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Aren’t Prescription Drugs “Safer” Than Street Drugs?

I’ve spent lots of time answering questions on drug-detox forums, and many people have asked this question. Let’s break it down into two underlying questions:

1. But the stuff I’m using is legal—so can I “really” be an addict?

A person can be just as much addicted to prescription drugs as they can to street drugs. For example, the drug that makes up heroin (diacetylmorphine) acts on the body in exactly the same ways as opioid painkillers do—including morphine. Heroin is in fact just a refined form of morphine—they act on the body’s opiate receptors in identical ways.

In terms of addiction, the only important difference between heroin bought on the street and morphine bought at the pharmacy is the likelihood of street-heroin to be diluted (or “cut”) with impure substances—and when you buy a bag, you never know what it’s cut with, or how much it’s been cut. When you buy morphine—or Oxycontin, or Vicodin, or any other opioid painkiller—its purity and strength are guaranteed by the manufacturer. From this perspective, pharmaceutical opioids could be considered more addictive than street heroin, whose purity can sometimes be quite low.

Long-acting prescription painkillers, such as methadone, can be beastly to detox from—unlike heroin, whose immediate withdrawal (I’ve been told by many heroin users) usually takes only about 10 days to pass.

2. Aren’t street-drug addicts “worse” than prescription-drug addicts?

When I think of a street-drug addict, I think of my cousin Danny, who died of a massive heart infection after years of shooting heroin and speed. When I think of a prescription-drug addict, I think of myself.

Was Danny any worse of a person than I was?—can you really compare people like this? I think Danny’s illness was plain for the entire family to see, whereas I managed to hide mine, making me secretive and deceptive even to my closest family until it became impossible to hide anymore. Danny and I were similar in that we used drugs that were kissing cousins in pharmacological action, and they took tolls on our physical and mental health—but Danny died because of the impurities of his drugs and methods of use.

Many people using prescription drugs inject or snort them, or buy them on the black market—just like those who use street-drugs. Shooting, snorting, or chewing prescription drugs all qualify as “drug abuse” because they’re taking a prescription drug “not as prescribed.” They’re unsafe and harmful. And prescription-drug and street-drug addicts share other commonalities: the secrecy and isolation of the life of a drug-user; and the resulting desperation and risk of serious harm.


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is the pseudonym of a 46-year-old woman who detoxed from a high level of prescription painkillers in November 2008. A professional writer, she has published two books of nonfiction, as well as essays and journalism, and she has written about health issues for 15 years. She covers news, reviews, and stories about addiction and recovery at her top-rated addiction blog, Guinevere Gets Sober.