What You Need to Know About Heroin, Illegal Opioids, and Non-Medical Use of Prescription Opioids


Opioids include medications prescribed for pain relief and illegal drugs like heroin. Non-medical use, also known as misuse, of opioid drugs, no matter how they are produced, can lead to addiction and dependence, arrest and incarceration, and fatal or non-fatal overdose.

Most people addicted to opioids began taking prescription opioids, usually prescribed after an injury. They often progress to misuse of pain medications (such as taking a higher dose than prescribed or taking them more frequently than directed), getting them from multiple prescribers and friends, or buying them from others. When people become addicted and can no longer obtain prescriptions or afford to buy pills on the street, they may turn to heroin and other illegal opioids.

Opioid addiction can happen to anyone. But increasing your knowledge about the risks of opioid misuse can help you better understand addiction and find help for yourself or someone you care about before things get worse.

Before you take an opioid, know the facts!

Non-Medical Use of Prescription Opioids

  • Most people who misuse prescription opioids get them from friends or relatives.
  • People also obtain multiple prescriptions through “doctor shopping” or other deceptive means.
  • Prescription opioids may be diverted in large quantities and sold to users who take them for non-medical reasons.
  • Clinics known as “pill mills” and unethical prescribers profit by intentionally overprescribing and distributing opioids.
Examples of Opioids Examples of opioids commonly prescribed to relieve pain include hydrocodone (Vicodin®), oxycodone (OxyContin®), oxymorphone (Opana®), morphine, and codeine. Two long-acting opioid medications, buprenorphine and methadone, are widely used by physicians and opioid treatment programs to help people recover from opioid addiction.

Use of Illegal Opioid Drugs

  • Heroin, non-pharmaceutical fentanyl compounds, and opium are the most common illegal opioids in the United States.
  • Heroin purity has increased dramatically over the years from about 10% to more than 30% pure.
  • People who use heroin no longer have to inject it to get the effect or to overdose. It can be sniffed, snorted, or smoked.
  • Illegal fentanyl and analogues (drugs with similar chemical formulas) are mostly produced in China and smuggled in to the United States.
  • These drugs may be blended into heroin and cocaine (powder and crack cocaine) or stamped into counterfeit pills sold as “prescription” opioids or counterfeit sedatives.
  • Current conditions have made use of street drugs more dangerous than ever before.
  • People can die from an opioid overdose of pharmaceutically produced opioids, heroin, illegal opioids, or a combination.

An opioid overdose can be reversed if the antidote, naloxone (NARCAN®), is administered in time. This medication works for an overdose involving any opioid, including prescription drugs and heroin. Injected naloxone, or the intranasal form, NARCAN®, is widely available in most states. In the case of an overdose, Call 911!

Illicit, Illegal, Non-Medical: Important Terms to Know Illicit opioid use refers to both non-medical use of legally manufactured drugs and use of heroin or other illegal opioids. This includes abuse of prescription painkillers such as oxycodone (OxyContin®) or hydrocodone (Vicodin®). Illegally produced counterfeit versions of prescription medications are sometimes sold on the street. These are exceptionally dangerous, as they are often more powerful and contain a mix of other drugs.Illegal opioid drugs have no legitimate medical use and are produced and imported by criminal means. They are sold “on the street.” The most common are heroin and non-pharmaceutical fentanyl.Non-medical use of prescription opioids means taking them other than as prescribed. (For example, taking prescribed painkillers when you are not in pain or taking someone else’s medications.)

Treatment for Opioid Addiction

There are effective treatments for opioid addiction. People are more successful when FDA-approved medications are used in combination with counseling and behavioral therapies. This is known as medication-assisted treatment (MAT). People have a choice of three approved medications—methadone, buprenorphine, and naltrexone—to support their recovery from opioid addiction. Misconceptions about MAT, such as “it substitutes one addiction for another,” are not correct. MAT helps people get back to their lives by decreasing withdrawal symptoms, cravings, relapses, and overdose, giving them a chance to recover. People undergoing MAT can drive, work, think, and function normally. MAT is provided in inpatient settings and at specially licensed outpatient clinics. It also can be prescribed by qualified physicians to take at home for up to 30 days at a time or even taken as a monthly injection.

Problem opioid use can be treated. The sooner people ask for help, the better. To locate help in your community for yourself, a co-worker, or a loved one, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website at www.samhsa.gov or call SAMHSA's free, confidential, 24/7 National Helpline at 1-800-662-HELP (4357).

This program was developed in conjunction with the Job-Site Safety Institute and Advocates for Human Potential.

Facts About Fentanyl Fentanyl is a potent, fast-acting synthetic opioid developed as ananesthetic for use during surgery. It is sometimes used to manage severe acute pain and prescribed to cancer patients for breakthrough pain. Although fentanyl is much more potent than morphine and small amounts can quickly cause death, pharmaceutical fentanyl is NOT the cause of the many recent fatal and non-fatal overdoses. Around 2007, illegally produced fentanyl compounds began appearing in the United States. These “street drugs” are smuggled into the country by international criminal groups. They are unpredictably dangerous and often mixed with heroin and cocaine or used to make counterfeit pills. In 2017, fentanyl was involved in more than half of overdose deaths.
Non-Medical Opioid Fact Sheet Download a PDF version of this page