Drugs & Health Blog

What’s the Connection Between Prescription Pain Pills and Heroin?

The NIDA Blog Team

Note: This is an updated version of a post we first published in 2014.

You may have heard (on this blog or elsewhere) that deaths from overdosing on heroin, and on prescription pain pills, have spiked in recent years. In fact, the increase has been so great, the problem is now a public health epidemic.

Heroin and prescription pain pills 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 in the body. When opioids attach to these receptors, they can decrease the amount of pain a person is feeling.

Opioids can also cause a person to feel relaxed and happy—and that can lead some people to misuse the drugs. And some who become dependent on prescription pain pills switch to heroin because it’s cheaper than opioids, easier to get, and has similar effects.

Misusing prescription pain pills, and using heroin, are very risky moves.

How opioids can kill

Opioid drugs of all kinds can be very addictive. When someone has an addiction to prescription pain pills or heroin, it’s very difficult for them to stop using the drug. When they try to stop, they may have withdrawal symptoms: restlessness, muscle and bone pain, diarrhea, vomiting, trouble sleeping, cold flashes with goosebumps, and uncontrollable leg movements.

Continuing to use opioids, however, can lead to sleepiness and constipation; worse, depending on the amount someone takes, opioids can reduce the person's ability to breathe. In fact, taking just one large dose of prescription pain pills or heroin could cause someone’s breathing to stop. This is how people die from an overdose.

Ending opioid abuse

The good news is, there are medications that can help a person stop abusing opioids and overcome their addiction. There’s also a medication called Naloxone® that can reverse the effects of an opioid overdose—if it’s given quickly enough to the person who has stopped breathing.

Did you know prescription pain pills and heroin work in similar ways, and misusing either of them can lead to death? In the comments, tell us your thoughts about the opioid epidemic.

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.

Comments

Education is so important to prevent prescription drug use from becoming an addiction. Thank you for this helpful information.
i love the pills that make me stop smoking
All of this talks about the misuse of painkillers. They fail to discus how doctors over precribre too many pills then ppl become dependent on then. There is a difference in misuse and and following what ur doctor said to do and becoming dependent. This is how so many problems arise. Doctors stop but the problem is stil there. They started it but they don't want to handle it.
Agree 100%
I find this author sadly misinformed. I have four sons ages 19 to 25. I have been to more of their friends' funerals than I have my own friends and family combined. To say, 'the good news is, ...." is so far from the reality I have seen in these kids. They want to quit. The withdrawals are presented as if they may happen. If I asked someone addicted to heroin to comment on the description of the withdrawals presented here, they would say, 'times 100, at least.' This is not about 'mis-using' pain medicine to feel relaxed and happy. I honestly cannot believe this perspective is actually published. It is so far from the reality of the situation, except for the point that this addiction is happening way too much.
The same active ingredient in prescription narcotics is the same active ingredient in heroin; exogenous opioids, which bind to the opioid receptors in the brain, and cause analgesia, euphoria, and respiratory depression. These effects are sought by people for pain relief and euphoria, but the adverse effect of respiratory depression, sometimes cessation of breathing, is what kills people and is very hard to prevent in people who use opioids chronically, abusively, or in a relapse after some sobriety. People easily become physically and psychologically addicted to opioids within a relatively short time span, but for two decades, these prescription painkillers, or opioids, have been liberally prescribed to people for almost any subjective experience of pain, and it is this medical practice that launched the current prescription opiate and heroin epidemic, with its horrible consequences, that we are presently experiencing. It did all start with prescription opiates by way of doctors and pharmaceutical companies. We are all suffering terribly from this!
You are encouraging to take drugs for your business products.
Buprenorphine is an opioid. Effective withdrawal from it requires inpatient care. How do you justify federal dollars for a dangerous cross addiction? You contend addiction is a disease. Since when is a disease treated with the drug that caused it? I know several people desperate to get off buprenorphine but can't.

We understand your concern. Bupenorphine is an opioid partial agonist–antagonist, prevents cravings, helps with withdrawal symptoms, and blocks the effects of other opioid drugs. There is overwhelming evidence that buprenorphine and methadone medications are far more effective at helping addicts stay off heroin than treatment without these medications. We still have a lot to learn about the optimal time for patient to stay on these medications, and such studies are underway. Using these medications in supervised doses also prevents a possible overdose, which can happen if the addicted person continues to use the illegal drug. In addition, using these medications keeps the addicted person away from drug dealers and related illegal activity and gives them time to make other adjustments necessary in their lives to stay off of illegal drugs. Here is an article about one related study: https://www.drugabuse.gov/news-events/nida-notes/2015/11/long-term-follo...

hi
hi
The only difference between opoids and heroin is the amount of money doctors continually rake in from pharmaceutical companies to push their opiod drugs. And that's it. Addiction is NOT a disease. If it is, as mainstream medicine & psychiatry would like us to believe, then it's nothing more than iatrogenic illness - caused by the doctors prescribing them. It is so tragic what's happening across the landscape of this country that it boggles my mind. And they are still blaming the patient, "oh, he/she has an addictive personality." This is hogwash. Pharma will never admit that the drugs they prescribe are addicting and can and do kill. Just look at the numbers. I'm still reading numerous peer review journal articles that state benzodiazepines are not addicting, or psychiatric drugs. Yet, they've discovered something entirely different. Of course, they won't listen to the millions of addicted patients stories, they don't want to hear the truth. We are discounted at every turn while big pharma is laughing all the way the bank, and they have the FDA backing them up. Our entire medical & psychiatric system is so crooked and full of fraud that every time I hear about another drug-induced suicide I cry, then I get angry.
big pharma are making millions, I'm sure for the last quarter of 2015, 33million was made from selling lyrica, pregablin. now add the profits from subutex,methadone oxys etc.too much money to lose.they want you to buy thir druds continually.they are drug dealers and the drs are the runners.
What do you do when your disabled neighbor is taken to the hospital twice in as many months because of overdosing on pain medication? The cleaning lady who looks after her always summons me when there is any crisis, and I am expected to handle the crisis. The police have been to her apartment a dozen times, and she has been taken away by them a number of times. And yet, nothing is done to prevent my neighbor from access to these medications--in fact she sleeps with them by her side. Her cleaning lady and her doctors provide her with as many drugs as she needs. How many times am I going to be expected to call 911 before she actually dies from one of these overdoses? And why is there no doctor in her life who is worried about this? Why is it just me? Is everyone else just waiting for her to die?

We are heartbroken to hear of this crisis in your neighborhood. It is not possible for a federal agency to get involved in an individual’s medical care, given strict medical privacy laws. However, this is not your responsibility as her neighbor, although you have been very kind to help with this situation. It appears that your neighbor needs the help of a county social worker, who can sort out the situation and work with any family members she might have. We are not quite sure why her cleaning lady is involved in dispensing medicines--you can report that to social services as well. At the very least, someone responsible should be ensuring safe dispensing of these medicines. We are surprised the 911 responders have not linked your neighbor to the appropriate county services, and if this happens again you might want to ask them what other services are available. Have you tried calling your local county social services officials? In addition, some communities offer services for its elderly citizens--look for an “office on aging” on your county’s website.

The U.S. Department of Health and Human Services has started to issue guidelines and recommendations related to the overprescribing of prescription pain relievers, and we hope that in the next few months and years ahead, more medical professionals will become aware of their potential role in this kind of a crisis: http://www.cdc.gov/drugoverdose/prescribing/guideline.html

My girlfriend is taking xanex ,muscle relaxers,percocets,and another one Iam not familiar with we broke up and recently got back together ,but she thinks Iam stupid and says to me she was in a vehicle and caused spinal injury and she can take a but load of percocets and not feel anything says it just targets pain.now she wants to try morphine because she is taking up to 5 percs a day we broke up yesterday because she kept saying she is not doing it for the high after I just got her 40 pills she is losing the battle.when we met for the first time is was Devine intervention.now she is ha wing sex with some guy that has pills .its like losing your best friend your love of your life. It's not easy to say I'll move on find someone else .but I know I only helped her addiction by getting them.she would have gotten them somewhere else .but that's all I have to say.
Prescription abuse is a serious issue. The CDC has several guidelines for doctors to follow when prescribing opiates. Here are a few. Opiates should not be first line treatment. They should only be used if benefits outweigh the risks. Before opiates are initiated there should be a treatment plan in place for how to transition off them. Lowest dose possible should be used. Every 3 months patients should be re-evaluated for their need of opiates. Providers should also utilize drug monitoring programs. This is a program which tracks prescriptions being filled. Patient found abusing medications should not be able to continue to get refills.
Thank you Sean. Prescription pain pill abuse is a very serious problem, especially among teenagers. In fact, studies show that in 2014 nearly half a million teens were using pain killers for non-medical reasons. Many of these teens are getting their medicine from family members. I think it is important to mention that studies also show that the rise of pain pill abuse parallels the rise of prescribing. This highlights the important role providers play in curbing this epidemic. For more facts on opioid addiction anyone can visit this site by the American Society of Addiction Medicine http://www.asam.org/docs/default-source/advocacy/opioid...

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