Did you know there are more deaths every year from prescription opioid overdose than from either traffic accidents or homicides? All too often people struggling with opioid dependency begin their descent into addiction with a single prescription for Vicodin, OxyContin, or another legitimate painkiller. Then, as dependency grows, the user increases the dose and eventually shifts to heroin. How can we balance pain management needs with the undeniable substance abuse problem the National Institute on Drug Abuse calls the worst addiction issue the U.S. has ever faced? Switching Between Drugs Opioid painkillers such as Vicodin and OxyContin affect the same parts of the brain that heroin does. The result is that people who crave the opiate high can get it without having to use a needle or other paraphernalia. Because the brain builds a tolerance to the opioid over time, taking more and more becomes necessary — and when pills become too expensive or difficult to get, the user simply turns to heroin, which is currently faster, stronger and cheaper. “The old-school user, pre-1990s, mostly used just heroin,” sociologist Stephen Lankenau told the New York Times. “And if there was none around, went thorough withdrawal. [Now] users switch back and forth, to pills then back to heroin when it’s available, and back again. The two have become integrated.” “The Perfect Drug” Since 2007, the number of people who admit using heroin has nearly doubled, according to the NIDA. Early access to opiate painkillers — often found in a medicine cabinet at home or offered by a friend — spurs a long-lasting desire. “You can get the pills from so many sources,” Oregon Health & Science University researcher Traci Rieckmann told the Times. “There’s no paraphernalia, no smell. It’s the perfect drug, for many people,” she added. In addition, one addiction specialist, Dr. Jason Jerry of the Cleveland Clinic, notes that of the 200 estimated people addicted to heroin he sees, roughly half began abusing with a legitimate prescription. “Often it’s a legitimate prescription, but next thing they know, they’re obtaining the pills illicitly,” he told the Times. Sadly, many prescription drug abusers begin to use heroin because of the lower cost and higher availability of the drug. Fighting Back Although opioid cravings may never disappear completely, learning to manage those feelings is possible with help from a heroin addiction rehab. In addition, the federal government is coordinating the effort between law enforcement and health organizations to reduce the availability of prescription drugs. Programs such as National Prescription Drug Take Back Day, where people with unused prescription opioids can give them to law enforcement safely, will reduce the number of accessible dangerous pills. Image: StockMonkeys.com