Prescription Opioids and Heroin Research Report

Drug overdose deaths involving prescription opioid pain relievers have increased dramatically since 1999. Concerted federal and state efforts have been made to curb this epidemic. In 2011, the White House released an interagency strategy for Responding to America’s Prescription Drug Crisis. Enacting this strategy, federal agencies have worked with states to educate providers, pharmacists, patients, parents, and youth about the dangers of prescription drug abuse and the need for proper prescribing, dispensing, use, and disposal; to implement effective prescription drug monitoring programs; to facilitate proper medication disposal through prescription take-back initiatives; and to support aggressive enforcement to address doctor shopping and pill mills and support development of abuse-resistance formulations for opioid pain relievers. 

Improvements have been seen in some regions of the country in the form of decreasing availability of prescription opioid drugs and a decline in overdose deaths in states with the most aggressive policies.1 Drug overdose deaths involving heroin rose from 1,960 in 1999 to 15,482 in 2017 before trending down to 13,165 deaths in 2020 and 9,173 deaths in 2021.2

In an effort to combat the intertwined problems of prescription opioid misuse and heroin use, in March of 2015 the Secretary of Health and Human Services announced the Secretary’s Opioid Initiative, which aims to reduce addiction and mortality related to opioid drug abuse by:3

  • reforming opioid prescribing practices
  • expanding access to the overdose-reversal drug naloxone
  • expanding access to medication-assisted treatment for opioid use disorder

The relationship between prescription opioid abuse and increases in heroin use in the United States is under scrutiny. These substances are all part of the same opioid drug category and overlap in important ways. Currently available research demonstrates:


  1. Johnson H, Paulozzi L, Porucznik C, Mack K, Herter B. Decline in drug overdose deaths after state policy changes – Florida, 2010-2012. Morbidity and Mortality Weekly Report (MMWR). Atlanta, GA: Centers for Disease Control and Prevention; 2014.
  2. CDC WONDER. Multiple Cause of Death 1999-2021. Centers for Disease Control and Prevention, National Center on Health Statistics. Released January 2023. Accessed January 2023.
  3. HHS takes strong steps to address opioid-drug related overdose, death and dependence [news release]. Washington, DC: U.S. Dept. of Health and Human Services; March 26, 2015. Accessed October 8, 2015.