Hillbilly Heroin: What Is It And Is It An Epidemic?

“Hillbilly heroin” is a street name for oxycodone, a powerful semisynthetic opioid painkiller sold under brand names like OxyContin and Percocet. The nickname emerged in the late 1990s and early 2000s as OxyContin misuse spread rapidly through rural America, particularly in Appalachian states like West Virginia, Kentucky, and Ohio, where the drug became cheaper and more accessible than heroin in many communities.

Purdue Pharma’s aggressively marketed OxyContin drugs as a less addictive alternative to other opioids. This claim was later proven false and resulted in billions of dollars in legal settlements, and fueled a prescription drug epidemic that devastated rural communities. As crackdowns on pill mills and doctor shopping made OxyContin harder to obtain, many people who had developed dependencies on oxycodone transitioned to heroin or illicit fentanyl, which were cheaper and easier to access.

How Does OxyContin Compare To Heroin?

OxyContin can be obtained illegally or by prescription. The practice of doctor shopping or using “pill mill” facilities are both ways of getting the drug that authorities are cracking down on.

OxyContin Potency

In terms of strength, higher doses of OxyContin are needed to achieve the same high available from heroin. Oxycodone is about 1.5 times as potent as morphine. Heroin is between 2 to 5 times more potent than morphine.

How Is OxyContin (Hillbilly Heroin) Used?

As with other opioids, people that snort, smoke, or inject drugs achieve a short, but very strong high compared to taking pills orally.

People that use OxyContin may:

• take the drug in pill form orally
• crush and snort it
• plug a solution rectally
• dilute and inject it
• (very rarely) smoke it

Any method of OxyContin use may result in additional short- and long-term effects beyond euphoria, sedation, and numbness that is expected.

Short-Term Side Effects Of Oxycodone

A person that regularly takes prescription opioids like oxycodone can expect short-term side effects that slow down major system functions due to the depressing impact that OxyContin has on the central nervous system.

A person that takes oxycodone may experience side effects like:

• slowed heart rate and low blood pressure
• dizziness
• drowsiness
• slowed breathing
• constipation
• nausea and vomiting

Long-Term Effects Of Hillbilly Heroin

Chronic or intense periods of oxycodone abuse increases the risk of irreversible mental and physical effects. Extended use also creates tolerance, addiction, and dependency.

A person that takes oxycodone may also take other drugs like other opioids, benzodiazepines, or alcohol — all of which can contribute to long-term health problems and accidental deadly overdoses.

Risk Of OxyContin Overdose

When too much oxycodone is ingested or is taken with a benzo like Xanax, the body may become overwhelmed and respond strongly. Life-threatening symptoms of an opioid overdose include respiratory depression and a slowed heartbeat.

Some signs of a potentially fatal oxycodone overdose include:

• weak pulse and heartbeat
• irregular or weak breathing
• gurgling or choking noises
• lost consciousness
• seizure / shakiness
• pinpoint pupils

If treated quickly at an emergency department, a person undergoing overdose may be saved with naloxone (Narcan).

Can Hillbilly Heroin Drug Use Lead To Withdrawal Symptoms?

OxyContin has a high potential for abuse and physical dependency. When a person that has taken OxyContin regularly suddenly stops, their body will respond strongly to the drug’s absence. Some medical therapeutics like supervised methadone tapers and buprenorphine administration can help people manage physical withdrawal symptoms.

OxyContin withdrawal symptoms include:

• fever
• seizures
• panic attacks
• nausea/vomiting
• shakiness
• trouble sleeping
• muscle aches
• high blood pressure
• elevated heart rate
• hallucinations
• mood swings
• irritability, depression, anxiety

OxyContin withdrawals can be uncomfortable, mentally taxing, and potentially dangerous.

Getting Help For Opioid Drug Use

Substance abuse involving illicit drugs in any form can be detrimental to anybody’s pursuit of a healthy life. If you or a loved one has been misusing prescription drugs like OxyContin, help is available.

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.