Turning to Heroin After Painkiller Abuse

Heroin initiation rates rose in people who had been misusing prescription painkillers

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Heroin use has been on the rise in the past couple of years. Using prescription painkillers for non-medical purposes may have been a gateway for some adults who started using heroin.

A recent report looked into whether people misused prescription painkillers prior to starting to use heroin.

The results showed an overall rise in heroin use in the US, and a high likelihood that people who started using heroin did so after abusing painkillers.

"Seek help for painkiller misuse."

The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the US Department of Health and Human Services, has released a report on prescription painkiller abuse in relation to starting to use heroin. Pradip K. Muhuri, PhD, a statistician at SAMHSA, led the research team.

According to the study's authors, after the makers of OxyContin designed a tamper-resistant pill in 2010, some individuals switched from painkiller misuse to heroin use.

The newer pills were more difficult to crush and less powerful, which lowered the demand for OxyContin on the black market.

For this study, the researchers looked at data from the National Survey on Drug Use and Health (NSDUH) from 2002 to 2011. The NSDUH gathered drug, alcohol and tobacco use data from people in the US ages 12 and older.

The researchers were mainly concerned with people just starting to use heroin rather than long-term users, so they limited the study to people ages 12 to 49.

In the previous year, people who had used prescription painkillers for non-medical use were far more likely to use heroin than people who had not misused painkillers (0.39 percent versus 0.02 percent).

From 2007 to 2011, the number of people who said they had tried heroin for the first time in the previous year increased from 106,000 to 178,000. 

In the same time frame, the number of people who reported using heroin in the previous year increased from 373,000 to 620,000.

The number of people who were dependent on heroin in the previous year jumped from 179,000 to 369,000 over the course of 2007 to 2011.

The use of heroin for the first time fell slightly among people ages 12 to 17, from 0.13 percent in 2002 to 0.11 percent in 2011. But heroin initiation rose from 0.17 percent among people ages 18 to 25 to 0.26 percent in 2011.

During the same time period, the rate of heroin initiation doubled among those in the 26 to 49 age group, from 0.03 percent to 0.06 percent.

Trying heroin for the first time was most common among people living in homes with an annual income of less than $20,000 at 0.18 percent, compared to 0.10 percent among households earning $20,000 to $49,000 and $50,000 to $74,999.

Heroin use in the past year was highest among non-Hispanic whites at 0.10 percent, and lowest among non-Hispanic black people at 0.02 percent from 2002 to 2011.

Overall, 3.6 percent of people who had started misusing painkillers went on to use heroin in the next five years.

“Prescription pain relievers when used properly for their intended purpose can be of enormous benefit to patients, but their nonmedical use can lead to addiction, serious physical harm and even death,” Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality, said in a press statement.

“This report shows that it can also greatly increase an individual’s risk of turning to heroin use — thus adding a new dimension of potential harm,” Dr. Delany said.

This report was published in August on the Substance Abuse and Mental Health Services Administration website.

Review Date: 
August 27, 2013
Last Updated:
August 27, 2013