Drugs & Health Blog

The Connection Between Pain Medications and Heroin

This blog post is archived and is no longer being updated. For the latest content, please visit the main Drugs & Health Blog page.
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.

Killing More Than Just Pain

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.


As a chronic pain suffer myself I as well as most in my "pain community" try to go natural, use physical therapy, OTC's, anything before having to rely on prescription pain meds. Even then we try an try not to take them as to not become Dependant on them, as living with all our ailments and the problems that arise due to them is enough of a problem! Inevetibly they become a daily part of life. :-( Now with the war on prescription pain meds being what it is were being stripped of what little relief we do get if any! This is just so we can do most things folks take for granted...bathing, cooking, cleaning, etc... Most of us have already had to stop working and miss out on so many events in life its sad. There was a natural pain killer that did work well called Kratom, but as of Sept. The govt made it illegal. Coincidentally they've also come up with this new "wonder drug" that's under testing that promises to not have the same addiction problems as the opiods...which is making me think they've now found and are patening Kratom hence making it illegal to us. Smh! So I'm glad u don't face these daily issues and can heal naturally but for a lot of us...do we not deserve any quality of life?
Thank you for putting it so eloquently. I had to stop teaching due to pain. I was taking 18 advil a day, seeing chiropractor 2 to 3x a week. Finally taking hydrocodone allowed me to work 4 more years. Then I physically collapsed from pain. After 2 surgeries I could no longer work at all. My pain meds simply allow me to do my chores, go out to eat once a week. Now due to federal guidelines my pain doctor says he is going to stop my meds. I'm allergic to other meds, stomach, liver is ruined from nsaids. I'm so stressed worrying about what to do I'm barely functioning. No one in the medical community seems to care about older women in pain.
I never knew pain killers could lead to h and actually I don't think it ever would either .... Maybe doing pain killers makes you more likley but I believe it's for a diff reason... Most people who take meds don't know the price of H or how much it cost per point . Ppl don't just know that stuff .. How do they learn ?? How do they take their first hit ?? Do they just go out on face book and start looking for it ? NO THEY DONT!!!! Someone you know/trust enough to hear them out explains to you the pros and most don't explain the cons or atleast they just say ..."ITS JUST LIkE MEDS Just a little bit worse " they take a hit the girl you like takes a hit . And your like man I'm out of meds and they are becoming an issue in my life . Why not try this just one time it's not like I know where to get it anyways . Boom . Excuse after excuse bc your "friend triggered that addiction thinking process where you can literally fool yourself.. And after taking that first hit its like I've already done it okay .. And then you start feeling bad for not paying for it or your friend starts getting stingy with it .. So you have to buy some for yourself and your like ah just this one time i never really got a good hit "lies" then you have to trust that so called "friend" to not lie about to price . Which 9/10 times he is going to lie to get him some or put cash in his pocket . And then you are an addict
People that have legitimate pain problems are now being policed like common criminals because of these regulations. Don't you understand, if you take pain relief away from people that need it, you won't stop the people that take it anyway they can get it (illegally). It's just like saying to murderers: it's illegal to have a certain weapon (maybe a gun). Do you think that they will stop and say: I was going to kill someone with a gun today but I just found out that's illegal, oh wait, murder is illegal. Criminals will find a way to do what they want to do, just like people looking for a high are going to do whatever they want to make that happen. Why punish law abiding citizens for the behavior of murderers, and why punish people that legitimately need pain medicine for their very real pain. The proof is in the pudding: heroin abuse has increased because people who were using medicine to treat their pain have now been forced to find new ways because their doctors are scared to death to lose their licenses. The people that were fictitiously getting prescription pain pills are either: (a.)Still getting them somehow or (b.)now turned to street drugs. Either way, the war on drugs is an outrageous failure and a travesty for the well being of pain sufferers everywhere.
Finally someone that approached this topic with a coherent and logical thought process... Frankly, it's my personal belief that everyone has the right to use whatever drug/medicine/poison they want; it's their body, if they want to take pills to such a degree that dying is a real possibility for them it's not my or anyone else's business so long as they aren't endangering anyone else in the process. And by the way people, a majority of these comments aren't actual users of Rx pain medications/heroin. They are staged posts on what you are told is a public forum, I basically do the same thing for a living, it's just targeted marketing and you can easily determine their key demographic based on the "comments" posted. I'm not saying I think kids should go out and do all the drugs they can get their hands on by any standard. I just want people to stop trying to make correlations with drugs that don't exist. Intoxication has always existed with humanity, and no matter how much you try to regulate the pharmaceutical companies, monitor the doctors, make it harder for honest patients, or even police the illegal users, there will always be a market for intoxicants. If people could just make their peace with a reality where this will always exist it will stop being an epidemic/crisis/scourge. Then arrangements can be made to have these substances used in such a way as to minimize the potential for harm. And as for teens who are thinking about trying it, maybe parents should just give them factual data so they can decide on their own, and make sure they are doing better jobs as parents. Or if that seems too difficult a task; don't have children. Clearly if you can not convince your own child that they shouldn't do drugs because it's probably in their best interests, your genes might not be the ones to be passing onto the next generation.
I must have taken at least 5000 pills after an accident. You name it - I took it, OxyContin, dilaudin, morphine, tramadol, fentenyl.. Even got many pills off the street because the prescriptions just weren't enough. I was in constant pain. Crawling around on all fours looking for body peace. The pain destroyed me, physically, mentally and spiritually. It took every inch of my being to keep going. I would maybe get 20 mins of sleep at a time. Totally maybe 2 hours a day. I had to sleep/sit in a zero gravity lawn chair for a year. So, whomever said 'heal naturally' is out of their effing minds. I had two small children. One with special needs. And I wouldn't let them into my room most times because it would have broke their hearts to see their mother like that. The pain was so great I couldn't sometimes make it to the bathroom - it was so humiliating. The point I am making is these painkillers are so needed. I wouldn't be here today without them. Was I going down the path of addiction. Probably. But I was taking them for pain management ONLY. So after this long journey of popping pills that when the pain subsided slightly I stopped taking prescription meds. Not even a withdrawal symptom. Nothing. I cut down on them slowly towards the end. Even though the pain subsided slightly it was still there constantly. But My tolerance for the meds started to decrease as my tolerance for the pain started to increase. So my advice to people wanting to stop is take it slowly. Instead of your 20mg dose of oxy take a 15mg dose. Bite them where you have a little left over. Once I popped my last prescription pill. With a renewal waiting for me at the pharmacy. I said enough. And never looked back. Do I miss them? Absolutely! And trust me on this - I love taking pills and have addictive personality. But in the end it's mind over matter. You can do it! Baby steps. Never tell yourself you will never take another again. That will be your demise. Ps. I'm 100% healed. Busted my back and shattered my leg/ankle. I got titaium galore and had 6 surgeries. I know what pain is and why these pills are needed. Just take them for what they are prescribed and you will be ok.
Painkillers are good for the people who need them, but for the people who don’t need them they are bad and get them addicted to herion when they can’t get their next hit.
The fact that painkillers are harder to get makes it very surprising that heroin is not being made harder to get. If painkillers were easier to get again heroin use would decrease. But, at the same time they could decrease heroin use by making it more expensive and making it a prescription drug. This option would not make painkillers easier to get again.
I’m most confused on why doctors prescribe painkillers when they know that the drug they are prescribing is highly addictive and can lead to death.

When used as prescribed, opioids can safely help someone who is in pain. Doctors and scientists are also working together to find alternatives to opioids.

If Opioids attach to specific molecules why can’t they find something that doesn’t so they lead people to drug abuse

Great question! Doctors and scientists are working together to find alternatives to opioids. To learn about what government agencies like NIDA are doing to help reduce the opioid crisis, check out this blog: https://teens.drugabuse.gov/blog/post/science-vs-opioid-crisis-heal-init...

Why are painkillers still prescribed if people have a high risk of getting addicted?

When used as prescribed, opioids can safely help someone who is in pain. Doctors and scientists are also working together to find alternatives to opioids.