Heroin addiction rare among painkiller abusers

Most people who use painkillers nonmedically do not progress to heroin, though the risk is significant for a small subgroup of prescription opioid abusers.

By Stephen Feller

WASHINGTON, Jan. 15 (UPI) -- A review of the relationship between prescription opioid-based painkiller abuse and heroin addiction in the United States found that while both have grown significantly in recent years, they are not necessarily connected.

A small portion of people who abuse prescription painkillers switch to heroin, researchers said in a comparison of studies on abuse of both drugs, but they are mostly separate problems that require similar solutions.


Deaths from heroin overdose have at least doubled in the last few years, according to a recent report from the Centers for Disease Control and Prevention, which also found people who abuse or are dependent on prescription opioid painkillers are 40 times more likely to abuse or be dependent on heroin.

A study at New York University also found most high school heroin users started with prescription painkillers.

"Coinciding with these efforts to reduce nonmedical prescription-opioid use and overdose are reports of increases in the rates of heroin use -- including both injection and noninjection routes of administration -- and deaths from heroin overdose," researchers wrote in the study, published in the New England Journal of Medicine. "Some researchers suggest that the very policies and practices that have been designed to address inappropriate prescribing are now fueling the increases in rates of heroin use and death."


Researchers in the new study said heroin users are 3.9 times more likely to report nonmedical use of opioids in the previous year, and 2.9 more times as likely to meet criteria for abuse or dependence on the drugs as people who don't use heroin.

That said, they also found 3.6 percent of nonmedical opioid painkiller users started using heroin within five years of starting their painkiller use, and only 4.2 percent of people who reported using the prescription drugs said they used heroin in the previous year.

The transition from prescription drug abuse to heroin is a strong risk, the researchers wrote, however it appears to be part of the drug use progression of a subgroup of nonmedical prescription drug users, not the overwhelming majority.

"Fundamentally, prescription opioids and heroin are each elements of a larger epidemic of opioid-related disorders and death. Viewing them from a unified perspective is essential to improving public health," the researchers wrote. "The perniciousness of this epidemic requires a multipronged interventional approach that engages all sectors of society."

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