Opioids

Get the facts on the misuse and abuse of prescription opioids such as hydrocodone, oxycodone, morphine, and codeine, and the illegal opioid, heroin.

Opioids are a class of drugs chemically similar to alkaloids found in opium poppies. Historically they have been used as painkillers, but they also have great potential for misuse. Repeated use of opioids greatly increases the risk of developing an opioid use disorder. The use of illegal opiate drugs such as heroin and the misuse of legally available pain relievers such as oxycodone and hydrocodone can have serious negative health effects. According to the CDC, 44 people die every day in the United States from overdose of prescription painkillers.

Prescription Opioids

A number of opioids are prescribed by doctors to relieve pain. These include hydrocodone, oxycodone, morphine, and codeine. While many people benefit from using these medications to manage pain, prescription drugs are frequently diverted for improper use. In the 2013 and 2014 National Survey on Drug Use and Health (NSDUH), 50.5% of people who misused prescription painkillers got them from a friend or relative for free, and 22.1% got them from a doctor. As people use opioids repeatedly, their tolerance increases and they may not be able to maintain the source for the drugs. This can cause them to turn to the black market for these drugs and even switch from prescription drugs to cheaper and more risky substitutes like heroin.

According to the National Survey on Drug Use and Health (NSDUH) – 2014 (PDF | 3.4 MB):

  • 4.3 million Americans engaged in non-medical use of prescription painkillers in the last month.
  • Approximately 1.9 million Americans met criteria for prescription painkillers use disorder based on their use of prescription painkillers in the past year.
  • 1.4 million people used prescription painkillers non-medically for the first time in the past year.
  • The average age for prescription painkiller first-time use was 21.2 in the past year.

Heroin

Heroin is a powerful opiate drug. Heroin looks like a white or brownish powder, or as the black sticky substance known on the streets as “black tar heroin.” It is diluted with other drugs or with sugar, starch, powdered milk, or quinine before injecting, smoking, or snorting. Some of the physical symptoms of heroin are euphoria, drowsiness, respiratory depression, constricted pupils, nausea, and dry mouth.

A heroin overdose causes slow and shallow breathing, blue lips and fingernails, clammy skin, convulsions, coma, and can be fatal.

Many young people who inject heroin report misuse of prescription opioids before starting to use heroin. In addition to increasing the risk of overdose, the intravenous use of heroin places individuals at higher risk of diseases like HIV and hepatitis C.

According to SAMHSA’s 2014 NSDUH (PDF | 3.4 MB):

  • 4.8 million people have used heroin at some point in their lives.
  • Among people between the ages of 12 and 49, the average age of first use was 28.
  • 212,000 people aged 12 or older used heroin for the first time within the past 12 months.
  • Approximately 435,000 people were regular (past-month) users of heroin.

For more information about the treatment of opioid use disorders, visit the topics Behavioral Health Treatments and Services, Mental and Substance Use Disorders, and Prescription Drug Misuse and Abuse.

Last Updated: 02/23/2016