Prescription drug abuse and the heroin epidemic are not separate crises for the American people.

A new study shows that heroin users are often boosting a prescription drug habit.

Senior investigator Theodore J. Cicero wrote to The New England Journal of Medicine about the study’s findings:

“On the East and West coasts, combined heroin and prescription drug use has surpassed the exclusive use of prescription opioids. This trend is less apparent in the Midwest, and in the Deep South, we saw a persistent use of prescription drugs, but not much heroin.”

Cicero worked with researchers at the Washington University School of Medicine to anonymously survey more than 15,000 patients in 49 states from January 2008 to September 2014.

The study showed the rate of people abusing prescription opioids from 2008 to 2010 was stable at 70 percent, but dropped to 50 percent by 2014. Meanwhile, reported heroin use nearly doubled from 23.6 percent in 2008 to 41.8 percent in 2014.

Cicero said the study found heroin addicts to typically be white, middle-class citizens. They’re often young and well educated.

“It’s not who you would picture a heroin addict to be,” he told the medical journal JAMA Psychiatry.

One of the reasons for this trend, Cicero said, is that heroin is easier to get a hold of than prescription drugs.

A recent PublicSource post said heroin costs about $8, which is slightly more than a pack of cigarettes.

“Pill mills,” offices and some fly-by-night shops where doctors freely prescribe drugs, have made it easier for addicts to obtain prescription opioids. But if users become addicted to the painkillers and suddenly can’t get them, they’re likely to supplement their addiction with heroin.

Pennsylvania is working to address the heroin epidemic. Gov. Tom Wolf issued a standing order Wednesday to make the heroin antidote naloxone readily available across the state.

“We must do all that we can to support those Pennsylvania families suffering from the effects of addiction,” Gov. Wolf told Essential Pittsburgh. “We do have this heroin problem, and we’ve got to address it.”

PublicSource has published several stories about the heroin crisis in the project Heroin: Riding the Rush.

Reach PublicSource intern Elaina Zachos at

This fact-based local reporting drives impact and creates change. Help power that impact.

James Baldwin wrote, “Not everything that is faced can be changed, but nothing can be changed until it is faced.” PublicSource exists to help the Pittsburgh region face its realities and create opportunities for change. When we shine a light on inequity in our region, like the “completely unacceptable” conditions in low-income housing in McKeesport, things change. When we ask questions about policymakers’ decisions, like how Allegheny County is handling COVID-19 safety for its employees, things change. When we push for transparency on issues that affect the public, like in the use of facial recognition software by Pittsburgh police, things change.

It takes a lot of time, skill and resources to produce journalism like this. Our stories are always made available for free so that they can benefit the most people, regardless of ability to pay. But as an independent, nonprofit newsroom, we count on donations from our readers to support this crucial work. Can you make a contribution of any amount (or better yet, set up a recurring monthly gift) to help ensure we can continue to report on what matters and tell stories for a better Pittsburgh?