Opioids, Heroin, and their Impact 

Understanding the impact

A heroin and opioid overdose epidemic has swept the United States in the past several years. South Carolina, like other states, has been overwhelmed with unsettling tragedies of lives full of possibility cut unexpectedly short. Some areas of the Palmetto State are as high as 200% above the national average for heroin and opioid-related deaths. Especially among young people, the problem has grown particularly acute. This epidemic began with the misuse and abuse of prescription painkillers (e.g. oxycodone, hydrocodone, OxyContin, and Percocet) which fueled an increased demand for heroin from traditional sources of supply, such as Mexican cartels and their domestic US proxies.

Nationwide opioid and heroin-related deaths have increased at an exponential rate from around 5000 in 1999 to over 33,000 in 2015. These preventable deaths now represent 63% of all drug overdose deaths in the US, equal to or more than vehicle or gun violence fatalities. Every day, 144 people die from drug overdoses. Among those deaths, 91 are from heroin and opioids. The 91 daily deaths can’t be blamed exclusively on the heroin variable in the “opioid-heroin” equation either. Prescription opioid deaths outpaced heroin deaths by a ratio of nearly two-to-one in 2013 and 2014.

 How it starts

For an individual user, the cycle of abuse and addiction begins with consumption of prescription opioids for recreational purposes. Over time, the user develops a psychological and physical dependence on the opioid. Once access to prescription drugs has been eliminated, heroin is a less expensive, comparable alternative. The user will find the same high with heroin as a prescription opioid offers. To cross the threshold from prescription pill misuse to heroin abuse, an individual may avoid the classic stigma of a needle-using “junkie.” The heroin of today is 300% purer than the heroin of 30 years ago; a first-time user may first snort and smoke the drug before the more stigmatized method of injection via intravenous needles.

Science has demonstrated that prescription opioids block the same pain receptors in the human brain as heroin and morphine while delivering a euphoric high. One opioid tablet is as powerful as a dosage unit of heroin. Individuals misusing and abusing these drugs outside the scope of explicitly prescribed usage run the risk, at best, of addiction and, at worst, of death. 80% of new heroin abusers today began their addiction by first misusing and abusing an opioid.

Confronting the Epidemic

Working with state and local law enforcement partners and community advocates such as WakeUp Carolina, the DEA seeks to confront and overcome this multilayered crisis. The solution calls for a 360-degree strategy: 1) Awareness and education to enable members of the community to make informed choices; 2) Traditional law enforcement to bring those sowing poison and profiting on the misery of others to justice; and 3) Diversion control to ensure that supplies of prescription drugs are properly and safely dispensed.

Frequently Asked Questions

Opioids belong to a class of highly addictive narcotics used for pain management, and their abuse often leads to the development of tolerance, dependence, and overdose. There are many synthetic and semi-synthetic drugs derived from morphine. www.cdc.gov/drugoverdose/epidemic.

Discuss with your doctor your desire to use other types of medication instead. For some types of pain, Tylenol or Ibuprofen will work.

No, the goal of pain medication is to make the pain tolerable.

Physical and psychological dependence can develop with opioid use. When too much drug is administered, the result is sedation and trouble breathing. In the worst cases, the person stops breathing altogether.

A family history of substance abuse is one of the factors which increases the likelihood of opiate dependence. Studies consistently show that genetic factors contribute to dependence behavior.

For treating acute pain, it is recommended to use the smallest amount of opiates that will make your pain tolerable, then quickly change to safer pain medication.

Retail pharmacies have products available for drug disposal. Some stores have take back boxes where you can drop your prescription bottle in, much like a mailbox. Other stores have pre-addressed mailers you can buy and mail for disposal. The DEA also sponsors community take back days twice a year. Your local police station may also have a take back box. http://scdhec.gov/HomeAndEnvironment/Recycling/UnwantedMedications/

No, some are stronger or weaker than others. A 5mg dose of one type of pill will not be equal to 5mg of a different type of opioid.

Your doctor may ask you to sign a contract which will specify how many pills you can receive how often. Some doctors may also require urine drug tests to confirm drug safety and compliance.