Question

Explain why many people have transitioned from opioids to heroin?

Answer 1

Many opioids are prescribed legally by health care providers as painkillers, these include oxycodone, hydrocodone, codeine, and morphine, among others. Use of these prescription drugs for short durations, as prescribed by a doctor, is generally safe. However, use of illegal opioids such as heroin and misuse of prescription opioids can lead to addiction and even overdose or death. Misuse can include taking a drug that has been prescribed for someone else, taking a prescribed medicine differently than prescribed (for example, at a higher dose or for a longer period of time), or taking it to get high.

Prescribed opioids and heroin have similar chemical properties and physiological impacts; when administered by the same method (i.e., ingested or injected), there is no real difference for the user.

Studies show 4% to 6% of opioid misusers will transition to heroin. Research indicates 80% of new heroin users started with opioid pain relievers.

A number of studies have suggested that people transitioning from abuse of prescription opioids to heroin cite that heroin is cheaper, more available, and provides a better high. Notably, the street price of heroin has been much lower in recent years than in past decades (Unick et al., 2014). In addition to these market forces, some have reported that the transition from opioid pills to heroin was eased by sniffing or smoking heroin before transitioning to injection (Mars et al., 2014). In a recent survey of people in treatment for opioid addiction, almost all—94 percent—said they chose to use heroin because prescription opioids were "far more expensive and harder to obtain" (Cicero et al., 2014).

Individuals at increased risk of opioid misuse include those with: acute and chronic pain, physical health problems, or a history of mental illness (such as depression) or other substance use or misuse. Youth who have witnessed a family member overdose or who have a large number of friends who misuse prescription drugs also are at increased risk. National data show that nearly half of adolescents ages 12 to 17 who reported misusing pain relievers said they were given or bought them from a friend or relative. This number is over half for young adults ages 18 to 25 who reported misusing pain relievers.