Prescription Opiates and Heroin: Two Paths that Often Converge

I am certain that most individuals who abuse opiate prescription drugs have little thought of progressing to heroin. Nonetheless, when doctors refuse to refill prescriptions and/or the drugs become prohibitively costly, a readily accessible and cheaper form of opium is frequently enlisted – heroin. This pattern of progression to heroin is illustrated over and over again in our practice every day. Consider the following three (3) stories.

The first client that comes to mind is a gentleman for whom I am now guardian. He was a fireman in a large NJ city and sustained many orthopedic injuries during the course of his job. These injuries gave rise to over 15 surgeries and years of opiate pain medication. Eventually, doctors realized that he was abusing the drugs although all recognized that he endured significant pain on a daily basis. While no one would suspect that he would resort to heroin, he did when the opiate medication was curtailed and he began to get sick. I am sorry to say that he overdosed on heroin shortly into his usage and this resulted in permanent brain damage for which he now resides in a nursing home. He has three small children.

Another story involves an individual who also sustained an orthopedic injury for which he was prescribed opiate pain medication. He also had problems with addiction to the medication and, in fact, entered a drug rehabilitation facility to combat his problem. Unfortunately, he decided to “party” with an acquaintence he met in rehab and the suggestion was made that he try heroin to quench his opiate thirst. I am sad to say that this short deviation into heroin also resulted in an overdose that proved fatal. This banker left a wife and three small children.

The third story, and the one which prompted this blog, involved a 24 year old young man I met today at the Middlesex County Jail. Although I knew that he had been battling heroin addiction for several years, I had no idea how it originated. Then I heard his story and immediately recognized so many attributes, including his obvious intelligence. He had sustained an orthopedic injury as a freshman at Rutgers University that resulted in his starting to consume opiate pain medication. He became addicted and experienced difficulty obtaining the medication, becoming very sick from opiate withdrawal. Someone suggested that he snort some heroin as it might combat his sickness. He took the suggestion and it started him off on a downward spiral whose end is still unclear. His future, which was once so bright, is now highly questionable and the pain caused to his family has been immeasurable.

I have many more stories of individuals resorting to heroin after a prescription drug habit cannot be quenched. My hope is that someone heading down the road of opiate prescription drug addiction recognizes that these stories are not so far fetched given the type of people I have described and does not make this progression. Indeed, every person in these stories came from good stable families and had absolutely no thought that heroin had any chance of crossing their path.