Painkiller Abuse Can Lead to Heroin, Study Reveals

Abuse of prescription drugs may be a gateway to abuse of hard, illegal drugs such as heroin, a new study says.

The study looked at a high risk group of adolescents who abused both injection drugs and prescription drugs. About 85 percent of the teens said they abused opioid painkillers, which include Vicodin and OxyContin , before trying heroin. On average, the painkiller abuse started two years before heroin use.

The key sources of the prescription drugs were the teens' family members. About 60 percent of participants grew up in or visited households where opioids were prescribed, and about 30 percent said they started misusing the drugs after stealing them from a family member.

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The findings may represent a new pattern in drug abuse, the researchers said. Before prescription drugs were as commonplace as they are today, the typical trajectory for an injection drug user was to use hard drugs before turning to prescription pain medication, said study researcher Stephen Lankenau, an associate professor in the School of Public Health at Drexel University.

Public health officials may want to try to reach adolescent opioid abusers before they progress to illegal drug use , the researchers said. In addition, parents should be vigilant and prevent their prescriptions from falling into the hands of their children.

"They're powerful drugs we're not talking about an aspirin," Lankenau said. "These are medications that are potent. I think they need to be treated accordingly, particularly by parents."

Drug abuseIn recent years, there has been an uptick in the number of adolescents who abuse prescription drugs. About 1in 5 high school students say they have abused prescription drugs, according to a 2009 study by the Centers for Disease Control and Prevention.

The researchers interviewed 50 injection drug users ages 16 to 25 living in New York City or Los Angeles, who had also abused perception drugs in the last 3 months. They asked the teens open-ended questions, such as "Why did you use it that first time?" and "Where did you get it?"

Forty-three of the participants said they had misused prescription opioids before using heroin. Adolescents most commonly obtained opioids from friends, family or their own medical prescriptions, which they later abused.

Typically, adolescents began taking the drugs orally. They would later crush the drugs and snort them to get a faster, more powerful high. Finally, they would inject the opioid drugs.

High risk group

The researchers said that the teens in the study were not typical.

While about 25 percent of young adults say they have misused prescription pain medications, only about 1 percent have used injection drugs, Lankenau said.

Therefore, the study's findings are likely to be true only for the high-risk group, the researchers said. These adolescents have other factors that put them at risk for illegal drug use, including living with a family member that misuses drugs or having a psychiatric disorder, such as depression or anxiety .

"We're not suggesting that if you pop a Vicodin once you're going to wind up being an injection drug user," Lankenau said. Instead, the study "shows how these prescription drugs are involved in this pathway towards becoming an injection drug user," he said.

The study will be published in an upcoming issue of the International Journal of Drug Policy.

Pass it on: Adolescent injection drug users often abuse opioids before turning to hard drugs.

Editor's note: This story was updated on July 27 to include the correct percentage of young adults who have misused prescription drugs vs. injection drugs.

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