Heroin Use on the Rise

OxyContin reformulation makes getting high more difficult so users have turned to heroin

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Prescription painkiller abuse problems were addressed by manufacturers by incorporating a tamper-resistant reformulation. Unfortunately, drug abusers have started using heroin to get high instead.

A recent article reported that people who abused OxyContin began using heroin when drug makers changed the formula to prevent abuse.

"Seek help if you are abusing drugs."

Theodore J. Cicero, PhD, professor of neuropharmacology in psychiatry at Washington University in St. Louis, led an investigation into the fallout from abuse-prevention formulas in the opioid painkiller OxyContin.

In August 2010, drug makers changed the formula of OxyContin to make it less able to dissolve and be absorbed when inhaled or injected. This reformulation was designed to prevent drug abusers from getting an immediate high or rush, but still provide pain relief for patients when used as directed by a physician.

For the study, researchers surveyed 2,566 patients in treatment for opioid abuse in 39 states from 2009 to 2012.

Dr. Cicero said, “Our data show that OxyContin use by inhalation or intravenous administration has dropped significantly since that abuse-deterrent formulation came onto the market. In that sense, the new formulation was very successful.”

Dr. Cicero then looked at the big picture. Yes, the abuse of OxyContin had dropped, but the fallout was that drug use in other areas had increased. Addicts are turning to heroin instead.

Dr. Cicero said, “We’re now seeing reports from across the country of large quantities of heroin appearing in suburbs and rural areas.”

From the surveys, researchers saw a drop from 47 percent of patients having abused OxyContin to 30 percent due to the reformulation. The use of heroin nearly doubled in the same time frame.

A total of 24 percent claimed to have figured out a way around the abuse-prevention formula in the new OxyContin. Sixty-six percent claimed they had just switched to another opioid, heroin for the most part.

Patients claimed that heroin was easier to get and cheaper to buy anyway.

Dr. Cicero said, “This trend toward increases in heroin use is important enough that we want to get the word out to physicians, regulatory officials and the public, so they can be aware of what’s happening.”

“Heroin is a very dangerous drug, and dealers always ‘cut’ the drug with something, with the result that some users will overdose. As users switch to heroin, overdoses may become more common.”

This article was published in the July issue of the New England Journal of Medicine. No financial information was given and no conflicts of interest were found.

Reviewed by: 
Review Date: 
July 19, 2012
Last Updated:
January 7, 2013