People Who Abuse Prescription Painkillers 19 Times More Likely to Use Heroin

A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that people aged 12 to 49 who had abused prescription pain relievers were 19 times more likely to have initiated heroin use recently (within the past 12 months of being interviewed) than others in that age group (0.39 percent  versus 0.02 percent). The report also shows that four out of five recent heroin initiates (79.5 percent) had previously abused prescription pain relievers.

While the report shows that people abusing prescription painkillers were at greater risk of later starting heroin, it also shows that the vast majority of people using prescription pain relievers nonmedically did not start using heroin. In fact, only 3.6 percent of the people who initiated the nonmedical use pain relievers went on to use heroin within five years.

“Prescription pain relievers when used properly for their intended purpose can be of enormous benefit to patients, but their nonmedical use can lead to addiction, serious physical harm and even death,” said Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “This report shows that it can also greatly increase an individual’s risk of turning to heroin use – thus adding a new dimension of potential harm.”

The report’s examination of the association between the nonmedical use of prescription pain relievers and the initiation of heroin use is part of SAMHSA’s efforts to identify some of the factors which may explain the rise in the rates of heroin use, dependence and initiation that have occurred in the past few years.

The number of people reporting that they have used heroin in the past 12 months rose from 373,000 people in 2007 to 620,000 people in 2011. Similarly, the number of people dependent on heroin in the past 12 months climbed from 179,000 people in 2007 to 369,000 people in 2011. The number of people starting to use heroin the first time in the past 12 months also increased from 106,000 people to 178,000 people during the same period.  

The report also found significant shift between 2008 and 2011 in heroin initiation levels and patterns. For example, although overall heroin initiation rose among all 12 to 49 year olds, these increases were only seen among adults aged 18 to 25 and 26 to 49, with no change in the rate among youths aged 12 to 17.  Heroin initiation among people with annual incomes less than $20,000 or $20,000-$49,999 also increased during this time period. 

Past-year heroin initiation rates went up sharply in all regions of the nation during this period except the South where the rate stayed lowest in country. Heroin initiation rates were also lower among Blacks than among other racial and ethnic groups.  

The report, Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States, is based on data from SAMHSA’s National Survey on Drug Use and Health (NSDUH), covering the period of 2002 to 2011. NSDUH is a national survey of over 67,500 people age 12 and older.