Drug Abusers Go from OxyContin to Heroin

A new formulation of the painkiller OxyContin (oxycodone) introduced in August 2010 was designed to be resistant to abuse, but new research suggests that it has had the unintended consequence of increasing abuse of a far more dangerous opioid: heroin. The findings were reported in a letter to the editor in the July 12, 2012, edition of the New England Journal of Medicine.

The researchers conducted quarterly self-administered surveys from July 2009 through March 2012 with 2566 patients in drug treatment programs who primarily abused prescription opioids. The portion of participants who named OxyContin as their primary drug of choice decreased from 35.6% before the release of the abuse-resistant formulation to 12.8% in March 2012. Over the same period, the portion of participants who said they had gotten high on OxyContin over the previous 30 days declined from 47.4% to 30.0%, whereas the portion that had gotten high on heroin doubled to approximately 20%.

In more in-depth interviews with a subset of participants, 66% of OxyContin users said they had switched to an alternative opioid and identified heroin as the most popular alternative due to its ease of use, low price, and widespread availability. The findings help explain why law enforcement sources have noted a recent increase in heroin use in rural and suburban areas where OxyContin abuse has been common.