Prescription Pills and Street Drugs
Prescription opioids such as hydromorphone, oxycodone, fentanyl, and morphine are Schedule II drugs, because of their “high potential for abuse” that may lead to “severe psychological or physical dependence”. Methamphetamine and cocaine are also Schedule II drugs. Heroin, LSD, and ecstasy are Schedule I drugs because of their “high potential for abuse” and “lack of accepted safety for use of the drug under medical supervision”. Read the Minnesota Statute 152.02 for more information on schedule II-V controlled substances.
The National Institute of Drug Abuse (NIDA) reports that 80% of heroin users first used, and then misused, prescription opioids. The reverse is not true; not all people who use prescription opioids move to heroin. According to the National Survey of Drug Use and Health, less than 4% of people who had misused prescription pain medicines started using heroin.
For acute pain, 90% of patients don’t use the entire first prescription. This indicates that current prescriptions are written for too long, and that the majority of people’s pain is managed in fewer days. Those who need a refill during a post-acute period are more likely to develop opioid dependence and/or addiction. In a 2012 cohort study published in JAMA, patients receiving an opioid prescription within seven days of surgery were 44% more likely to become long-term opioids users within 1 year compared with those who received no such prescription.
With the increased awareness around opioid use disorder and opioids overdose deaths, many prescribers have worked to reduce the duration (number of days a prescription is written for) and dose (the strength or potency of a drug) of prescribed opioids. Patients who are already dependent and/or addicted to opioids require chemical and/or behavioral health treatment, including medication assisted treatment (MAT), to address the underlying cause of their opioid use. Eliminating opioids does not eliminate addiction.
Approximately 30% of patients are misusing opioids (taking more than directed, taking medications not prescribed to themselves), and 10% of patients are addicted. For patients who are prescribed opioids for more than 45 days, one in ten develop a substance use disorder from prescription use.
Please visit the Opioid Dashboard for more information on opioid overdose death, nonfatal overdose, use, misuse, substance use disorder, prescribing practices, supply, diversion, harm reduction, co-occurring conditions, and social determinants of health.