Heroin More “Practical” Than Prescription Opioids, Abusers Say

Heroin More “Practical” Than Prescription Opioids, Abusers Say

Abusers of opioids ditched prescription opioids for heroin (or a combination of prescription opioids and heroin) for “practical” reasons, such as accessibility and cost, researchers wrote in the New England Journal of Medicine.

“The drugs are becoming less accessible, the drugs are more expensive but you’ve still got these people with terrible addictions,” said Theodore J. Cicero, Ph.D., the study’s lead author, in an interview with The Taos News.  The professor of psychiatry at University of Washington School of Medicine in St. Louis went on to say, “They’re turning to heroin because it turns out that it’s cheaper.”

Cicero and colleagues collected quarterly data from January 1, 2008, to September 31, 2014, using self-administered surveys that were completed anonymously by 15,227 people who abuse opioids. Of these 15,227 people, 267 agreed to online interviews to gather qualitative information in order to amplify and interpret findings from the structured national survey.

The key findings include:

  • Abuse of prescription opioids alone has decreased 6.1% annually
    • Exclusive abuse of prescription opioids fell from 70% of the total population to 50%
  • Abuse of heroin alone has increased 14.4% annually
    • Exclusive abuse of heroin was low overall, but more than doubled from 4.3% to 9%
  • Abuse of prescription opioids and heroin combined has increased 10.3% annually
    • Abuse of both prescription opioids and heroin combined increased from 23.6% of the total population to 41.8%
National Opioid Rates in Previous Month

Image Courtesy of The New England Journal of Medicine

The author noted that there is too much focus on cutting the supply of prescription opioids, which not only affects how abusers access opioids, it has an impact on how those who legally and appropriately use prescription opioids access them, too.

To this point, one National Pain Report reader commented, “I gave up trying to legitimately fix my health issues. Do you know what that resulted in? Me becoming a heroin addict. Not because I WAS prescribed opiates…..but because I WASN’T.”

Dr. Cicero says that the underlying problem of addiction is what needs to be addressed.

“We need to address the demand,” he told The Taos News. “Prohibition didn’t reduce the demand for alcohol. The same argument can be extended to opioids.”

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Authored by: Staff

There are 10 comments for this article
  1. Duffy at 11:52 am

    People are finding ways to inject suboxone and subutex. The research that they talk about in these articles are nothing but BS. I too am a chronic pain sufferer and I cannot get the medication I need to live a life without being in pain all day everyday. Drs are ‘afraid’ to write prescriptions that would help ppl such as myself for fear of the DEA coming in to shut them down! A person can buy pills, heroin and other drugs on the streets easier and cheaper than going to a Dr and paying cash in ungodly amounts and then driving to pharmacies in three or four states to try to get them filled…it’s a crock of [edit]… That is the main reason that Meth is so abundant now…ppl are making their own medicine at the risk of death…like I said, it’s Bull[edit].!

  2. Brooke at 2:55 pm

    It would be nice to see the entire study rather than just the highlights the researchers chose to include in the abstract. A study like this is a waste unless you separate out people using opioids and heroin recreationally from people taking (notice I don’t say “using”) opiods and heroin for pain treatment. I am in a 12 step recovery program–clean from non-opioid/opiate abuse for over 17 years. I have a severe painful condition called chronic pancreatitis and require pain meds but luckily I do not need a large amount and have no desire to take it if I don’t need it. Only until the past couple of years have I witnessed more and more people entering our meeting rooms who became hooked on heroin and in most cases overdosed one or more times. Some of these people turned to heroin after their pain doctor stopped prescribing and left them with no treatment plan. Many of these people had pain management, with a contract, for decades and never overdosed or didn’t comply with the contract. You see, no pain doctor who accepts insurance prescribes within 100 mile radius of Albany, NY. They only do implants and procedures now (most of which are not evidence based for the conditions they are treating or FDA approved). So, here we are with people overdosing, depending on street heroin dealers as their “doctors”, and playing russian roulette not knowing what the heroin is cut with or the exact strength of the “dose”. Heroin dealers in the U.S. should have an MD at the end of their names. But, they are doctors of death. Doctors of relief for some, but ultimately doctors of death. This is beyond ridiculous. The DEA suck at their jobs. They have absolutely no control over the heroin problem so they put a few notches in their belts by cutting off people in pain. This is America? I am sick of people coming to our recovery meetings with deadly heroin problems. Some never return and I assume they died or are continuing to put their lives in jeopardy. It is sad and unnecessary.

  3. Nancy R at 1:31 pm

    The study group was small, a small percentage of the people who filled out the survey. The decrease in opioid abuse sounds promising. The increase in opioid with heroin perplexing…why both?
    I agree cutting the supply of opioids will cut the supply to legitimate pain patients. Everytime I read these article, I feel a little optomistic and then I read another one that slams the first one. Abuse is not the same as using opioids for pain. We are not looking to get high, we just want to be able to get through a day without terrible pain. Addiction sucks, just as much as untreated (withheld) intractable pain.

  4. Scott michaels at 12:32 pm

    Please go to the new england journal of medicine and open a free account on order to comment on ballentyne and sullivan from PROP. THEY SAY WE CHRONIC PAIN PATIENTS SHOULD SUCK IT UP” this article shows just how ignorant and cruel they are. please have everybody you know write scathing comments about them and explain how opioid therapy has helped you. They are only taking comments thru TOMMOROW. WE MUST SUPPORT EACH OTHER OR THEIR ARTICLE WILL LOOK LIKE IT HAS MERIT.
    WE NEED THOSE PEOPLE OUT OF OUR LIVES OUT OF MEDICINE AND HOPEFULLY IN JAIL FOR MALPRACTICE AND MISDIAGNOSIS.
    PLEASE PLEASE WE ONLY HAVE 1 DAY TO FILL THE COMMENT BOARD OR A VERY IMPORTANT MEDICAL JOURNAL.
    NEJM.ORG
    NEJM.COM
    NEW ENGLAND JOURNAL OF MEDICINE. SEARCH ARTICLE AND COMMENT.
    LETS HIT 1000 COMMENTS!!!!

  5. LouisVA at 12:13 pm

    Addiction (or out of control substance abuse) should be a medical problem, not a legal one. Putting folks in jail for being sick is wrong-headed and only increases the problem. Let’s offer help instead of a record that punishes people for the rest of their lives. It’s the moral thing to do!

  6. Steve P. at 11:31 am

    Finally, a researcher who has a clue!

    The propagandists need to stop attacking the weakest segment of society, who already live an extremely difficult life and focus of the actual perpetrators.

    Unfortunately, there are too many politicians and doctors looking to make a name for themselves, at any cost, without regard to the truth or how many people they hurt.

  7. Scott michaels at 10:55 am

    in my previous post i made it sound as though i was jappy heroin use is up. I AM NOT! I JUST WAS ONCE AGAIN PROOVEN RIGHT. WHEN THE GOVT AND INSURANCE COMPANIES GET INVOLVED WITH OUR MEDICAL NEEDS NO MATTER WHAT THOSE NEEDS ARE, THEY MAKE IT WORSE FOR PATIENTS.
    UMFORTUNATELY HEROIN USE IS UP FOR REASONS THAT HAVE NOTHING TO DO WITH PAIN PILLS.
    WHEN I WAS A KID IN THE 60S I SAW A VIDEO IN SCHOOL OF SOMEONE SHOOTING HEROIN, IT SCARED ME TO DEATH. I WOULD NEVER USE IT. TODAY THE KIDS HAVE ACCESS TO IT LIKE POT WAS IN THE 70S, even easier. DONT GET ME WRONG HERE, BUT WHEN THE TALIBAN HAD CONTROL IN AFGANISTAN YOU WERE KILLED FOR GROWING OPIUM. TODAY IT IS THEIR LARGEST EXPORT. ITS CHEAP AND PURE. WE IMPORT MILLIONS OF CONTAINERS OF GOODS FROM CHINA, MARK MY WORDS THERE ARE TONS OF HEROIN SCATTERED WITHIN THOSE CONTAINERS. IF WE TRULY WANT HEROIN UNAVAILABLE IN THE U.S. THE ONLY WAY IS TO EDUCATE OUR KIDS AT VERY YOUNG AGES. LIKE 5,6,7. WE NEED TO PUT AN IMPRESSION IN THEIR BRAIN THAT EQUATES HEROIN TO DEATH. FOR TODAYS USERS WE MIST COMMUMICATE WITH OUR CHILDREN. WE MUST PLACE INTENCE PUNISHMENTS FOR DEALERS. NO LESS THEN 20 YEARS. FOR USERS 2 REHABS THEN 1 YEAR IF CAUGHT AGAIN. AFTER THAT 5 YRS ETC. AS LONG AS THERE IS A DEMAND IT WILL BE THERE. WE CANT STOP IT.
    THE OTHER THING IS TO JUST LEGALIZE IT REGULATE IT. AND THEN AT LEAST WE TAKE THE CRIME OUT OF THE EQUATION. WEVE SPEN TOO MUCH MONEY ON THE WAR. LETS FACE IT WE LOST!
    WHEN IT COMES DOWN TO PRESCRIPTION PAIN MEDICINE IT WORKS FOR WAY TOO MANY OF US.
    IT ALLOWS US TO LIVE A LIFE WITH QUALITY. I LIKE MANY OTHERS CONTIMPLATED SUIDIDE BEFORE I FINALLY ALLOWED MY DOCTOR TO DO HIS JOB. I DEDICATE MY LIFE TO HIM. I WAS SO CLOSES MINDED ABOUT OPIOUD THERAPY AND NOTHING WAS WORKING DEATH SOUNDED LIKE A GOOD PLAN. TODAY I LIVE ANOTHER DAY. NOT PAIN FREE BUT NOT SO BAD I CANT GET OUT OF BED OR FEED MYSELF.

  8. Tootie Welker at 10:24 am

    It would be interesting to also research if alcohol consumption also increases for those with chronic pain who are unable to access appropriate relief. But that’s right, alcohol is legal do it’s ok.

  9. Dee Green at 10:03 am

    That’s why the media apparatus has tried to lump heroin addiction in with chronic pain medicine- that changes the dialogue and makes it appear as if the medical providers are the criminals along with their patients.

  10. Scott michaels at 10:00 am

    FINALLY! EUREKA!

    As i have said for months. we, the chronic pain patients arent heroin addicts. we do as directed. WE TAKE OUR PAIN PILLS WHAT EVER DOSE AS DIRECTED. by doing so, we lead better, more productive lives. junkies cant get pain pills like they used to, even if they could they cant be injected.or snorted!. NOW DEA GO DO YOUR JOB AND STOP HEROIN AND COCAINE. LEAVE US OLD CHRONICALLY PAIN PATIENTS ALONE. CDC YOU NEED TO STOP ALL TIES WITH PROP. YOU LOOSE YOUR LEGITIMACY. YOU ARE DEALING WITH THE EQUIVILLANT OF SNAKEOIL SALESPEOPLE. THEY ARE HURTING YOUR GOOD REPUTATION.