November 3, 2014

Prescription Opioid Abuse: A Gateway to Heroin and Overdose

Prescription Opioid Abuse: A Gateway to Heroin and Overdose

Opioid-involved overdoses in the United States have dramatically increased in the last 15 years, largely due to a rise in prescription opioid (PO) use. Emerging evidence suggests the increase is linked to unintentional PO misuse that easily turns into addiction.

Individuals who regularly use opioid analgesic medications do not often recognize that they are using a medication that can be a gateway to heroin use.

“According to the National Survey on Drug Use and Health, the number of individuals reporting past year heroin use almost doubled between 2007 (373,000) and 2012 (669,000). Emerging evidence suggests the increase may be linked to prescription opioid (PO) users who transition from oral and/or intranasal PO use to heroin use, with POs providing the entryway to regular opioid use, and ultimately, heroin injection.”

Switching from POs to heroin is only one problem. Overdose is another concern. New York University’s Center for Drug Use (CDUHR) and HIV Research and the NYC-based National Development Research Institutes (NDRI) published a recent study examining the overdose knowledge and experience of nonmedical PO users. Researchers found that people who abuse POs fail to educate themselves on the risks of overdose.  Dr. Pedro Mateu-Gelabert, lead investigator with CDUHR and NDRI, said in a statement:

We found that despite significant overdose experiences, nonmedical prescription opioid users were uninformed about overdose awareness, avoidance, and response strategies.”

Most of the users in this study were generally uniformed about the benefit of naloxone treatment for overdose recovery. Naloxone comes in pre-filled auto-injection devices and is used along with emergency medical treatment to reverse the life-threatening effects of opioid overdose. Having this medication on hand can save lives when PO or heroin users overdose.

PO users in the study tended to see themselves as distinct from traditional heroin users. Today the average PO abuser is more likely to be young, white and middle class. They are also unlikely to utilize harm reduction services that address drug users’ health and safety. This is because PO abusers don’t usually see themselves as substance abusers or addicts. PO misuse often leads to long-term opioid dependence, as well as transition to less costly heroin.

Nora D. Volkow, M.D. at a hearing of the US Senate Caucus on International Narcotics Control stated:

“To address the complex problem of prescription opioid and heroin abuse in this country, we must recognize and consider the special character of this phenomenon, for we are asked not only to confront the negative and growing impact of opioid abuse on health and mortality, but also to preserve the fundamental role played by prescription opioid pain relievers in healing and reducing human suffering. That is, scientific insight must strike the right balance between providing maximum relief from suffering while minimizing associated risks and adverse effects.”

The US is seeing an increase in the number of people who are dying from overdoses, predominantly after abuse of prescribed opioid analgesics. This disturbing trend appears to be associated with a growing number of prescriptions in and diversion from the legal market. People from all walks of life are being prescribed addictive painkillers.  This trend must stop.

 

 

 

http://www.ijdp.org/article/S0955-3959(14)00206-0/abstract

http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2014/americas-addiction-to-opioids-heroin-prescription-drug-abuse

http://www.samhsa.gov/data/sites/default/files/NSDUH-SR200-RecoveryMonth-2014/NSDUH-SR200-RecoveryMonth-2014.htm

Richard Taite
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