Heroin belongs to the opioid drug class. However, heroin is an illicit opioid and Schedule I drug with no accepted medical use and a high potential for abuse, while most prescription opioids are classified as Schedule II drugs.
In 2018, heroin was involved in 14,996 drug overdose deaths, but prescription opioids were almost just as deadly and implicated in 14,975 deaths, reports the National Institute on Drug Abuse (NIDA).
Given the similar death tolls between heroin and prescription opioids, why is heroin considered to be more deadly and dangerous? Here’s what you need to know about the difference between heroin and painkillers.
Why Do Prescription Opioids Cause as Many Overdose Deaths as Heroin?
Prescription opioid use is widespread in the United States, where an estimated 191 million opioid prescriptions were dispensed to patients in 2017, reports the CDC. Of the people who use prescription opioids, 11.5 million report misusing them. In comparison, an estimated 948,000 people in the U.S. use heroin, reports the NIDA.
All opioids are highly addictive and offer a high potential for abuse, regardless of whether they are illicit or legally prescribed. Though the number of overdose deaths is similar between heroin and prescription opioids, the percentage of heroin deaths is far higher given its lower number of users.
Why Is Heroin More Dangerous Than Prescription Opioids?
Heroin tends to be more deadly than prescription opioids because it is unregulated and generally produced in non-sterile environments. Each batch of heroin can differ from the next in terms of purity, strength, and quality, and may also contain different ingredients that increase the risk for severe illness, overdose, and death. People who use heroin may not know exactly what they’re getting from one batch to the next, and face the risk of becoming sick or experiencing an overdose at any time.
Some heroin producers mix or cut their batches with synthetic opioids like fentanyl and carfentanil, both of which can be up to hundreds or thousands of times more potent than morphine and heroin. These synthetic opioids are often produced in overseas labs and tend to be relatively low in cost and easy to obtain. Heroin producers and dealers may add synthetic opioids to their heroin batches to save money and keep buyers coming back for more given how highly addictive these drugs are known to be.
Why Would Anyone Switch From Prescription Opioids to Heroin?
Up to 80% of heroin users report that they initially misused prescription opioids before making the switch to heroin, reports the NIDA, which also states that an estimated 4% to 6% of people who currently misuse prescription opioids will likely end up switching to heroin.
Though heroin is illegal and known to be more deadly than prescription opioids, many users switch to this drug on behalf of addiction. In the United States, prescription opioids have become more difficult to obtain in recent years due to tightened restrictions on prescribing amidst an ongoing epidemic. Many long-term opioid users now receive fewer pills at a time and are limited to fewer prescriptions. When they can no longer obtain opioid prescriptions from their doctors, many of these individuals head to the streets to buy heroin—especially since it is often far cheaper and easier to obtain than prescription opioids.
Heroin addiction and prescription opioid addiction can be safely and effectively treated at drug and alcohol rehab centers using inpatient treatment and behavioral therapies. If you are struggling with any type of opioid addiction, consider seeking treatment at Baystate Recovery Center as soon as possible to overcome dependence and addiction—and to reduce your risk of an overdose.