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Drugs & Health Blog

The Connection Between Pain Medications and Heroin

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Sara Bellum

Note: We published an updated version of this post in 2015. Read the updated version here.

More and more young people are using heroin these days, and sometimes they start using it because they’ve gotten addicted to prescription painkillers.

One study showed that people who abuse painkillers like OxyContin are 19 times more likely to start using heroin. The study also found that 8 out of 10 people who started using heroin abused painkillers first.

Heroin and painkillers belong to the same class of drugs: Opioids. Opioids attach to specific molecules called opioid receptors, which are found on nerve cells in the brain, spinal cord, intestines, and other organs. When painkillers or heroin attach to these receptors, they can decrease the feeling of pain. Opioids can also cause a person to feel relaxed and happy, which can lead some people to abuse the drugs.

Opioids have many negative effects. Painkillers and heroin can cause sleepiness, constipation, and, depending on the amount taken, affect a person's ability to breathe properly. In fact, taking just one large dose of painkillers or heroin could cause a person’s breathing to stop, sometimes killing them.

Why do people switch from painkillers to heroin? In an effort to cut down on painkiller abuse, changes have been made to laws and prescription drug tracking systems. Because it’s getting harder to get painkillers, people may turn to heroin because it is cheaper and easier to get.

The Danger in Abusing Painkillers or Heroin

Not everyone who abuses painkillers starts using heroin, but even painkiller abuse alone can hurt you. Opioid drugs of all kinds can be very addictive. Addiction is a disease where you feel like you need to use a drug even if that drug is hurting you and messing up your life. Addiction is caused by chemical changes in the brain after drug use.

When someone is addicted to painkillers or heroin, it is very difficult for them to stop using the drug. People trying to stop using opioids after they are addicted may have withdrawal. Some of the effects of opioid withdrawal are restlessness, muscle and bone pain, trouble sleeping, diarrhea, vomiting, cold flashes with goosebumps, and uncontrollable leg movements.

Did you know abusing painkillers was so dangerous and could lead to using heroin? Tell us in comments. 

Comments posted to the Drugs & Health Blog are from the general public and may contain inaccurate information. They do not represent the views of NIDA or any other federal government entity.


there are more facts to this and teens need to be more aware thank you for this post.
And how many people that used pain pills weren't addicted and this happen 2

Most people using heroin started with prescription opioids. However, most people using prescription opioids do not switch to heroin. In fact, less than 4 percent of people who abuse prescription opioids switch to heroin. (You can read more about that here:

At issue is the very large number of people being given prescription opioids. Even if a fraction switch to heroin, it represents a very large number of people. And even if they don’t switch to heroin, many die by overdosing on the pills (about 19,000 people a year).

When I was a pharmaceutical representative in 2003 I had to attend a training seminar about pain medication prescribing in which we compared heroin to prescription pain pills. We were taught that on the seventh consecutive day of taking either a pill or shooting up heroin, the human physiology is to become physically dependent to the point of having to feed the habit, to stave off the sickness, or become violently ill in going through the long withdrawal period. This was not made clear in the marketing of oxycontin. All pain pills that contain a derivative of morphine are subject to the same danger of addiction as heroin and until we educate the public and get the physicians to prescribe correctly, 5 day on with a 3 day wash, we will continue to have the addiction to pain pills and the crossover to heroin epidemic that we are swimming in today.
UR CRAZY IF U THINK I'M DOING THAT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!AND ITS SAD IF U DO :(
take away pain kills people will just goto what they can find and that heroin. this "drug war" is a losing battle. drugs aren't the main problem its the consequences of making them illegal.
Not strong enough with regards to "one large large dose of pain killers or Heroin could cause a person to stop breathing, somtimes killing them. The ignorance regarding all the factors is killing more and more young people. Half-Life of any medication needs to br publicized. Body size, weight and age as well as gender. Metabolism if each is individual is completely different and unique. I received a call, wrong number, from a 18 year old female who's friend died from an "accidental" overdose of Clonazepam and heroine, age 19, by the hand of her 24 year old boyfriend. He didn't call for help. I spent a long time talking and explaining why this "accident" ended her life. EVERYTHING I explained to her, I would ask, "Have you ever been told or were aware of this?" Her answer was always "no" By the time I finished explaining Half-Life, body type, and metabolism, she stopped crying. Education on physiology of the human body, metabolism and the build up of drugs, even in a weekend of abuse for a 100 pound young girl, will potentially kill you. As it did to her friend. RUSSIAN ROULETTE is the game they're playing. Because it's all about fun to the uneducated young who live for fun in the moment. Ignorance because no one is Teaching them. One time. One weekend. They haven't any idea how much their body has remaining in it's system from the last time. They feel fine. "CUMULATIVE" and Half-Life need to be yelled from every high school. Daughter/sister to Anesthesiologists'. Ever Vigilant, my dad would say about his medical field. Constantly and endless recording and even observation of the color of his patients fingernails.
your doctor will consider your health history, age, physical condition, life stressors and other factors to determine which medications may be right for you. Some medications may be prescribed only during the detoxification period, when your body is adjusting to the absence of heroin.
I was addicted to oxycotin and as my need for them got greater I could not keep up with the demand my body needed to function. I got so tired tired tired of witwithdrawal. Bad enough when your supplier were your own parents, it was there monthly medication. Their doctor had no problem writing 300+ for oxy/dros/dilaudid each meds for each of them. So we became full blown addicts right along with other people who would get pills from them as well. So one month after I had taken my last oxy and your body not ok but it jolts when you hear ive no more. I think you get sick faster than anything. Well i remember being hours in my withdrawal my mother said I can help you out but dont ask no questions. I had no problem with not asking, I just want the pain to go away. She took my arm tied it up and because I trusted my mother I didnt know she was about to introduce me to herion.
My God, how could she do her own child like that???
It really is a struggle I started out taking oxys and opanas then I started them. But the pills got sparse and expensive when I could find them, and believe it or not the needle is more addictive than the pills. If you've never shot up you wouldn't understand (also if you've never shot up don't ever try it) but when shooting up pills you end up with a lot of fillers and b.s. in your veins, which is no good. But then there was heroin, easy to find, if you get good stuff its not as bad for your veins as the pills, and it is a lot more potent. I used to crave the pills but that was nothing compared to how ungodly sick I got when I couldn't get heroin. Not to mention all the friends that I've watched fight it for years, many of which now have hep c, many have lengthy prison sentences for what they did while desperate to get high, and sadly many of my friends died fighting this addiction. Its no joke trust me I made my mistake and im still struggling to get away from it. I hope at least one person will read this and decide never to go near heroin or people who are doing it, because you'll end up just like them if you're around them long enough. Herion addiction is a terrible life long struggle that has taken many of my friends lives, and if you go down that road chances are you'll never find your way back
Wow good thing you made the right choice on the end
Will you email me please? I get this may be weird but I can't comment

Hi W, we can't email you (sharing contact information is against our blog commenting policies), but if you want to talk with someone, you can try one of the resources here:

Thanks for the info
dank memes
I'm addicted to pills. Just got woken up 5 hours into my sleep by withdrawals. Couldn't go back due to the crazy hot flashes, sweating, then freezing, goosebumps, restlessness, the need to change position every few minutes after getting comfortable, nausea, everything hurts, negative thoughts, I get crazy nightmares also when I withdrawal. So I decided to do some internet surfing. Anyhow, this is only an hour or two into the withdrawals. I popped 2 pills just now and I'm waiting for them to subdue. It's not enough to get high, I just want these symptoms to calm down.
I'm so sad for you. I hope you over come this addiction. I am praying for you Lena.
How can we get you the help you need to kick your habit?
I take morphine and the dr writes me out a prescription for 60: 60mg extended release and 120: 10mg extended release and also 4 bottles of morphine solution per month at 10mg/5ml concentration. (600mg in each bottle). (I had a 75ug fentanyl patch before the morphine) I wouldn't say I'm full blown addicted but I would say 100% that I am dependant on the medicines. I take them for chronic pain and it scares me the thought of not having them for pain and also the withdrawals that will happen if I do stop taking them. I'm prescribed 80mg slow release twice a day and upto 80mg of oral solution a day. It is true tolerance to strong opioids builds fast and the way it says "a big dose can kill" if someone with no tolerance tried a fentanyl patch it even warns them on the box that it's only for people with opioid tolerance. I will also say do not start using painkillers unless you really need them! I remember when they first gave me codeine, then dihydrocodeine, then tramadol then after a few years on that it was onto the fentanyl patch then finally now where I'm on morphine. I live in the uk and here it's harder to get opioids but they still prescribe them. If I could rewind the clock and start from fresh I wouldn't take them. The side effects are horrific the nausea and constipation are the worst. Some days when the pain is bad I will take 200-250mg of extended release tablets in the morning then take my usual 80mg at night. Before I started opioid therapy I used to see heroin addicts as junkies and smack heads but now I am dependant on an opioid I can definitely see how there is a bigger picture and how 80% of heroin addicts start out on painkillers. I have always said to my self as soon as I start to feel the pendulum is swinging from dependance to addiction is when I tell the dr straight away. I live in England and here the problem of teenagers getting prescribed painkillers and turning to heroin isn't as bad as we don't have to pay stupid prices for our prescribed medicines. All we have to pay is £8.05 per item so for them 3 items it is £8.05 x 3. Also I am age 22 and take the morphine (along with other non opioids like Lyrica and amitriptyline.) for back pain, hip pains, knee pain and they don't know what it is. This website has a lot more info than the UK website talk2frank has.
I don't understand? Was there physical pain first and no relief and the heroin helps like Advil? I thought heroin was taken to disappear from reality. Zone out. What does it mean to get high? And when a pain killer makes someone sleepy, is that getting high, too?

When we talk about "getting high," we mean a rush of relaxed and happy feelings that come from drugs' effects on the brain. Sometimes that includes feeling sleepy, and sometimes not. Opioids and Advil work in different ways. Heroin and opioid pain relievers both attach to molecules in the body called opioid receptors. That blocks pain messages being sent to the brain, and typically makes users feel high and zoned out. (Advil, on the other hand, works by reducing swelling.) Some people abuse prescription opioid drugs -- that means taking them to feel high, not because a doctor prescribed them for pain -- and get addicted. If they can't get more prescription opioids, they sometimes start using heroin, because it affects the same part of the brain as prescription opioids. Unfortunately, both heroin and prescription opioids can be very dangerous and even deadly if abused. You can read more about how different drugs work here:

The article said, "In an effort to cut down on painkiller abuse, changes have been made to laws and prescription drug tracking systems. Because it’s getting harder to get painkillers, people may turn to heroin." It's quite interesting that the Taliban had almost completely eradicated the poppy fields in Afghanistan until the U.S. invaded - they are now back up to almost 100%. The government has begun a smear campaign and is cracking down hard on legitamate doctors and on patients who need pain medication. The TV is full of commercials about the "dangers of prescription opiods". Facebook is flooded with ignorant memes about the pharmaceutical companies that make legal pain meds and the pharmacies that sell them. Is it a coincidence that you can go online and see pics of U.S. soldiers gaurding the poppy fields at a time that the streets are flooded with heroin? Is this why it's hard to legally get pain meds? he streets are flooded with heroin.

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