Opioids are a class of drugs used to reduce pain. Opioids include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.

All opioids are chemically related and interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to addiction, overdose incidents, and deaths.8

Heroin is a powerful opioid drug that produces euphoria and feelings of relaxation. It slows respiration, and its use is linked to an increased risk of serious infectious diseases, especially when taken intravenously. People who become addicted to opioid pain relievers sometimes switch to heroin instead, because it produces similar effects and may be cheaper or easier to obtain.9

Heroin use has increased sharply across the United States among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes.

How is heroin harmful?

• Heroin is an illegal, highly addictive opioid drug.
• A heroin overdose can cause slow and shallow breathing, coma, and death.
• People often use heroin along with other drugs or alcohol. This practice is especially dangerous because it increases the risk of overdose.
• Heroin is typically injected but is also smoked and snorted. When people inject heroin, they are at risk of serious, long-term viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart.

How big is the problem of heroin overdoses?

Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioid pain relievers. Nearly all people who use heroin also use at least one other drug.

As heroin use has increased, so have heroin-related overdose deaths.

Who is most at risk of heroin addiction?

• People who are addicted to prescription opioid pain relievers
• People who are addicted to cocaine
• People without insurance or enrolled in Medicaid
• Non-Hispanic whites
• Males
• People who are addicted to marijuana and alcohol
• People living in a large metropolitan area
• 18 to 25 year olds

Prescription opioids can be prescribed by doctors to treat moderate to severe pain, but can also have serious risks and side effects. Common types are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone. Fentanyl is a synthetic opioid pain reliever. It is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain. Illegally made and distributed fentanyl has been on the rise in several states.

Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. Once addicted, it can be hard to stop. Taking too many prescription opioids can stop a person’s breathing—leading to death.

Risk Factors for Prescription Opioid Abuse and Overdose

Research shows that some risk factors make people particularly vulnerable to prescription opioid abuse and overdose, including:

• Obtaining overlapping prescriptions from multiple providers and pharmacies.
• Taking high daily dosages of prescription pain relievers.
• Having mental illness or a history of alcohol or other substance abuse.
• Living in rural areas and having low income.