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Prescription Opioids and Heroin

Increased drug availability is associated with increased use and overdose

From 1991 to 2011, there was a near tripling of opioid prescriptions dispensed by U.S. pharmacies: from 76 million to 219 million prescriptions (IMS Health, 2014a; IMS Health, 2014b). In parallel with this increase, there was also a near tripling of opioid-related deaths over the same time period.

Mexican heroin production increased from an estimated 8 metric tons in 2005 to 50 metric tons in 2009—more than a six-fold increase in just 4 years. Domination of the U.S. market by Mexican and Colombian heroin sources, along with technology transfer between these suppliers, has increased the availability of easily injectable, white powder heroin (National Drug Intelligence Center, 2011). In a recent survey of patients receiving treatment for opioid abuse, accessibility was one of the main factors identified in the decision to start using heroin (Cicero et al., 2014).


  • Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7):821-826.
  • IMS Health, National Prescription Audit, Years 1997-2013. Data extracted 2014.
  • IMS Health, Vector One: National, Years 1991-1996. Data extracted 2014.
  • National Drug Intelligence Center, U.S. Department of Justice. National Drug Threat Assessment 2011. http://www.justice.gov/archive/ndic/pubs44/44849/44849p.pdf. Published August 2011. Accessed October 8, 2015.

This page was last updated January 2018

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NIDA. (2018, January 17). Prescription Opioids and Heroin. Retrieved from https://www.drugabuse.gov/publications/research-reports/prescription-opioids-heroin

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