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Substance Showdown: Heroin v. Prescription Painkillers

Today it is going to be a showdown between two infamous substances: heroin and prescription painkillers. Just like our previous substance showdowns, heroin and prescription painkillers will go head to head for three rounds based on: health effects, insidiousness and legality and withdrawal. The WORST of each round will be the winner.

This substance showdown should get interesting because heroin and prescription painkillers happen to be relatives; pretty close relatives separated at birth.

Let’s introduce the contenders!! Heroin!! Heroin started off with a nice enough life and ended up on the streets and has fought its way up to being a worthy and dangerous substance. And prescription painkillers; prescription painkillers were raised in a nice middle class family, doctors as parents, with all the money it needed to achieve their status as worthy prescription narcotics.

Who will come out on top of this substance showdown?!?



Heroin: The health effects of heroin can vary depend on the route that is taken to ingest it. Heroin can be snorted in powder form, smoked in tar form, and injected or “shot up” in either form

Brain: The negative effects on brain functioning may include a decrease in working memory, episodic memory, and decision making.  Active heroin addicts may exhibit poor impulse control, planning, decision making, verbal functioning, and visual-spatial analysis.

Health effects of injecting heroin: Injecting is a particularly common route of administration among heroin users.  This is a concern because additives in street heroin may not dissolve readily.  As a result, injecting heroin can contribute to the clogging of the blood vessels that lead to the lungs, liver, kidneys, and brain. Collapsed veins, cellulitis (inflammation under the skin), and abscesses are common problems among chronic injection heroin users.

Health effects of smoking heroin: Some short term effects associated with heroin smoking may include fatal viral diseases that affect the white matter of the brain (leukoencephalopathy), reduced lung function, shortness of breath, and asthma.

Lungs: The poor health of heroin users and the depressing effects heroin causes on respiration are contributing factors to pulmonary (lung) complications including various types of pneumonia.

Immune System: Heroin depresses the immune system and mixed with unhealthy eating and using other drugs can lead to many infections and sicknesses.

Infections: Along with abscesses and cellulitis (inflammation under the skin), endocarditis (inflammation or infection within the lining of heart chambers and valves) is also reported in injection drug users.

Blood borne viruses and infections in the liver: The risks for acquiring hepatitis B, C, and A are increased in heroin users who administer the drug intravenously.  In general, hepatitis B and C may occur due to sharing of contaminated drug injecting equipment.  Hepatitis A, which is typically transmitted in the general population by the normal fecal-oral route, may be transmitted among heroin users due to poor hygiene in the preparation of the drug. HIV is also a serious concern, particularly among injection drug users.

Overdose due to death.

Prescription painkillers: Prescription painkillers have many of the same adverse health effects of heroin (see above) because regardless of the fact that they are medications they can still be smoked, snorted or “shot up” (injected) (see above injecting heroin).

Common health effects of the abuse of prescription painkillers may include:

  • Depression
  • Rapid decrease in blood pressure not explained by other medical conditions
  • Disorientation or confusion in familiar surroundings
  • Constipation or other digestive irregularities
  • Shortness of breath

THE WINNER OF THIS ROUND IS: HEROIN: Heroin gets the win on the health effects round because of its potential to be laced with other substances aka being an illicit street drug. Prescription painkillers can have all the same health effects as heroin depending on which route of administration is used but there is no chance it is going to be laced with something because you get prescription painkillers from a pharmacy.


Heroin: Heroin is not legal in any sense of the word. Heroin is schedule 1 substance under the DEA drug scheduling so its insidiousness is not based on legality what so ever. In fact heroin has a bad rap all together. Heroin is portrayed on T.V., in films, by D.A.R.E. programs and by families as being exactly what it is and that is a dangerous and highly addictive substance. Really, I cannot think of way that heroin is insidious in the least. Its dangers are well known and well documented. There is nothing sneaky about it.

Prescription Painkillers: Prescription painkillers are insidious; very insidious. They are not entirely illegal. They are only illegal if you take them not as prescribed, sell them to someone who doesn’t have a prescription, or take them without a prescription. Prescription painkillers are so insidious because a doctor/medical professional prescribes them to you. You would never think that a doctor would give you something that is not safe. The truth is prescription painkillers when abuses are highly dangerous. This makes prescription painkillers one of the most insidious drugs out there. People begin taking prescription painkillers innocently and then shortly find themselves addicted to the substance.

ROUND 2 WINNER IS: PRESCRIPTION PAINKILLERS Because they are prescribed most people dub them as safe; when really they are some of the most dangerous drugs out there.


Heroin: Heroin is highly addictive and has a rough withdrawal.  Common heroin withdrawal symptoms include: nausea, vomiting, diarrhea, chills, a runny nose, goosebumps, sweating, tears, insomnia, aches and pains in the muscles and joints, extreme restlessness, yawning, abdominal cramps, and dilated pupils. Many patients also experience psychological symptoms including anxiety and depression, with severe cravings for the drug. They can also develop muscle spasms in the legs which cause them to kick.

Prescription Painkillers: Prescription painkillers are also highly addictive. Depending on which prescription painkiller exactly that a person has been taking depends on what kind of withdrawal they will experience. For instance, Suboxone and methadone are touted to be the worst prescription painkiller withdrawal. Methadone withdrawal in fact can kill you. Here are some prescription painkiller withdrawal symptoms which are very similar to heroin withdrawal symptoms (they can vary based on what kind of prescription painkiller you are taking)


•Lack of energy



•Pain (Muscle aches and pains)

•Flu-like symptoms

•Gastrointestinal issues such as nausea and diarrhea

•Loss of appetite







•Extreme Irritability

•Restless leg syndrome

•Gastrointestinal issues


Certain prescription painkiller withdrawals can last for week’s even months whereas heroin withdrawal usually only lasts a few days up to a couple weeks and is not fatal. Certain prescription painkiller withdrawals are especially horrendous and methadone withdrawal can possibly in rare events be fatal.


Prescription painkillers beat out heroin in insidiousness for sure and in the withdrawal due to its encompassing the narcotic opioid methadone. IF you are going to get in the ring with a drug it really should be neither prescription painkillers nor heroin but if you had to choose believe it or not it would be heroin that gave you a better shot at coming out on top!

If your loved one is in need of treatment for heroin or prescription painkiller addiction, please give us a call at 800-951-6135

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