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What is Hillbilly Heroin?

Mary McMahon
Updated Mar 03, 2024
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Hillbilly heroin is a slang term used to refer to oxycodone, a synthetic opioid used as an analgesic. Oxycodone abuse began to be documented in rural regions of the United States in 1990s, explaining the origins of the slang term. A “hillbilly” is someone who lives in a rural area, and oxycodone is a narcotic that is chemically related to heroin.

People abuse oxycodone, often in the form of the time-release formulation OxyContin®, because it delivers a high similar to the one experienced on heroin. Since it is a legal drug, hillbilly heroin can be easier to obtain than heroin. Patients get the drug through doctor shopping, which means they go to multiple doctors seeking analgesic medications, as well as from dealers, who sometimes include unscrupulous doctors. Using prescription drugs can be safer than street drugs, such as heroin, as it is easier to tell when drugs are adulterated or counterfeited, allowing people to avoid drugs with unsafe additives.

The opioid characteristics are what makes oxycodone so effective for pain management; in fact, heroin itself was once used for analgesia in medical settings. Thus, pharmaceutical companies cannot change the formulation of the drug to reduce abuse. Cracking down on how the drug is dispensed can help address abuse, but it also makes it more difficult for patients who legitimately need the drug to obtain it. People such as cancer patients and individuals with chronic pain conditions can develop tolerances that require high levels of the drug, setting off alarms at pharmacies required to report high utilization of oxycodone and certain other drugs.

Although people refer to oxycodone addiction with terms like “hillbilly heroin,” addiction to this drug is a problem in urban areas as well. Some very high profile individuals, including celebrities, have found themselves in legal or medical trouble as a result of using hillbilly heroin. The problem with the drug is that as people take it, they build up a tolerance and thus require higher doses in order to obtain a high. Soon, people can skirt a dangerous line between finding a high and depressing their central nervous systems so much that they stop breathing.

Drug diversion, in which pharmaceuticals end up being used recreationally, is a serious problem in many nations. Government task forces have been formed to address issues such as abuse of hillbilly heroin and other prescription drugs. Narcotics, in particular, tend to be popular targets for drug abusers in addition to being an important treatment tool for patients. Programs aimed at identifying and stopping drug diversion must weigh the legitimate needs of patients against abusive use, and sometimes it is difficult to distinguish between the two.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments
By lapsed — On May 14, 2011

@softener - Methadone is used as a long-term treatment program for oxycodone addiction where the addict slowly take less and less methadone over time. However buprenorphine - commonly known as Suboxone - has been shown to work better for withdrawal and has a shorter detox time. My cousin was treated this way for heroin detox and he's been doing much better. It can also be used in the same long-term maintenance way as methadone.

This applies for all painkillers including pills like Percocet as they're all just different kinds of opiates.

By softener — On May 12, 2011

Is methadone ever prescribed to treat oxycodone withdrawal, or is it only for heroin withdrawal?

By rjh — On May 09, 2011

They have definitely cracked down on how oxycodone is dispensed where I live. After I got shoulder surgery they only gave me 20 Instant Release capsules for a week and then nothing.

I think I understand why this is necessary though, because I can see how people could develop an addiction to painkillers quite easily - they're definitely very sedating drugs - but they're also one of the most dangerous to abuse for a number of reasons. It's difficult to get repeat prescriptions unless you have cancer or chronic pain, which means you'd be regularly subjected to opiate withdrawal which is not a pleasant experience at all. Opiates cause physical dependence, so if you've been abusing it regularly and then all of a sudden you have to stop taking it, you're going to be subjected to severe anxiety, insomnia, even vomiting.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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