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A heroin addict smokes heroin in Lamu November 21, 2014. Picture taken November 21, 2014. To match KENYA-DRUGS/LAMU Reuters/Goran Tomasevic

Researchers at the Washington University in St. Louis (WUSTL) have found that prescription opioids are not being completely abandoned for heroin among drug users. According to a 15,000-patient survey at rehabilitation centres in 49 states across the US, many report concurrent use of the two, depending on availability. The findings also highlight the regional variations in the use of prescription painkillers and heroin.

The study, titled “Shifting Patterns of Prescription Opioid and Heroin Abuse in the United States,” has been published in The New England Journal of Medicine on Oct 29. It shows that around 42 percent of drug users under treatment in the US had used prescription painkillers and heroin within a month of starting treatment in 2014. This is the almost twice the number in 2008 – at 23.6 percent, says a WUSTL press release.

Senior investigator Theodore J. Cicero said in the release, “On the East and West coasts, combined heroin and prescription drug use has surpassed the exclusive use of prescription opioids.” He adds, “This trend is less apparent in the Midwest, and in the Deep South, we saw a persistent use of prescription drugs — but not much heroin.”​​​​​​​​​​​​​​​

The team conducted anonymous surveys asking users about their drugs of choice and use and abuse patterns when they entered treatment. Detailed data from 267 patients was included in the study, of which 129 reported having used prescription opioids before heroin and 73 percent explained factors, such as accessibility and cost, behind using heroin.

A crackdown on “pill mills” by the federal government and the illegal prescribing of painkillers by doctors has led to difficulties in procuring prescription painkillers. In this scenario, heroin becomes the supplement of choice for addicts. “If users can’t get a prescription drug, they might take whatever else is there, and if that’s heroin, they use heroin,” said Cicero.

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