How Dependency on Prescription Pain Killers Can Lead to Heroin Addiction

Man struggling with pain medication and heroin abuse

It is estimated that between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription pain killers. In 2012 and an estimated 467,000 people were addicted to heroin. Several factors may contribute to the severity of the rising prescription drug abuse problem.

Some factors can include marked increases in the number of prescriptions (written and dispensed), greater acceptability for using medications for varying purposes, and aggressive marketing by pharmaceutical companies. Prescription opioids are similar to, and act on the same brain systems affected by, heroin and morphine.

These drugs are most dangerous and addictive when taken in ways that increase their euphoric “high” such as crushing pills and then snorting, or injecting the powder, or combining the pills with alcohol or other drugs.

Use of Prescription Painkillers

Opioids (including OxyContin, and Vicodin) that are mostly prescribed for the treatment of moderate to severe pain. These drugs, when taken, attach to specific proteins called opioid receptors, which are found on nerve cells in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs attach to their receptors, they reduce the perception of pain and can produce a sense of well-being.

Man struggling with prescription abuseOpioids can however, produce drowsiness, mental confusion, nausea, and constipation. The effects of opioids are typically regulated by opioid receptors that are activated by the body’s own opioid chemicals (endorphins and encephalins). With repeated use of opioid drugs (prescription or heroin), the production of natural opioids is inhibited.

Opioid can produce a sense of well-being and pleasure. These drugs affect the brain regions involved in reward and therefore people may seek to increase the experience by taking the drugs in other ways than prescribed. For example, extended-release oxycodone is designed to release slowly and steadily into the bloodstream after being taken orally in a pill; this minimizes the euphoric effects.

People who abuse pills may crush them to snort or inject which not only increases the euphoria but also increases the risk for serious medical complications, such as respiratory arrest, coma, and addiction.

Over prescription of painkillers and Heroin affect the part of the brain that controls emotions and perception of pain. This can occur because when crushed and ingested, all of the medicine can be released at one time, rather than in a slow release.

Tolerance occurs when the person no longer responds to the drug as strongly as they first did, and therefore needs a higher dose to achieve the same effect. Tolerance occurs when the abused opioids desensitize the brain’s own natural opioid system, making it less responsive over time.

The Impact of Heroin Abuse

Heroin abuse, like prescription opioid abuse, is dangerous both because of the drug’s addictiveness and because of the high risk for overdosing. In the case of heroin, this danger is compounded by the lack of control over the purity of the drug injected and its possible contamination with other drugs (such as fentanyl, a very potent prescription opioid that is also abused by itself).

Young man deep in thought while looking into the distanceAll of these factors increase the risk for overdosing, since the user can never be sure of the amount of the active drug (or drugs) being taken. Nearly half of young people who inject heroin surveyed in three studies reported abusing prescription opioids before starting to use heroin.
Some individuals reported switching to heroin because it is cheaper and easier to obtain than prescription opioids.

Prescription painkillers and Heroin area all derived from opium. Heroin has similar effects to painkillers and acts as a seamless way to replace painkillers. Painkillers can cost anywhere from $60-$100 per pill whereas heroin is approximately $10 for a single dose. Painkillers when crushed or dissolved are designed to turn into a sticky goo that cannot be injected. Heroin is purchased in a fine powder that is usable instantaneously.

The Connection Between Heroin and Painkillers

A recent report by the CDC stated that heroin overdose deaths doubled from 2010 to 2012 in 28 states. Two things according to the study, seem to be driving this rise in overdoses. One is widespread exposure to, and addiction too prescription opioids and increase in heroin supply. Many abusers start off with abusing prescription painkillers.

Once that source is exhausted, Heroin seems to be abusers next drug of choice. It is derived from the same plant and reacts similarly in the brain which connects to the brains reward center and provides a sense of euphoria. Many abusers natural progress into heroin as it is cheaper and easier to access.

Community Discussion – Share your thoughts here!

What do you find most used in your community? What are your observations about the differences between prescription painkillers and heroin in terms of accessibility, use, and affects?

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Certified Eating Disorder Specialist (CEDS) who works with individuals and families in the area of eating disorders. Mrs. Lyons works in the metropolitan St. Louis area and has been practicing in the field for 11 years. Libby is also trained in Family Based Therapy (FBT) to work with children-young adults to treat eating disorders. Mrs. Lyons has prior experience working with the United States Air Force, Saint Louis University, Operating Officer of a Private Practice, and currently works with both Saint Louis Behavioral Medicine Institute within their Eating Disorders Program and Fontbonne University


[1]: Retrieved from 2016
[2]: Retrieved from 2016
[3]: Retrieved from 2016

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 7, 2016
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About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.