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Max injured his back and got a prescription for Vicodin to dull the pain. The Vicodin worked. But it didn’t just help Max’s back pain. It made him feel good. It helped him relax. It helped him worry less. And when his back healed and his prescription for Vicodin ran out, he needed more. He visited different doctors and different pharmacies to get more Vicodin until one pharmacy realized what was going on and put a stop to it.



Heroin and opioid painkillers both belong to the opioid family. And, as the story above illustrates, both have the potential for addiction. What’s the difference between heroin and opioid painkillers?


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What is Heroin?

Heroin is a dangerous and highly addictive substance. In the United States, more heroin is becoming available and being abused, leading to tragic overdoses.



Heroin is an opioid drug made from the poppy plant. It can be ingested through snorting, smoking, or injecting. Once ingested, heroin is broken down into morphine, a well-known painkiller. Morphine induces pain relief, a sense of euphoria, and calm. It does this by binding to opioid receptors throughout the body, especially mu-opioid receptors.


What are the mu-opioid receptors? Mu-opioid receptors are found throughout the body in the brain, the gut, and even the immune system. When heroin and other opioids bind to these receptors they are able to act on the body in various ways. For example, when heroin binds to mu-opioid receptors in the respiratory centers of the brain, it depresses them and causes the user to breathe more slowly. When heroin binds to mu-opioid receptors in the gut, it slows the gut down and causes constipation.



Heroin has a high affinity for mu-opioid receptors. This means that it only takes a small amount of heroin to bind strongly to these receptors and have its effects.




What are Opioid Painkillers?

Opioid painkillers include Vicodin, Oxycontin, and Percoset. These medications are used to treat acute or chronic severe pain. Like heroin, opioid painkillers bind to mu-opioid receptors in the body to exert their effects. The big difference is that these medications do not bind as strongly to these receptors as does heroin.



For example, Oxycontin, once ingested, is broken down to oxymorphone and no oxycodone. These two chemicals bind to the same mu-opioid receptors that heroin does but with less affinity. For this reason, you would need a larger amount of Oxycontin–as compared to heroin–to activate mu-opioid receptors in the body. This is why Oxycontin is considered a “mild opioid” with less painkilling potential than heroin, which itself is considered a “major opioid.”




What is the Difference Between Heroin and Opioid Painkillers?

Heroin and oxycodone essentially work by the same mechanism in the body and lead to essentially similar effects. But there is a big difference between heroin and oxycodone. Heroin is an illegal, Schedule I substance. Heroin is classified as a Schedule I substance because it can easily be abused and it has “no legitimate medical purpose.” Opioid painkillers, by contrast, are prescription drugs that do serve a legitimate medical purpose.



Opioid painkillers are indicated in the treatment of severe pain that is associated with traumatic injury, major surgery, and cancer. When prescribed appropriately and used appropriately, opioid painkillers can provide much-needed pain relief. So how are opioid painkillers prescribed “appropriately?”



Healthcare providers who work in pain management are well aware of the World Health Organization Analgesic Ladder. While modifications to the ladder have been made over the past 24 years, its stepwise approach to using medications for pain management and its five recommendations continue to be useful to healthcare providers. The five recommendations for using painkillers are as follows:


  1. Give painkillers orally instead of intravenously or via other methods of administration whenever possible.
  2. Give painkillers at regular intervals to ensure continuous pain relief and to avoid breakthrough pain.
  3. A patient’s pain should be evaluated using a pain assessment tool, and the patient should be treated according to his or her reported level of pain.
  4. There is no one-size-fits-all when it comes to prescribing painkillers. Tailor the prescribing of painkillers to each unique patient.
  5. Prescribe painkillers in a way that is understandable to patients and their families so that these painkillers may be taken appropriately.



There is no doubt that opioid painkillers can be and have been abused. This does not change the fact that opioid painkillers are indicated for the treatment of certain medical conditions. In fact, the issue that many healthcare providers are facing now is the under-treatment of pain out of fear that patients will develop an addiction to the medications prescribed to them. Experts in many fields from neurology to pain management know the types of pain that opioid painkillers can help and the types of pain for which these medications are useless. If you or someone you love has been prescribed opioid painkillers, do not hesitate to talk to your physician about these medications, why they are being used, and how to make sure they are used appropriately.




How to Treat Addiction to Heroin or Opioid Painkillers

Opioid addiction is an epidemic. If you find yourself addicted to heroin or opioid painkillers, you are not alone. Here are ways that opioid addiction can be treated:


  • With medications: Medications like buprenorphine, naloxone, and naltrexone can be used to help a person detox from opioids. Symptoms of withdrawal from opioids–such as insomnia, pain, and anxiety–may be very difficult to deal with and may even cause you to start using again. The medications listed above can lessen your cravings and calm your withdrawal symptoms, making it more likely that you will be able to stop using opioids.
  • With therapy: Interventions like cognitive behavioral therapy can help you overcome your addiction to opioids. Therapy may help you identify why you use drugs, understand your triggers for using, and encourage you to find ways of coping that do not involve drug abuse.
  • With formal rehab: Rehabs often combine medications and therapy with additional interventions to help you get clean and stay clean. If you are interested in the heroin rehab process, specialists can help you determine what type of rehab is best for you, how you can pay for it, and where you can go for the help that you need to break the cycle of addiction.

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