How Common Is Prescription Opioid Abuse in Teens Who Start Using Heroin?

Heroin consumption is on the rise in America, and that rise has been accompanied by an increased rate of heroin addiction and overdose. Current evidence shows that a substantial portion of heroin consumers actually start out as abusers of prescription opioid medications. While many experts focus on the link between the two forms of substance intake in adults, the same connection also affects significant numbers of teenagers. In fact, the results of a recently published study indicate that the clear majority of U.S. teens who consume heroin in their senior year of high school first abused an opioid medication.

Prescription Opioids versus Opioid Street Drugs

Prescription opioids are a large family of medications that come directly or indirectly from mind-altering substances found in a plant called the opium poppy. In addition to producing an intense feeling called euphoria inside your brain’s pleasure center, these medications help block or reduce your brain’s ability to sense pain. It is this second property that makes prescription opioids a common treatment option for people with certain types of moderate to severe pain symptoms.

Heroin and other opioid street drugs also come from mind-altering substances found in the opium poppy. They also have the same euphoria-producing, painkilling effects as opioid medications. However, opioid street drugs are not produced under the same types of monitored conditions as prescription opioids. This means that no user can accurately predict the potency of any given batch of these drugs, or predict whether or not a batch contains dangerous additives or contaminants. In addition, while opioid medications are only legitimately prescribed by a licensed doctor, opioid street drug consumption by its very nature occurs without medical supervision.

Prescription opioid medications such as OxyContin and Vicodin share two other unfortunate traits with heroin and other illegal opioid street drugs. First, inside the pleasure center, repeated exposure to both groups of substances can lead to long-lasting chemical changes that set the stage for physical dependence and full-blown opioid addiction. This means that, regardless of which specific substance you consume, any habitual abuse or misuse of an opioid medication or street drug comes with clear addiction risks. In addition, if you consume too much of any of these substances, you can develop the potentially lethal toxic reaction known as an overdose.

Prescription Opioid Abuse

Since opioid medications can trigger addiction or overdose if consumed in excessive amounts, you must have a prescription to use them legally. Technically speaking, you become a prescription opioid abuser whenever you start consuming an opioid medication in larger amounts than your doctor intends. However, for clarity’s sake, many experts refer to this behavior as opioid misuse, not opioid abuse. That is because opioid abuse also has a separate, official definition as part of a diagnosable medical condition called opioid use disorder. It is important to note that, no matter how much medication you consume, any use of a prescription opioid without a doctor’s written approval also qualifies as opioid misuse.

Teenagers and Prescription Opioids

Misuse of prescription opioids occurs in a small but substantial number of American teenagers. The federal government tracks this misuse with information gathered from an annual, nationwide survey called Monitoring the Future. According to the most recent results from this survey, reported in late 2015, roughly 4.4 percent of all high school seniors misuse the medication Vicodin (which contains the opioid hydrocodone) at least once a year. Roughly 3.7 percent of seniors misuse the medication OxyContin (which contains the opioid oxycodone) at least once yearly. Younger teens misuse these two medications at a lower, but still significant, rate. On any given day of the year, roughly 2,500 American teens misuse an opioid medication for the first time. Altogether, about 12 percent of all teens throughout the country have a lifetime history of prescription opioid misuse.

Teenagers, Opioid Medication Misuse and Heroin

Addiction experts know that improper use of opioid medications is sometimes a gateway for heroin consumption. Several factors help explain this connection. For example, some prescription opioid misusers switch to heroin because the street drug is often much cheaper and easier to obtain than an opioid medication. Some OxyContin misusers switch over to heroin consumption because changes in that medication’s formula now discourage tampering and easy illicit use.

About 1.2 percent of all American teenagers have used heroin at least once. In a study published in November 2015 in Drug and Alcohol Dependence, a team of American researchers used five years of data from Monitoring the Future (2009-2013) to determine how many high school seniors who consume heroin started out as prescription opioid misusers. After analyzing information gathered from a total of 67,822 seniors, these researchers found that fully three-quarters of the students involved in heroin use had a previous history of improper opioid medication intake. Among those students who misused a prescription opioid 41 times or more, the rate of lifetime heroin intake jumped from the baseline of 1.2 percent to a shocking 25 percent.

The chances of transitioning from prescription opioid misuse to heroin consumption are not equally distributed among all high school seniors. The researchers found that one particular group, seniors with European-American ancestry, has substantially higher odds of making this dangerous switch. However, whatever their racial/ethnic background, teenagers who start misusing prescription opioids often do so because they consider these medications to be safer than street drugs. This mistaken perception has potentially tragic consequences.

Prevention and Help

Fortunately, prevention campaigns targeted at teenagers can significantly lower the rate of medication misuse and help halt the gradual slide into heroin consumption. If your teen misuses a prescription opioid, you can seek help from a professional addiction treatment resource. You can also seek professional advice from an addiction specialist if you suspect that your teenager has any degree of involvement in heroin use.