Heroin use and overdose deaths have skyrocketed in recent years, and emerging information suggests this is the result of prescription painkiller addicts transitioning to the hardcore street drug. According to statistics recently released by the National Center for Biotechnology Information, most people reporting heroin use initially started on pills.
According to the NCBI:
Between 2002-2004 and 2008-2010, past year heroin use increased among people reporting past year nonmedical use (PYNMU) of opioid pain relievers, but not among those reporting no PYNMU. Frequent nonmedical users – people reporting 100-365 days of PYNMU – had the highest rate of past year heroin use and were at increased risk for ever injecting heroin and past year heroin abuse or dependence as compared to infrequent nonmedical users (1-29 days of PYNMU).
In 2008-2010, 82.6% of frequent nonmedical users who used heroin in the past year reported nonmedical use of opioid pain relievers prior to heroin initiation compared to 64.1% in 2002-2004.
The possibility that people are using heroin as a substitute for pain relievers makes sense given the similarities between the drugs, according to this article: from a pharmacological perspective, there are few differences between painkillers like OxyContin and heroin, not to mention the fact that heroin is cheaper and readily available. In a survey of drug treatment residents for whom opiate pills was their drug of choice, their preference for OxyContin dropped 64%, while within the same group of residents, reports of heroin use nearly doubled, the article notes. The article also calls into question whether prescription drug monitoring databases reduce drug abuse or merely divert it. The majority of states have such databases in place, though many are suffering from lack of funding or outdated technology.