Current Impact

Opiods today are severely regulated in the United States. However, street demand continues to support a black market characterized by crime and poverty.

Overall, there are three groups of opiod users in the U.S.:

1. street abuser. The average street abuser tends to be a young male, black or Latino with a history of antisocial problems. Typically, he was introduced to heroin by another heroin user and he in turn introduces it to others. Drug abuse usually starts in mid-teens, first with marijuana, then harder drugs, like heroin by age 18. By age 20, the heroin addict is usually arrested for the first time.
2. medical abuser. The "medical" abusers of prescription opiods are predominantly middle-class individuals, women, the elderly, health-care professionals, and people with pain syndrome. The histories of these individuals may be more similar to that of alcoholics than to street abusers, although street opiod abusers also tend to rely on legal prescriptions from physicians as they get older.

   In the 1960's and 1970's propoxyphene HCL (Darvon) was the most abused prescribed opiod in the U.S. with 500 deaths reported in 1979. Many propoxyphene HCL dependents abused prescriptions given them by physicians for pain relief, taking the drug indiscriminately. Commonly abused opiods include such drugs as meperidine (Demerol), morphine, and pentazocine HCL (Talwin). Healthcare professionals are especially at risk to abuse opiods because of their accessibility.

3. methadone abuser. The methadone abuser, while being administered methadone at a clinic, may supplement his maintenance dose with black market methadone, alcohol, or other drugs. Or he may ask to go on methadone maintenance only because he is temporarily unable to obtain opiods, or because he wants to decrease his tolerance to an amount he can afford.

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