From prescription drugs to Heroin, how did I get here?

In the U.S., over 7 million people are abusing prescription pain medication and nearly half a million are addicted to heroin. There is a link, and information regarding the most recent upsurge in heroin addicts suggests that many new heroin users first abused prescription pain killers non-medically before phasing into their heroin habit. To highlight how frequent this is, a recent study confirmed that approximately 75% of new heroin users abused prescription opioids prior to abusing heroin.

Here's how the two problems go hand in hand, and how you probably ended up with a heroin addiction if you were once abusing prescription drugs. Americans are prescribed most of the prescription medications that are manufactured containing the opioid pain relievers oxycodone and hydrocodone in the world. The prescription drug abuse epidemic began about 20 years ago when these drugs flooded the market and became so readily available. Since the 90's, sales of prescription pain killers quadrupled rising from 76 million in 1991 to nearly 207 million in 2013. Fatal deaths involving prescription opioids have also quadrupled.

A great majority of "patients" who are getting their hands on these drugs, either abuse them intentionally to get high because they have a drug problem or become involved in abuse through a legitimate prescription. Addiction to prescription opioids through a legitimate prescription for pain is one of the driving factors in the epidemic. These drugs have been given to patients completely unethically for decades now, and acute pain which could have been alleviated with a non-opioid drug was instead addressed with a highly addictive drug. Once the patient became dependent to their prescription opioid medication there was no turning back from it, and they got stuck in the cycle of dependence and addiction to it. Withdrawal symptoms caused by an actual physical dependence to all opioids are pretty much the same, so someone who becomes addicted to prescription pain killers has the same manifestations of dependence and addiction as someone addicted to heroin.

The reason most people who abuse prescription pain killers phase over into heroin use and addiction is because of availability as well as cost. When you are addicted to any opioid it can be truly punishing if you don't satiate your cravings for the drug. It can be extremely difficult, due to the most recent measures to curb the prescription drug epidemic, to keep up with a prescription drug habit. Many of the prescription opioids that used to be readily available have been reformulated so they can't be abused as easily as they have been in the past. For example, capsules and pills have been reformulated so they cannot be crushed and snorted or perhaps intravenously injected for a more intense high.

So, when someone gets addicted to prescription pain killers, and they can't easily obtain them because of lack of availability or rising cost, they will very likely switch to heroin. As stated before, it's in the statistics that nearly ¾ of individuals who begin abusing pain killers do. Heroin is a more than suitable substitute for someone who has a prescription pill habit they can no longer maintain logistically and financially. Heroin is easier to obtain, readily available, cheaper for the most part, and doesn't have any loopholes to the person getting high from it.

Because of the recent upsurge and high demand for heroin, the illicit market has been flooded with heroin of significantly increased purity which contributes to the growing epidemic. This is also unfortunately a contributing factor in the rise in heroin related deaths which have more than tripled over the last three years.

So now that we understand how this can happen, it is also important to understand how to fix it. If someone does develop a prescription drug problem, they need treatment for opioid addiction in a drug treatment program. It is no different than a heroin addiction, and unless it is treated just as eagerly it will lead to heroin addiction or a fatal overdose for most people. When someone has developed a heroin addiction and they abruptly stop taking the drug it is painful and harsh but not fatal. Things can be done to ease these symptoms, but it will be difficult, and this is one of the most common reasons people relapse.

A robust support system and extensive treatment for heroin addiction, any opioid addiction really, is crucial and there are different ways to go about this. Many heroin addicts and prescription pain killer addicts are introduced to medication-assisted treatment of opioid addiction with drugs such as buprenorphine or methadone. Before starting treatment, patients should be aware that there is still addiction and overdose potential with these drugs and it is a daily logistical and financial commitment once started.

There are alternatives to medication-assisted treatment for heroin and prescription opioid addiction which have shown extreme promise, which involve behavioral interventions, screening and treatment of co-occurring mental health disorders, holistic treatment services, and therapeutic treatment communities which help individuals transition back to a drug free lifestyle.