The Next Gateway Drug: How Prescription Drugs Have Started a New Epidemic

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Prescription opioids, such as Oxycodone, Morphine, Codeine, and Hydrocodone are administered to patients to relieve mild to severe pain, but for those who abuse the drug it can cause a euphoric effect similar to heroin. When taken as prescribed, opioid painkillers are effective for pain management. According to the NIH (National Institutes of Health), “frequent prescription opioid users and those diagnosed with dependence or abuse of prescription opioids are more likely to switch to heroin; dependence on or abuse of prescription opioids has been associated with a 40-fold increased risk of dependence on or abuse of heroin.” With the opioid epidemic on the rise, more addicts are finding it difficult to obtain prescription pills and instead are turning to alternatives, such as heroin, which are more available and cheaper.

An Ever-Increasing Cost

Most addictions begin with the user abusing a prescription given to them by a doctor, or by getting pain pills from friends or family. As their tolerance increases, so does the cost to get high. On the street, depending on the opioid, pills can sell for $10-$50, but as their tolerance builds they have to increase the number of pills they take in order to get high. Although the chemical composition of both prescription opioids and heroin are almost exactly the same, heroin is considered to be three times stronger than morphine, and almost twice the strength as oxycodone.

Dwindling Availability

As the opioid epidemic continues, more laws and regulations are enforcing stricter limits on the quantities of prescription opioids distributed to a patient at a given time. For example, the State of Ohio Board of Pharmacy prohibits dispensing or selling more than a 90-day supply of an opioid prescription, regardless if it was issued for a greater amount. As it becomes increasingly difficult to obtain prescription opioids, addicts are turning to heroin for their fix. Heroin and prescription opioid pain relievers belong to the same class of drugs and have a similar chemically induced high. Because heroin is more easily available, cheaper, and stronger, it can become a more attractive option for users than prescription opioids.

An Upper-Middle Class Problem

What was once thought of as a poor, inner-city problem, now includes the upper-middle class, suburban, and youth populations. Heroin is most commonly injected directly into the body using a needle. In recent years, drug dealers are pushing heroin products into the suburbs in the shape of a prescription pill. By eliminating track marks (scars left on the skin after intravenous drug use), the pill form of heroin is a much more appealing option as it reduces the visual signs of drug abuse.

Unregulated Danger

The NIH reports that heroin overdoses have increased in recent years. As an unregulated substance heroin contains impurities, which can lead to long-term effects to your organ systems and makes precise dosing an impossibility. The combination of additives is a huge danger, as users don’t know if they’re getting heroin, fentanyl, or some other concoction of drugs.

How to Protect Your Employees

Early recognition of drug use in the workplace can prevent significant personal, health and professional consequences. Listed below are possible signs of substance abuse.

Emotional / Social

  • Personality change
  • Mood swings/anxiety
  • Irritability
  • Erratic or decreased performance
  • Drunk/intoxicated at social events
  • Social withdrawal
  • Frequent tardiness
  • Problems with law enforcement
  • Increased customer complaints
  • Sudden decrease in work productivity


  • Disheveled appearance
  • Unexpected weight loss
  • Change in diet
  • Smell of alcohol
  • Unexplained minor injuries
  • Needle marks
  • Addition of long sleeves
  • Signs of intoxication or withdrawal e.g. slurred speech, tremors, excessive sweating, dilated or pinpoint pupils

In addition to early recognition, establishing pre-employment and ongoing random drug testing policies can help deter someone from using drugs in the first place.

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About DISA Global Solutions

Founded in 1986, DISA is the industry-leading provider of employee screening and compliance services. Headquartered in Houston, with more than 35 offices throughout the U.S. and Canada, DISA’s comprehensive scope of services includes drug and alcohol testing, background check, occupational health, and transportation compliance. DISA assists employers in making informed staffing decisions while building a culture of safety in their workplace.

DISA Global Solutions aims to provide accurate and informative content for educational purposes only and does not constitute legal advice. The reader retains full responsibility for the use of the information contained herein. Always consult with a professional or legal expert.