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Are Pills in Your Medicine Cabinet a Gateway Drug to Heroin?

By: Jeremy Martinez, MD

Opiate use has been escalating among young people.[i]Pills in your own medicine cabinet may be the Gateway to Heroin, and I will explain how.

High school students are among those who have begun to experiment with Vicodin, Percocet, Norco, and other strong pain-killers.

Prescription pills can appear innocuous to many.  These pills have been given by a doctor, which makes a person feel that they are safe.  These pills are also made by a professional manufacturer, and may appear safer than street drugs.

The problems with opiate addiction begin with regular use of these drugs. Tolerance to opiates begins after daily use over an extended period of time.  A person’s body changes with regular opiate use, and this causes withdrawal when the drug is stopped.[ii]

Stopping the pain-killers leads to runny nose, nausea and vomiting, severe muscle pain, and diarrhea. Opiate addicts commonly refer to this as getting “sick,” and may feel like a bad flu.  Withdrawal can also cause muscle twitching, or “kicking,” that can occur in the arms or legs.

Opiate addicts are afraid of becoming “sick,” which can be extremely painful, and leads to the regular,daily use of stronger and stronger opiates to stay “well.”  Many who are addicted to these drugs will tell you that they are just trying to stay “well.”  At some point they are no longer trying to get “high.”

Using pain-killers regularly can lead to a rapid tolerance.  Using Vicodin or Percocet will turn into Roxicet or OxyContin, which can be more than 100times stronger[iii]than Vicodin.  OxyContin is often sold illicitly, or “on the street” for up to $80 per pill.[iv]  You can imagine how expensive this becomes!

The pricey OxyContin (also called“OC’s” or “OP’s”) will often become difficult to get, and heroin provides a cheaper option to “stay well.”  People are often introduced to heroin by smoking it. Smoking heroin does not have the stigma or “scariness” of injecting the drug IV.  For a high school student who has smoked marijuana, it might not be as scary to try smoking heroin.

Smoked heroin has only 1/4 to 1/2 the potency of IV heroin.[v]Once again, the addict begins to spend so much money smoking the heroin, that injecting heroin begins to look like an attractive option.  The addict desperately needs some form of opiate to avoid “the kick.”

This is how the pain pills in your medicine cabinet may ultimately lead to a young person’s addiction to heroin.  Not every young person that takes a Vicodin becomes an opiate addict. The danger of addiction arises from regular, daily use of these drugs.

What can be done to prevent this from happening?

There are simple steps that you can take today to prevent your pain medications from leading to another person’s life-long addiction…

First, if you take painkillers such as Vicodin, or the other pills mentioned here, it is important to keep these in a locked container.  Locking pill containers are available at most drug stores.

Second, it is also critical that you never give your pain medications to another person.  If they are prescribed to you, you are the only one who should take them.

And lastly, if you have pain medications that you are no longer taking, these should be destroyed.  The FDA actually recommends that opiates be flushed down the toilet because of the high risk of abuse by others (

If you have concerns about opiate addiction for yourself or a loved one, talk to your doctor about the treatment options available.

Jeremy Martinez, MD is an Addiction Psychiatrist who works at Pasadena Recovery Center and The Solstice Clinic in Los Angeles, CA.


[i]HallAJ, Logan JE, Toblin RL, Kaplan JA, Kraner JC, Bixler D, Crosby AE, PaulozziLJ. Patterns of abuse among unintentional pharmaceutical overdose fatalities.JAMA. 2008 Dec 10;300(22):2613-20.

[ii]OuyangH, Liu S, Zeng W, Levitt RC, Candiotti KA, Hao S., An emerging new paradigm inopioid withdrawal: a critical role for glia-neuron signaling in theperiaqueductal gray., ScientificWorldJournal. 2012;2012:940613

[iii]OrdóñezGallego A, González Barón M, Espinosa Arranz E., Oxycodone: a pharmacologicaland clinical review., Clin Transl Oncol. 2007 May;9(5):298-307.

[iv]Kavilanz,Parija. Prescription drugs worth millions to dealers, CNNMoney, 2011 June

[v]U.S.Department of Health and Human Services. Substance Abuse and Mental HealthServices Administration. Division of Pharmacologic Therapies.Medication-Assisted Treatment for Substance Use Disorders. 42 CFR Part 8 OpioidDrugs in Maintenance and Detoxification. Treatment of Opiate Addiction; FinalRule. Published January 17, 2001.

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