Prescription Opioids And Heroin Crisis Overlap in Important Ways

Dr. Wilson Compton

Dr. Wilson Compton

For more on Opioids on MedicalResearch.com please click here.

MedicalResearch.com Interview with:
Wilson M. Compton, M.D., M.P.E.
Deputy Director
National Institute on Drug Abuse

Medical Research: What is the background for this study? What are the main findings?

Dr. Compton: Deaths related to opioids (from both prescription pain killers and street drugs, like heroin) have dramatically increased in the past 15 years.  How these different types of opioids are related to each other is important because the pain killers ultimately are derived from prescriptions written by health care providers and street drugs, like heroin, are from illegal sources.  The different types of opioids vary in there source but are quite similar in their effects in the brain.  Given the different sources, interventions to reduce availability vary across the two categories. There is also a concern that interventions to reduce the availability of prescription opioids may be encouraging people to switch to heroin.  That’s the main question addressed in this review.

Medical Research: What should clinicians and patients take away from your report?

Dr. Compton: The prescription opioid and heroin crises overlap in important ways.  Heroin use is increasing because of both the high rates of prescription opioid use AND the greater availability of pure and cheap heroin in many parts of the country.  Federal and state policies aimed at curbing inappropriate prescribing of opioids (e.g., educating health professionals and the public about appropriate use; implementing prescription drug monitoring programs; taking enforcement and regulatory actions to address egregious prescribing; and developing prescription opioids that incorporate abuse-deterrent technologies) have not directly led to the recent increases in heroin use across the nation. Heroin market forces, including increased accessibility, reduced price and high purity of heroin appear to be the major drivers of the recent heroin use increases and related deaths.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Compton: There is a need for improved approaches to treat opioid addiction, including medication-assisted treatments, continuing prevention and education efforts, as well as expanded access to naloxone to treat overdose.  Research to determine the specific impact of these separate and combined efforts is needed.

Citation:

Relationship between Nonmedical Prescription-Opioid Use and Heroin Use

Wilson M. Compton, M.D., M.P.E., Christopher M. Jones, Pharm.D., M.P.H., and Grant T. Baldwin, Ph.D., M.P.H.

N Engl J Med 2016; 374:154-163
January 14, 2016
DOI: 10.1056/NEJMra1508490

 

For more on Opioids on MedicalResearch.com please click here

Wilson M. Compton, M.D., M.P.E. (2016). Prescription Opioid And Heroin Crisis Overlap in Important Ways

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