The epidemic of prescription opioid abuse, the subsequent rising prevalence of heroin use, and the federal response

J Pain Palliat Care Pharmacother. 2015 Jun;29(2):102-14. doi: 10.3109/15360288.2015.1037521.


Opioids are a mainstay in the treatment of pain both chronically and acutely. In the past 20 years, the prescribing of opioids has increased exponentially. As the population for whom opioids are indicated has grown, with the number of opioid prescriptions written increased, so have indicators of opioid misuse, abuse, morbidity, and mortality. The purpose of this article is to review and explore the combination of factors of events that led to the current "epidemic" of prescription opioid abuse and overdose deaths, as well as the subsequent resurgence of heroin use among opioid addicts. Federal initiatives to mount war on prescription opioid abuse are reviewed, including responses from the White House, Drug Enforcement Agency (DEA), Food and Drug Administration (FDA), and interagency initiatives. Many initiatives are currently in place to combat the rising rates of morbidity and mortality associated with opioids, and those involved are hopeful in their efforts to curb the epidemic of this deadly phenomenon.

Keywords: federal agencies; heroin; opioid abuse; pain; prescription opioids.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Chronic Pain / drug therapy
  • Epidemics / prevention & control
  • Epidemics / statistics & numerical data*
  • Health Policy
  • Heroin Dependence / epidemiology*
  • Heroin Dependence / etiology
  • Heroin Dependence / prevention & control
  • Humans
  • Legislation, Drug
  • Pain Management / adverse effects
  • Pain Management / methods
  • Prescription Drug Misuse / mortality
  • Prescription Drug Misuse / prevention & control
  • Prescription Drug Misuse / statistics & numerical data*
  • Prevalence
  • United States / epidemiology
  • United States Food and Drug Administration
  • United States Government Agencies


  • Analgesics, Opioid