Hillbilly Heroin: OxyContin Vs. Heroin

Hillbilly heroin is a slang term for the prescription opioid oxycodone. The use of hillbilly heroin poses several health risks including physical dependency and overdose death.

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Dr. Langdon M.D.

Medically Reviewed By: Kimberly Langdon M.D.


The term hillbilly heroin refers to the prescription opioid painkiller oxycodone (OxyContin). Oxycodone is more potent than morphine and has similar effects to the illicit street drug heroin.

Hillbilly heroin is a drug used in midwestern and rural Appalachian regions of the United States. It’s highly addictive, cheaper, and more accessible than regular heroin.

Hillbilly heroin is prominent in the following states:

  • West Virginia
  • Ohio
  • New York
  • Kentucky
  • Maine

Over the past few years, oxycodone drug use has become a problem in these regions due to economic anxieties, unemployment, and other related issues.

The Difference Between Oxycodone And Heroin

While heroin and oxycodone are similar in chemical composition, there are also some notable differences in their physical characteristics and potency.


Oxycodone comes in pill form and can be snorted, smoked, or injected to achieve a powerful euphoric high. This drug is more potent than morphine but not as powerful as pure heroin.

When ingested, oxycodone produces intense feelings of well-being and painlessness and may be accompanied by dizziness, slowed breathing, and drowsiness.

The price of oxycodone may be anywhere between $1 and $6 per tablet when sold legally, depending on the dosage. On the black market, the street price of oxycodone is as high as $10 per pill.


Heroin can come in multiple forms including white or brown powder or a sticky tar-like substance called black tar heroin. This drug can be smoked, snorted, intravenously injected, or “plugged” (rectally inserted)

When a person takes heroin, they are instantly flushed with a warm, euphoric high. Their heart rate and breathing will slow, and they may drift in and out of consciousness for hours at a time.

Heroin is an illicit street drug. A baggie of heroin sells for $5, depending on location. Heroin is particularly hard to find and more costly in areas where oxycodone is readily available.

Learn more about different types of heroin.

How Hillbilly Heroin Is Abused

People who abuse hillbilly heroin typically do so through a process called “doctor shopping”, which is the process of seeing multiple healthcare providers to procure prescription painkillers such as oxycodone.

While there have been laws passed that are attempting to address the issue of doctor shopping and irresponsible opioid prescribing, there’s still a strong market for the drug in parts of the U.S.

Side Effects And Dangers Of Opioid Abuse

When oxycodone is abused over a long period of time, or mixed with other depressants such as Xanax, it can pose serious risks to a person’s health. These could include permanent brain damage or overdose death.

Evidence of an oxycodone overdose may include:

Life-threatening symptoms of opioid abuse include slowed heartbeat, respiratory depression, coma, and more.

In the event of an overdose, you can save a person’s life by administering the counteracting medication naloxone (Narcan).

Treatment Programs For Heroin And Opioid Abuse

If you or a loved one are addicted to hillbilly heroin or other opioid analgesics, help is available in the form of evidence-based treatment for substance abuse.

Treatment options for drug abuse include:

  • medication-assisted treatment (MAT) using buprenorphine or methadone
  • heroin detox
  • outpatient or residential care
  • dual diagnosis treatment for co-occurring disorders
  • support groups and 12-step programs
  • mental health services

It’s important to seek professional help when addicted to opioids and other substances before attempting to quit on your own to avoid severe withdrawal symptoms.

Find Addiction Treatment At Bedrock Recovery Center

Call our helpline at Bedrock Recovery Center for more information about treatment services for opioid misuse. Our inpatient treatment program can put you on the path to addiction recovery.

  1. National Institute on Drug Abuse (NIDA) — Opioids https://nida.nih.gov/drug-topics/opioids
  2. National Institute of Health (NIH) — Do painkillers serve as “hillbilly heroin” for rural adults with high levels of psychosocial stress? https://pubmed.ncbi.nlm.nih.gov/28678649/
  3. U.S. Department of the Interior (DOI) — In First Raid, New Opioid Task Force Seizes $2.5 Million worth of Meth and $22,000 in Marijuana, Heroin and Other Narcotics https://www.doi.gov/pressreleases/first-raid-new-opioid-task-force-seizes-25-million-worth-meth-and-22000-marijuana

Written by Bedrock Recovery Center Editorial Team

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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