Prescription Drug FAQ

What are “opiates” or “opioids?”

Opioids usually come in pill form and are prescribed to reduce pain. Medical doctors and dentists prescribe them after surgery or to help patients with severe pain or pain that lasts a long time. When opioids are taken as prescribed by a medical professional, they are relatively safe and can reduce pain effectively. However, dependence and addiction are still potential risks when taking prescription opioids. These risks increase when these drugs are abused. Painkillers are one of the most commonly abused drugs by teens, after tobacco, alcohol, and marijuana.

Listed below are common types of opioids:

  • Hydrocodone (Vicodin, Lortab, Lorcet)
  • Morphine (Kadian, Avinza, MS Contin)
  • Codeine
  • Fentanyl (Duragesic)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Methadone

View a photo of common opioids.

Is it risky to use any prescription painkiller?

All medications carry risks. Pain medications that contain synthetic opiates (also known as opioids) are no exception.

If you are prescribed opioid medications by your doctor, thoroughly discuss the risks and benefits of the medication. Use the medication only as prescribed and do not share it. This significantly reduces the likelihood that you will develop an addiction.

Does everyone who develops an addiction to prescription painkillers move on to heroin?

Not everyone who uses prescription painkillers does or will use heroin. However, according to the CDC, approximately 3 out of 4 new heroin users report having abused painkillers prior to using heroin.

In interviews, people who switched from painkillers to heroin said they made the transition because painkillers became unavailable, because heroin is cheaper, and because they were desperate for relief from opiate withdrawal.

There is evidence that, as prescription painkillers become less freely available, heroin use is increasing. There has been a worrying rise in heroin deaths over the last few years. Nationally, deaths from heroin have tripled in the last five years.

Virginia experienced the largest increase (38.9%) in the number of fatal overdoses on record in 2016 compared to 2015. Although 2017 numbers surpassed those of 2016, the rate of change (7.6% increase) was not as significant as that seen in 2016 compared to 2015.

The total number of fatal heroin-related overdoses have been increasing since 2010. Fatal heroin overdoses often occur as the primary drug causing death, but more recently, fentanyl and/or fentanyl analogs in addition to heroin have caused fatal overdoses. Fatal heroin overdoses increased by 24.6% in 2017 when compared to 2016.

Since 2007, fatal prescription (Rx) opioid overdoses have been the leading category of drugs causing or contributing to death in the Commonwealth, with historically, oxycodone being the most common drug. Given the transition in fatal fentanyl overdoses from pharmaceutically produced fentanyl (2007-2014) to nearly all illicitly produced fentanyl (2015-present), fentanyl needs to be removed from the Rx opioid category and analyzed separately. This allows one to see the significant impact the drug is having on fatal overdose numbers in Virginia. By removing fentanyl from this Rx category, it is to be expected that Rx opioid fatalities from 2007-2013 to be slightly undercounted because true Rx fentanyl overdoses are excluded and combined with all ‘fentanyl’ to capture recent trends of illicit fentanyl in Virginia.

What can I do to make sure my child doesn’t get involved with drugs?

There is no guaranteed protection against substance use, but there are protective factors. These factors reduce the chances that your child will use drugs or alcohol and develop an addiction.

Parents often feel that their influence over their adolescent children is minimal. In fact, research and clinical experience show that parents can have a significant influence over their children’s decision to use drugs or alcohol. Parents are advised to build a trusting relationship with their children, regularly discuss the risks of substance use, and model healthy behaviors for children to learn from. Parents should also be aware of and monitor childrens’ risk factors. Children with a family history of addiction, a mental health condition, an impulsive/risk-taking personality, and/or a history of trauma are at greater risk of substance use and addiction.

What’s the difference between treatment and Twelve Step support groups?

Twelve Step support groups are a form of peer support. They are the most widely available mutual support groups for people trying to break the cycle of addiction and those in recovery. In addition there are other peer support options including: Women for Sobriety (WFS), SMART Recovery (Self-Management and Recovery Training), and Secular Organizations for Sobriety/Save Our Selves (SOS).

Although they are not professional treatment, Twelve Step groups can complement and extend the effects of professional treatment.

Professional treatment involves a structured program over time that includes credentialed counseling for substance abuse which is often accompanied by closely supervised medication. This can occur in a treatment facility for in-patient or out-patient clients. Out-patient treatment can also be received in a variety of community based locations.

What’s the difference between detox and treatment?

Detox is a process of managing the acute physical symptoms of withdrawal. Detox may be medically managed in an inpatient facility or hospital. It may also occur on an outpatient basis. Detox is a short-term process, usually lasting less than a week.

Treatment addresses the biological, psychological, and social aspects of addiction. It should last longer than detox. Research tells us that most addicted people need at least three months in treatment to really reduce or stop their drug use and that longer treatment time result in better outcomes.

Depending on the type of treatment, detox may be the first step in a drug treatment program. But detox alone with no follow up is not treatment.

Detox treats withdrawal. Treatment treats addiction. Treating withdrawal is not the same as treating addiction.

I have some reservations about the use of Methadone or Suboxone to recover from opiate addiction. Isn’t that just trading one addiction for another?

Used properly, medications do not create another addiction. Medications allow an addicted person to regain a normal state of mind, free of drug-induced highs and lows. It frees the person from thinking all the time about the drug. It can reduce problems of withdrawal and craving. These changes can give the person the chance to focus on the lifestyle changes that lead back to healthy living.

Medication-assisted treatment for opiate addiction is just that: medication-assisted. The medication is just one ingredient. To recover from opiate addiction, most people also need some form of counseling and support from friends, family, or other members of the recovery community.

If an individual treated with these medications tries to take an opioid such as heroin, the euphoric effects are usually dampened or suppressed. Patients undergoing maintenance treatment do not experience the physiological or behavioral abnormalities from rapid fluctuations in drug levels associated with heroin use. Maintenance treatments save lives—they help to stabilize individuals, allowing treatment of their medical, psychological, and other problems so they can contribute effectively as members of families and of society.

Are heroin and prescription painkillers basically the same thing? What’s the difference?

Heroin is an illegal, opioid drug. It is most frequently used via injection, which rapidly result in a pleasant feeling of euphoria, warmth, drowsiness and decreased pain. Opioid painkillers are drugs that are prescribed to relieve mild to severe pain – but they can also elicit a reinforcing, euphoric effect similar to heroin due to their shared neural receptor interaction and subsequent activation of the brain’s reward circuitry.

We encourage Virginias to take steps to prevent non-medical use of prescription painkillers and, in so doing, to break the connection between heroin and prescription painkillers. Together, we can stop opiate addiction before it starts.