The Reasons for Prescription Opioid Abuse in the United States
Heroin has made a comeback in the United States primarily because of prescription opioid painkillers. Dr. Thomas Friedman, the Director of the Centers for Disease Control, had this to say in 2014 –
“When prescriptions (opioids) go up deaths go up. When they go down, deaths go down. Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem.”
For a number of years, prescription opioids were overprescribed almost at will. Even though the majority of pain pills such as Vicodin and OxyContin were only intended for short-term management of acute pain, many doctors were instead prescribing them for long-term chronic pain, often as their first and only line of treatment.
- In 1991, there were approximately 76 Million opioid prescriptions dispensed in the US.
- By 2012, that number had skyrocketed to 259 Million.
- To give that number some perspective, that is enough for every adult in America to have their own personal bottle of pain pills.
- The US uses 99% of the world’s hydrocodone and 81% of its oxycodone.
This is such a problem because prescription opioids are highly habit-forming. It is all-too-easy for a person with a legitimate level of pain to first, become dependent, then, develop a tolerance, and finally, spiral into full-blown addiction.
The American Society of Addiction Medicine reports that almost 2 Million American have a substance abuse disorder that involves prescription painkillers.
The next step beyond addiction is overdose:
- In 2014, there were over 47,000 fatal drug overdoses in this country.
- Almost 19,000 of those involved opioid prescription pain relievers.
- In 1999, there were only 4030 fatal painkiller overdoses.
- Alarmingly, 91% of people who suffered nonfatal overdoses from opioid painkillers between 2000 and 2012 were able to obtain refills.
- Approximately 70% of the time, the same physician wrote both prescriptions.
Changing Opioid Painkiller Regulations Leads to Heroin Abuse in the United States
“Today’s announced changes to the labels of opioid products will finally reflect what we have known about these drugs for decades – they are dangerous and addictive and can lead to dependency, overdose, and death.”
~ Massachusetts Sen. Edward Markey
It took a while, but various national and state regulatory agencies have started to respond. Within the last few years, the country seen several changes:
- Tighter limits on prescription size
- Expanded databases to prevent patients from “shopping” doctors to obtain multiple prescriptions
- Prescription “Take-Back” events, where unwanted prescriptions can be safely disposed of
In late March 2016, the US Food and Drug Administration announced that it will begin requiring “black box” warnings on immediate-release opioid pain medications.
Specifically, the labels will indicate that opioid painkillers should only be used as a “last resort”, when no other effective treatments are available.
On the positive side, these measures are having an impact on prescription painkiller abuse and deaths:
- According to the CDC, in 2012, fatal overdoses from opioid pain medications declined for the first time in more than 10 years.
- In December of 2015, Dr. Eric C. Strain, Executive Vice Chair of Johns Hopkins Bayview Medical Center’s Department of Psychiatry and Behavioral Sciences and Director of the Center for Substance Abuse and Research, said, “It appears were seeing some stabilization or evening decrease in prescription opioid misuse.”
But while the tide of prescription opioid abuse and overdoses seems to be slowing down, the use of heroin – and its associated dangers –is rising dramatically. Dr. Strain continues, “…we’re seeing a shift from prescription painkillers to heroin.”
This assertion is confirmed by the numbers:
- Between 2013 and 2014, the number of individuals who self-reported heroin use within the past 30 days rose from 681,000 to 914,000.
- Between 2002 and 2013, the US fatal heroin overdose rate nearly quadrupled.
- In 2014, there were well over 10,000 heroin-related fatalities in the country.
- Four out of five heroin abusers began with prescription opioid misuse.
- In the young adult demographic (18-25), heroin use has more than doubled.
- In 2014, 28,000 teens 12-17 used heroin within the past 12 months.
- Roughly 18,000 underage US teenagers have a current heroin abuse disorder.
Why Do People Switch from Prescription Opioid Painkillers to Heroin?
There are three main reasons why substance abusers move from the issues of prescription opioids to street heroin – the mechanics of their addiction, the ready supply of heroin (compared to more tightly-controlled prescription opioids), and the greatly-lessened cost.
For someone who is already dependent or addicted to prescription opioids, the availability and cost are the prime factors for the switch.
According to a recent survey, 94% of patients in rehab for opioid abuse/addiction switched from pain medications to heroin because the prescription opioids were “far more expensive and harder to obtain”.
- The Mechanics of Addiction–Because they’re both opioids, both prescription painkillers and heroin act upon the scene areas of the brain. A person who has been misusing prescription opioids can receive the same euphoric “rewards” from heroin.
- The US Supply of Heroin–According to the 2015 National Drug Threat Assessment, issued by the DEA last October, heroin availability in the United States was higher in 2015 than it was in 2008 in every region of the country.
Between 2013 and 2014, heroin availability in the US has risen by roughly 50%.
Drug Enforcement Agency arrests for heroin were double what they were in 2007. In fact, in 2014, heroin arrests surpassed marijuana arrests for the first time ever.
- The Cost–Mexican and Colombian heroin has flooded the US market, giving opioid abusers a cheap, high-quality alternative. The street value of an OxyContin tablet can be between $80 and $100, while heroin can be purchased for as little as $10.
What to Do If You or Someone You Love Is Abusing Heroin
It’s evident that it is all-too-easy move down the slippery slope of addiction from opioid misuse to heroin abuse/dependency/addiction. If this is happened to you or someone you care about, then it is of the utmost importance that health is received and treatment is begun as fast as possible.
For people in the Pacific Northwest – the states of Oregon, Idaho, and Washington –NorthPoint Recovery offers the best drug and alcohol rehab costs, providing every need service, from detox to residential care to counseling and therapy for the entire family.
Using the latest evidence-based and wellness-focused substance abuse treatment strategies, NorthPoint Recovery can help you safely move from opioid addiction to a sober life of restored health and hope.