Heroin and Opioid Painkillers: Is There a Difference?

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With today’s heroin epidemic rising significantly, it’s easy to say that too many Americans are experiencing the effects of current or past heroin abuse. However, it is not only heroin that friends and family need to worry about. Opioid painkiller abuse is also taking a heart-wrenching toll on American families. Although heroin addiction is viewed more negatively, is there truly a difference between heroin and opioid painkillers?

The ability to distinguish one from the other is almost impossible. First, the origin of the opioid drug class as a whole derives from the same source. Second, the effects they have on the individual consuming them, during or after active addiction are very similar. Also, evidence proves that extensive painkiller use is a gateway to heroin abuse.

Stigma, although harmful, plays a large role in categorizing heroin addiction from painkiller addiction. The opinions of non-addicts contribute to the many theories and discussions on why heroin and opioid painkillers differ on the spectrum of drug abuse. Despite being under the same umbrella of addiction, painkillers are commonly considered “acceptable”.


Heroin is an illegal, highly addictive drug that is created from morphine, a natural substance deriving from an extraction of the opium poppy plant.

Heroin use occurs intravenously (IV) or intranasally (snorted), and the effects of heroin are euphoric to the user. It binds to and activates specific receptors in the brain called mu-opioid receptors (MORs).

MORs release dopamine, causing an increase in activity at the reward system of the brain. Although natural chemicals occur in the body and activate this reward system, the external administration of the drug can lead to severe consequences. Between the long-term effects of heroin use and an addict’s inability to abstain from the drug, it becomes deadly.

When an addict injects heroin he initially feels a rush followed by a warmness through his body. IV heroin use is also accompanied by intense feelings of relaxation which put the user in a trance.

The rush is what keeps the user coming back for more. After experiencing a rush for the first time, the addict continues to chase the high initially obtained from using. Addicts typically refer to this as “chasing the dragon.”

Opioid Painkillers

Opioid painkillers are a synthetic form of opiate which also derives from the opium poppy plant. The term “opioid” refers to the entire family of opiates, including its natural and synthetic forms. Opioid painkillers are typically in pill form. Abuse occurs when an individual consumes the drug in abundance or converts the pill to another form either to inject, smoke, or snort.

Since both heroin and opioid painkillers derive from the opium poppy, they produce similar effects on the user. However, when it comes to painkillers, they have not been “stepped on” by dealers or other users. What this means is that unlike heroin, an opioid such as oxycodone will most likely be in its purest form depending on the source. This leads to a lesser chance of overdose caused by the dangerous chemicals used to cut a substance such as heroin. Generally, it is this comparison that causes users and outsiders to view painkillers as safer.

Painkillers are not illegal, even though they can be obtained through non-medical professionals. Since the legality issue regarding heroin and opioid painkillers differ, people justify their painkiller abuse as being a safer alternative, which is not based on the numerous studies of thelong and short-term effects of opioids as a whole.

Unfortunately, not all effects of opioid painkillers are “blissful” and non-damaging. There are endless dangers resulting from drug use over an extended period of time; the downward spiral of addiction takes place in the abuse of both types of opioids.

Comparing the Two

There are several opioid painkillers currently on the market—while not illegal, they are also as highly addictive as heroin. The purpose of an opioid painkiller is to treat chronic pain and are to be used under severe circumstances. The necessity for opioid painkillers is evaluated by medical professionals first. The abuse comes after the prescription runs out and whether the individual eventually becomes dependent on them.

Since it was deemed illegal in 1924, heroin is a street drug accessible to users through drug dealers. Many heroin users obtain the drug through street dealers, which elicits the concern of whether what the buyer is purchasing, is in fact heroin. This leads to developing theories that opioid painkillers are safer than heroin.

More often than not, painkillers are obtained through a doctor—meaning the substance is pure. Compared to heroin, a street drug that passes through the hands of many before it reaches the addict, it is more than likely to have cutting agents. This means that the drug is “stepped on” for the dealer’s financial benefit. Impurities of the substance lead to a higher risk of overdose because the addict never knows what chemicals are in the drug he or she is using.

Although the differences are clear, the similarities of the two are far more obvious as the disease of addiction progresses. Both heroin and opioid painkillers are drugs that will be abused under certain circumstances. If the individual has a history of drug abuse or an additive genetic makeup, it is more likely he will succumb to addiction. Even if they are not pre-dispositioned to the disease, both drugs are highly addictive substances that can easily lead to dependence.

Whether an individual is addicted to heroin or painkillers, he will undergo a series of similar bodily and chemical changes including withdrawal, cravings, and especially the high associated with opioids.

How Does Stigma Affect the Addict?

Stigma is defined as a set of negative beliefs that originate from the ideas of society as a whole, which can be considered as discrimination toward specific human rights. Many addicts face the negative consequences in association with stigma because of the outlook certain people have about drug abuse. With an increasingly large amount of people judging addicts, stigma contributes to higher death rates, incarceration, and mental health concerns relating to addiction.

However, the general public targets their concerns more toward illegal drug use rather than drug use as a whole. Despite producing relatively similar effects, people will view opioid painkillers as acceptable simply because they are administered by a doctor. Disregard of the actual effects of the substance, with focus leaning more toward legality issues, is what keeps the addict ashamed and in constant fear of judgment. Ultimately, stigma is one of the leading factors in the negative perception of drug addiction.

Are Heroin and Opioid Painkillers Truly Different?

In conclusion, heroin and opioid painkillers are nearly identical; both substances produce the same side-effects and withdrawal symptoms. Addiction is developed through the abuse of the substances as well as a plethora of negative side effects both short and long lasting. While it’s true they do have different statistics as far as overdose rates and a number of people abusing each substance, they are both treatable and use is preventable under the same treatment routes.

The similarities between painkillers and heroin truly outweigh the differences from the eyes of someone once addicted to both substances. When focusing on what each substance does to the body and brain, they are almost indistinguishable from one another. The negative side-effects and harsh realities of addiction as a whole, despite the substance, reveal how badly an addict is affected.

It is not the addict’s choice, it is an unfortunate series of events that lead them to believe they need the substance. With people misunderstanding drug addiction, wrongly comparing the substance, and also pointing a finger at the addict, it creates an illusion for the addict to use drugs based on how society views them. This illusion gives the addict a false sense of accomplishment because, for the most part, they will experience the same effects from either heroin or opioid painkillers.

Negative judgment toward drug abuse is alarmingly high. It not only affects the person participating in the judgment of another person, but it creates an overwhelming feeling to the user. Ultimately causing them to refrain from seeking help in fear of being viewed as less than.

Are You Struggling With Drug Abuse?

Heroin and opioid painkillers are becoming the leading causes of death in America. Don’t become another statistic. Finding a way out of the grips of addiction can be challenging, but recovery is possible. If you or someone you know is struggling with addiction and decide it’s time to start the recovery process call Pathway to Hope at (844) 557-8575 or contact us online. Trained medical staff are available 24/7 to help you regain control of your life.

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