New research finds potential links between teen prescription opioid misuse and later heroin use in high school.

A University of Southern California (USC) study recently revealed some troubling information. When teens use prescription opioids as a way to get high, they are more likely to then move on to using heroin by the time they graduate from high school.

The first use of heroin is one that almost always leads to addiction because of the potency of the drug and the rapid onset of its high. In many cases, people who use heroin begin using more powerful opioids like fentanyl as a way to chase the desired effects, which can ultimately lead to overdose.

The Findings

According to the study, prescription opioids and heroin activate the same areas of the brain’s reward and pleasure circuit in similar ways. When a teen experiences and enjoys the high of prescription opioids, they are more likely to seek out other drugs that produce a similar effect, say researchers heading up the study.

The study was published in JAMA Pediatrics and took place from 2013–2017. It’s the first study to examine the relationship between the use of prescription opioids and first-time heroin use in a group of teens tracked over an extended period.

Researchers administered surveys twice a year to study when high school students used different drugs. They followed 3,298 freshmen from high schools located in Los Angeles until they reached their senior year.

As part of the research, participants answered questions about current and previous prescription pain medications use. These include brand-name drugs such as OxycontinPercocet and Vicodin.

Along with asking study participants about their use of prescription pain medications, researchers asked students about their use of other substances, such as heroin, marijuanaalcoholmethamphetamine, cigarettes and inhalants.

Researchers statistically adjusted to account for differences in family and home environment, family history of substance abuse and psychological considerations.

Of the students in the survey, 596 said they used prescription opioids as a way to get high during their first 3.5 years of high school. Approximately 13.1% of participants who used prescription opioids and 10.7% of those who previously used prescription opioids used heroin by the end of high school. Only 1.7% of surveyed students who didn’t use prescription painkillers to get high went on to try heroin by the end of high school.

The Relationship Between Prescription Pain Medications and Heroin

When researchers conducted their study, they looked at whether the use of other substances — including marijuana and alcohol — was linked to heroin use later on. However, they found that the link between the use of prescription opioids and heroin was stronger than links between heroin and other substances. Researchers stated they couldn’t conclude causation, but they went on to say there could be something distinctive about opioids that make teens more vulnerable to trying heroin.

The Relationship Between Parental Opioid Use and Adolescent Opioid Use

separate study found when parents use opioids non-medically, it can also be a significant predictor of adolescent opioid use by their children. The study looked at 35,000 parents and their children. Researchers found that, in addition to parental non-medical opioid use being linked to adolescent use, maternal non-medical use of opioids was significantly linked with use by both adolescent boys and girls. All of this comes along with the startling fact that over the past twenty years, the death rate related to opioid overdoses among kids and teens in the United States has tripled. These deaths include accidental poisoning, as well as unintentional overdoses.

If you or someone you care about is struggling with opioids or other substances, contact The Recovery Village to learn more about treatment options.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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Medically Reviewed By – Ashley Sutphin
Ashley Sutphin Watkins received her degree from the University of North Carolina at Chapel Hill in Psychology and Journalism. Read more

Hopper, Leigh. “Teens who abuse opioids are more likely […]oin, USC study shows.” USC News, July 8, 2019. Accessed July 30, 2019.

Hlavinka, Elizabeth. “For Teens, Opioid Abuse Begins at Home.” MedPage Today, February 26, 2019. Accessed July 30, 2019.

Reinberg, Steven. “Opioid Overdose Deaths Triple Among Teens, Kids.” WebMD, December 28, 2018. Accessed July 30, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.