The opiate epidemic in the United States cannot receive enough press. The problem is of paramount concern, as is the education of parents, teens, and treatment of users.
The Centers for Disease Control has reported that for the past two decades, deaths due to drug overdose has been steadily increasing, and has become the leading cause of death due to injury.
In 2012, over 40,000 lives were claimed due to drug overdose, and around 20,000 were related to pharmaceuticals. Among those deaths, 16,007 (72%) involved opioid analgesics.
Why Opioid Abuse Leads to Heroin Use
According to the Centers for Disease Control, “health care providers wrote 295 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.” With 295 million narcotic prescriptions in circulation in one year, imagine how many of those pills end up in the wrong hands.
Yes, some physicians may be unscrupulous. And, there may be some who do not exercise enough caution when prescribing opioids. But, I would say the majority of doctors would not knowingly inflict harm on patients. Regardless, the physician can only take so much responsibility in a patient’s addiction.
When a doctor prescribes pain medication, he is operating under good faith that you are not going to abuse or distribute the medication elsewhere, since that is a felony now. We all know that is not always the case.
There is not a scanner a doctor can use to scan your body for addiction, or malicious intent. There are tell-tale signs of addiction, but seasoned addicts are not going to show any them. And, let’s face it, some doctors are just naïve. So, it is really up to the person who has the prescription filled as to how that prescription is used.
So, therein lies the crux of the problem. We, as a culture, and society, are very quick to go to the doctor, and to take medication, from Tylenol to Dilaudid. This reflects our love for convenience and instant gratification. Preventative measures are rarely used, or any type of attempt at a holistic remedy. Obviously, some cases warrant pain medication.
Also, instead of going to a pain management specialist, it is often the case that people just go to their general practitioner over and over again, who is not specialized in opioid use or long-term pain management. For this reason, many people are on a long-term program of use for an intended short-term use medication. And, the longer you use an opioid, the more dependence you will have, and higher likelihood of developing the disease of addiction.
Aside from out-and-out doctor shopping, another way that pain medication is illegally obscured is through the family medicine cabinet. If anyone other than the person the medication was prescribed to has access to the medicine cabinet, or other location, there is a potential for abuse and distribution.
With these staggeringly increasing overdose and death rates, lawmakers have created some obstacles from prescription drug abuse, like stiffer penalties, more comprehensive databases for pharmacies, and more safeguards in doctors’ offices.
Another niche market that has formed due to prescription drug abuse is the abuse-resistant category of opioid drugs. Such as, a drug that turns into liquid when it is crushed, making it impossible to snort or shoot.
All of these attempts at reducing the addiction and death rate to opiates have been effective, but, by no means have they come close to putting an end to opiate abuse, addiction, or distribution. And, it has been found that because of the changes in narcotic pain pill manufacturing and distribution, many are using heroin because it is cheaper.
OxyContin, for instance, is not manufactured in generic form. You have to buy the brand name, so it is really expensive for someone to support a habit solely on OxyContin. Unfortunately, an indirect consequence of the stiffer prescription laws and monitoring is a rise in heroin use. Additionally, heroin is more readily-available than OxyContin.
The Facts on Opioids & Heroin Use
The National Institute on Drug Abuse cites a study performed by the American Family Physician (AFP) publication. The AFP reports: “The results of this investigation suggest that the abuse of opioid analgesics constitutes a new route to heroin abuse, placing new populations at risk for heroin addiction.”
Also, “This is a reversal of the classic pattern in which heroin users would turn to prescription opioids when heroin was unavailable. In addition, although many new heroin users may begin by snorting the drug, most progress to injection drug use as their tolerance develops and the quality of heroin varies.”
Also, in a study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), it was found that “this nationally representative study finds a strong association between prior non-medical use of pain relievers and the subsequent past year initiation of heroin use.”
These studies are breaking new ground. In the past, the case was that heroin use led to narcotic abuse, especially if there was a shortage in heroin. So, heroin would have been the precursor to narcotic abuse, not the other way around, which is what we are seeing in current trends.
Additionally, SAMHSA explains, “there are many plausible explanations for this finding, including the gateway theory of drug use that posits that the use of some drugs may expose individuals to a repertoire of biological and behavioral factors that could influence their future use of other drugs. In this case, NMPR use may precondition one to engage in heroin use because prescription pain relievers have a similar pharmacological effect as that of heroin, given their similarities in chemical structure.” NMPR means “non-medical pain reliever.”
In conclusion, using illicit or abusing prescription drugs, of any kind, can be life-threatening. No, everyone who uses an opioid will not progress to using heroin. And, everyone who is addicted to opioids is not going to progress to heroin. But, we do know that opioid use is a pathway to heroin use.