the world are consumed in the U.S.A, which encompasses only 5% of the world population. It is therefore not surprising that drug overdose is the leading cause of unintentional deaths in America where someone dies of an overdose of prescription medication every 19 minutes on average.

What Are Opioids?

Opioid drugs are prescribed to patients with severe pain that does not respond to other pain medication. They reduce or eliminate pain by binding to the opioid receptors present throughout the body, minimizing or blocking the transmitting of pain signals to the brain. The following types of drugs are called opioids:

• Codeine (generic)
• Fentanyl (Fentora, Actiq, Durgesic)
• Hydromorphone (Exalgo, Dilaudid)
• Hydrocodone (Zohyro ER, Hysingla ER)
• Hydrocodone/acetaminophen (Lortab, Lorcet, Vicodin, Norco)
• Methodone ( Methdose, Dolophine)
• Oxycodone (Oxecta, OxyContin, Roxicodone)
• Opana
• Oxycodone and Naloxone (Targiniq ER)
• Oxycodone and Acetaminophen (Enocet, Percocet, Roxicet)
• Meperidine (Demerol)
• Morphine (Avinza, Astramorph, Kadian, Ora-Morh SR, MS Contin)

Fentanyl comes as a patch which allows the drug to be absorbed through the skin. The rest are oral drugs.

Opioid Abuse

There are several factors that may have contributed to the gravity of prescription drug abuse including:

–              A drastic increase in pain medication prescriptions written by doctors and dispensed by pharmacies;

–              Aggressive marketing of opioid prescription drugs by the Pharmaceutical Industry;

–              Increased social acceptance of the use of medications for pain and other ailments.

Together, these factors have helped to create a broad environment of prescription medication availability in general; and opioid pain relievers in particular.

The Relationship Between Prescription Opioid Abuse And Heroin Abuse

A recent trend has seen a switch from opioid drug abuse to heroin use with a significant rise in the population of new heroin users, particularly among younger people. There is growing evidence that opioid drug abusers are changing to heroin as prescriptions for opioids become less available and harder to abuse. For example, following the recent introduction of an OxyContin abuse-deterrent formulation, there was a downward trend in abuse of OxyContin followed by an increase in heroin use. The transition from opioid abuse to heroin abuse may in some form be contributed to the development of chemical intolerance to prescribed opioids, combined with increasing difficulty in illegally obtaining these drugs. In some communities heroin is cheaper and easier to obtain than illegal opioid prescriptions.

The Dangers Of Heroin Abuse For Opioid Prescription Abusers

Like opioid abuse, heroin abuse is extremely dangerous because it is highly addictive and carries a high risk of overdose. With heroin in particular the danger of overdose is compounded by the user’s lack of control over the purity of substance as it could be contaminated with impurities such as other potent drugs, including prescription opioids which in itself carries a high risk of overdose. As the user is never sure of the amount of the active drug in heroin obtained illegally, the risk of fatal overdose increase dramatically.

In addition to the risk of overdose, heroin is an opioid that is generally injected intravenously which increases the risk of transmission of HIV, Hepatitis C, sexually transmitted diseases and other blood-related diseases through shared and contaminated equipment, as well as sexually transmitted disease from risky sexual behavior engendered by drug abuse.  Heroin can also cause bacterial infections, abscesses, collapsed veins, cellulitis and heart valve infections.

The Dangers Of Heroin Abuse

Marijuana is often referred to as a gateway drug that opens doors to other types of drug abuse. This reference also applies to prescription drugs as a gateway to heroin abuse. Many heroin addicts confess to starting out with abuse of prescription drugs like Vicodin or OxyContin. Not every opioid drug abuser moves on to heroin abuse but the risk is not worth taking. It may start off quite innocently when a teenager decides that it is safer to use prescription drugs than an illegal drug like Ecstasy to get high, but soon finds that it is difficult to stop. As opioids work on the brain in the same way that heroin does, it is sometimes just a matter of time before prescription opioids are not enough anymore and is substituted by heroin – a dangerous decision, considering the consequences and potential risk of death.

Surveys have shown that high school students have long regarded heroin as one of, if not the most, dangerous drugs, and once addicted it is very hard to come off. A person trying to come off heroin will suffer serious withdrawal symptoms which cause severe restlessness, bone and muscle pain, involuntary leg spasms, vomiting, diarrhea, insomnia, cold flushes and goose bumps. However, once addicted to prescription opioids, it is easy for an abuser to switch to heroin when it becomes too difficult to obtain illegal prescriptions for painkillers, disregarding all the dangers involved.