“Gateway drugs” are seemingly innocent or low-risk substances that lead people to taking stronger, more dangerous drugs such as heroin. There is often a progression through other illegal drugs before people turn to heroin. However, prescription drugs can also lead to heroin use.
Opioids are a family of drugs that were originally derived from the opium plant. The opioids used in painkiller medications work on the same receptors in the brain as illegal drugs like heroin and opium and are similarly addictive.
More people in the U.S. are addicted to prescription drugs than to illegal ones like heroin. In 2014, Dr. Nora Volkow of the National Institute on Drug Abuse reported that, in 2012, an estimated 2.1 million people suffered from a substance use disorder related to opioid pain relievers. An estimated 467,000 people were addicted to heroin.1
In medicine, prescription opioids are most commonly used as pain-relieving medications. The opioid levels in most prescription medications tend to be low. When taken for a short time and in accordance with a doctor’s instructions, these drugs are safe and unlikely to pose any addiction problems.
The risk increases for patients being treated for chronic pain. Chronic pain differs from acute pain in that it is permanent or recurrent. People with chronic illnesses or injuries who take opioid medications are exposed to these drugs for prolonged periods, which increases the risk of addiction.
The body builds up tolerance after repeated exposure to these medications, and tolerance reduces the effectiveness of the drugs. To achieve the same level of pain relief, it is necessary to increase the dosage. Tolerance can lead to dependence, in which people go into withdrawal if they do not take the drug. People may pressure their doctors to continue prescribing pain relievers because they do not like the withdrawal symptoms if they stop.
How Opioids Act as Gateway Drugs
It is not uncommon for people with chronic pain to be taking dozens of pills every day. That level of usage comes with a hefty financial burden. People who struggle to pay for their medication may look at alternatives like heroin or illegally produced fentanyl, both of which are significantly cheaper than medications.
This makes prescription medications, particularly pain relievers, gateway drugs. In 2014, Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse, acknowledged that prescription drugs have become gateway drugs to heroin use.2
When people develop dependency on or addiction to opioids, they will find it very hard to quit taking them. Those who try to do so without medical and therapeutic help are unlikely to be successful. Fortunately, there are excellent rehab facilities throughout the country that can help people manage opioid addiction and find relief. This is a far better option than turning to illegal drugs.