There is no consistent evidence of an association between the implementation of policies related to prescription opioids and increases in the rates of heroin use or deaths. Instead the heroin market forces, including increased accessibility, reduced price, and high purity of heroin appear to be major drivers of the recent increases in rates of heroin use.
This finding contradicts the White House claim that the huge increase in heroin overdose deaths---440 percent in the past seven years---is directly related to prescription pain killers and changes in prescribing policies aimed at making them harder to obtain and abuse.
The article appearing in the New England Journal of Medicine is a product of leading researchers at the National Institute of Drug Abuse, the Food and Drug Administration, and the Centers for Disease Control and Prevention. They surveyed dozens of recent, peer-reviewed studies on heroin use. Initiation patterns, overdose deaths and the effects of policy changes in prescribing opioids.
President Obama himself recently, remarked at an October event in West Virginia that, “In fact, four in five heroin users – new heroin users –started out by misusing prescription drugs; then they switched to heroin. So this really is a gateway drug – that prescription drugs become a gateway to heroin. As a consequence, between 2002 and 2013, the number of heroin-related deaths in America nearly quadrupled.”
The NIH researchers, taking into account the study the President cites and many others, found that instead of prescription drugs being the gateway to heroin, the reality is “heroin use among people who use prescription opioids for nonmedical reasons is rare, and the transition to heroin use appears to occur at a low rate.”