Dear Reader,
We've
all heard it, that the majority of street drug users started with a
prescription from their doctor. Although I believe that people turned
to the street when their prescriptions were cut off, I don't believe
the stats itself is true. It's something the media has been telling
us for years.
In
the Debunking lies section from thedoctorpatienforum.com it states:
FACT:
That statistic is false and it’s done enormous harm.
The “80%” claim came from a 2013 SAMHSA report, which said that 80% of recent heroin users had previously used prescription opioids nonmedically. That means they got pills illegally or from friends, not through legitimate medical care. It never said 80% were prescribed opioids by a doctor.
Despite this, media outlets, policymakers, and advocacy groups twisted the number to suggest doctors caused the heroin crisis. This distortion became a cornerstone of the opioid elimination narrative, used to justify restrictive guidelines, forced tapers, and lawsuits, while stigmatizing millions of pain patients.
Here’s what the real data show:
“Nonmedical use” ≠ medical prescribing. It means using pills without a prescription or for the feeling they cause.
Most misuse didn’t come from doctors. A 2016 SAMHSA report found 53.7% of misused pills came from friends or family, not healthcare providers.
Heroin initiation patterns have shifted. By 2015, 32% of people with OUD began with heroin, not prescription pills (Cicero et al., 2019).
Taking opioids as prescribed rarely leads to heroin use. NIDA confirms that heroin use is rare among people who take prescription opioids as directed.
Even Nora Volkow and Tom McLellan reported in the New England Journal of Medicine that the risk of true iatrogenic addiction, addiction caused by medical treatment, is generally below 8%, and often much lower.
Yet this myth fueled a decade of harm:
Doctors were punished and surveilled
Patients forcibly tapered or cut off
People mislabeled with “opioid use disorder”
Abatement funds and lawsuits built on inflated stats
The truth: The “80%” stat was never about doctors or legitimate pain care. It was a misused soundbite that blurred the line between medical use and misuse, and justified policies that punished patients to push the litigation narrative and expand addiction medicine.
Read the full breakdown, data tables, and printable resources on our Patreon page
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