How Can Prescription Drugs Lead to Heroin Use?

From Rx to Heroin

Nearly half of young people who inject heroin start by misusing prescription (Rx) pain medicine, also known as opioids. Some teens start by misusing it with friends because they're curious, to self-medicate or because they think it will make them feel good. Others start taking it legitimately when prescribed by a doctor after an injury or medical procedure. But in some cases, legitimate use turns to dependence, misuse, addiction and then heroin use. Tragically, many overdose fatalities are now being driven by heroin laced with fentanyl, a synthetic opioid, or similar compounds which are even more powerful and deadly.

Follow Katie's journey below to see how Rx drug misuse can lead to heroin addiction.


Katie suffers an injury that requires surgery. Throughout the healing process, she is prescribed painkillers.

Prescription drugs are one of the most commonly abused drugs among 12-13 year olds.

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On track to be a scholarship athlete in college, Ronnie started abusing Rx painkillers at 15. Watch his story. Watch his story.


After a few months of taking the painkillers, Katie notices that they don't work as well or last as long. She begins taking more pills than prescribed.

1 in 10 teens report having abused or misused an Rx drug at least once in their lifetime.


Katie quickly runs out of her Rx — and feels like she needs it. She begins stealing pills from a friend's medicine cabinet. She learns that crushing and snorting the pills can help her feel better, faster.

Of teens who abuse Rx pain relievers, more than half say they got them from family or friends.

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He would ask to use the bathroom in other people's homes. He'd go in their medicine cabinets and steal prescription drugs. Watch the Montez Family's story:


Katie's parents notice that she is behaving strangely — and that she has a new set of friends. When they find a baggie of loose pills in her room, they become concerned and confront her. Katie denies that she has a problem.

95% of parents believe their child has never taken a prescription drug for a reason other than its intended use.

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Not all teens start abusing painkillers because of an injury. Watch this clip from the documentary Out of Reach, created by a teen filmmaker to capture the issue of teen medicine abuse.


Katie asks her doctor for more painkillers, but he refuses. She can't find enough pills and begins to suffer from withdrawal. Her friend Jacob says he has heroin (also an opioid), but no painkillers. Katie never thought she would use heroin, but feels desperate to stop the horrible withdrawal symptoms. She starts snorting heroin.

4 out of 5 heroin users began first with recreational use of Rx pain relievers.

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Watch Nacho, a young man in recovery, describe the symptoms of withdrawal.


Katie's tolerance is very high and she cannot afford the amount she needs to keep away the powerful cravings. Jacob says she can use less heroin if she injects it. She is afraid of needles, but Jacob offers to inject the heroin for her. She agrees. Neither of them know that the heroin he bought contains fentanyl, which is much more powerful than heroin. Katie is breathing very slowly and is turning blue. Jacob calls 911 and leaves her.

Nearly 80 percent of people who inject heroin start by abusing Rx drugs.


The paramedics find Katie and administer Naloxone, which reverses the effects of the heroin overdose. They need to giver her more Naloxone though because fentanyl is so potent. Katie is watched closely at the hospital.

Naloxone (brand name Narcan) is a drug that can reverse an opioid overdose and save lives.


Soon after, Katie's parents enroll her in an adolescent treatment program, which includes medication-assisted treatment, counseling and support. Post-treatment, Katie's family is committed to continuing her care.

Medication-assisted treatment with counseling and support is the preferred treatment for heroin and other opioids.

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Addiction is a brain disease and can be successfully treated with a combination of therapy and medications such as Naltrexone, Methadone and Suboxone. Listen to addiction and recovery experts explain the benefits of Medication-Assisted Treatment.


Katie is in recovery and working hard to stay healthy.

With ongoing recovery support, it is possible to lead a healthy, productive life after addiction.

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Recovery is possible. Watch Chelsea's story

Could your teen or young adult be on a similar path?
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