A Washington University School of Medicine study of opioid users over a seven-year period found that the number of people who used only prescription drugs decreased by 6.1%, while the number of people who used prescription opioids and heroin increased by 10.3%.
According to the Centers for Disease Control and Prevention (CDC), opioid prescriptions have fallen 18 percent since their peak in 2010.
The US Department of Health and Human Services (HHS) has responded to America's prescription drug abuse crisis, outlining the federal government's efforts to combat the ongoing epidemic of opioids and prescription drugs.
Many opioid and prescription drug users have switched to more accessible street drugs such as heroin and fentanyl. You can't get heroin without a prescription, so many heroin users start abusing prescription opioids and then turn to illegal opioids.
Deaths from prescription drug and heroin overdoses continue to rise, rising 14% between 2013 and 2014 and being the leading cause of unintentional deaths among Americans, according to the US Centers for Disease Control and Prevention.
Recent research shows that the typical heroin addict now consumes 23%, is more likely to live in affluent suburbs, and is tempted into heroin by painkillers prescribed by his doctor, according to the National Institute on Drug Abuse (NIDA) and the Drug Enforcement Administration (DEA).
Fentanyl and fentanyl citrate are two of the most potent controlled substances in the world and a major source of heroin and fentanyl.
Bryce Pardo, a researcher at the Rand Corporation, said no one could say exactly how or why fentanyl, first synthesized as a powerful painkiller in 1959, entered the modern illicit drug market.
In 2013, people in New England and Ohio began overdosing on heroin with fentanyl, and in October 2015, San Francisco saw the first known fatality from fentanyl - heroin with fentanyl in the United States, he said.
The DEA estimates that 3.4 million Americans use fentanyl, compared with 475,000 heroin users, meaning the potentially exposed pool is ten times larger. That's a frightening development, according to the U.S. Centers for Disease Control and Prevention.
The trend in fatal overdoses suggests that growing access to prescription opioids has laid the groundwork for opioid addiction in the United States.
When doctors prescribe legal opioid painkillers and political efforts effectively restrict opioid access and prescription, the nation's opioid addiction becomes a crisis.
While opioid overdose deaths continued to rise to new record highs in 2017, growth rates, which are slowing to their lowest levels since 2013, suggest that the opioid epidemic may be waning.
As the access to prescriptions has declined, consumers have turned more to illegal opioids, leading to an acceleration in overdose deaths, according to the Centers for Disease Control and Prevention.
Redirected illegal opioids increase the risk of overdose because consumers can't so easily assess the effectiveness and quality of the drug on the black market, according to the Centers for Disease Control and Prevention.
Some suggest that the opioid overdose epidemic is due to a lack of access to prescription opioids, not a lack of them.
Advocates believe that restrictions will reduce the supply of prescriptions for opioids, thereby reducing overdose deaths. The number of deaths from prescription opioid overdoses is low in US states, but still higher than in other countries.
Since 2011, the death rate from opioid overdoses has risen rapidly despite reduced prescribing, according to the Centers for Disease Control and Prevention.
This shift coincides with efforts to reduce access to and abuse of prescription opioids, including the reformulation of OxyContin to make abuse more difficult.
Indeed, transnational criminal organizations have exploited unmet demand for opioids and flooded the black market.
As the supply of opioid prescriptions declined, dependence persisted, and consumers began to turn more to illegal opioids, according to the Centers for Disease Control and Prevention.
A National Security Council report released Tuesday concluded that Americans are now more likely to die of an opioid overdose than from eating food.
In 2014, misuse of the drug led to nearly 50,000 overdose deaths in the United States, according to the Centers for Disease Control and Prevention.
While the rate of prescription opioid overdose deaths has slowed, the rate of illicit opioid overdose deaths has accelerated in recent years, as they have soared.
Opioid overdoses account for more than a third of all deaths from prescription drugs.
In other countries, the use of opioid painkillers is closely linked to the availability of heroin, Hadland said. Heroin and fentanyl are now far more commonly involved in overdose deaths in the US than prescription opioids, he said.
In 2001, for example, misuse of illegally manufactured fentanyl in Estonia led to the deaths of more than 1,000 people, most of them children.
Similarly, heroin shortages have been linked to shortages in Finland, where addicts get the drugs from maintenance treatment programs.
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