Prescription Opioids to Heroin — Changing Forms of Addiction

America’s overdependence on painkillers saw the nation facing a prescription drug epidemic. The condition is such that it threatens to derail the United States. Those who are looking to go sober suffer severe withdrawal symptoms, ultimately leading them to cheaper options like heroin.

It has been observed that there is a growing trend of people moving from prescription painkillers to heroin, either as a recourse or a fallout of their long-term use. One of the reasons for this trend is the similarity between heroin and prescription painkillers. It is because heroin is an opiate analgesic, just like oxycodone and tramadol, which are frequently prescribed for pain control, said Dr. Vitaly Gordin, division chief of chronic pain management in the Department of Anesthesiology at the Penn State Hershey Medical Center.

It is not an issue for patients who use these medicines to get rid of short-term acute pain, like after a surgery. “The vast majority of them will very easily get off these medications as their condition improves and pain is decreasing,” said Gordin.

It is also not a problem for those with chronic conditions requiring medicines or painkillers in high doses over a prolonged period. “There are a lot of very legitimate patients who are receiving these medicines in a chronic setting who are not abusing them,” said Gordin.

Proper exit strategy for painkillers is important

The problem starts only after somebody on high doses of these medicines for a long time has been put off them. These medicines have been pronounced as addictive, primarily contributing to the epidemic. So, many primary care physicians, specialists, and surgeons are discontinuing narcotics for these patients, according to Gordin. Without a proper exit strategy, things can go haywire.

“But if they don’t have an exit strategy and get referred for alternate treatment, addictions counseling or rehabilitation, they can become desperate as they go through withdrawal,” said Gordin. And when a prescription for narcotics is not renewed, a patient invariably turns to heroin as an escape route.

Mixing heroin with other drugs is another problem

Prescription painkillers are regulated and are under the purview of the Food and Drug Administration (FDA), but heroin bought from a dealer is mostly unverified. It is an unregulated substance and its use poses a huge threat. Getting drugs from unverified sources is an invitation to calamity.

Mixing heroin with other drugs is another ominous problem. “Several years ago there was a string of deaths of addicts who bought heroin laced with a potent painkiller called fentanyl. Because it’s all an underground, illegal business, you don’t know exactly what you’re getting,” said Gordin.

A large number of deaths that occur each year can be attributed to mixing prescription painkillers with other substances, such as benzodiazepine or alcohol. It is often a lethal mix. Those with a history of drug abuse, untreated mental health conditions, or preadolescence abuse of any kind are more prone to develop addictions.

Encourage patients to seek treatment

One of the main steps to address this epidemic is to destigmatize addiction as a character flaw, said Gordin. Smearing an addict will only make the victim reluctant in seeking help. Addiction is a disease, not a crime. Instead of rebuke and snub, the addicts need compassion and encouragement to seek treatment.

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