Hillbilly Heroin being filled inside of a needle

Past drug epidemics have typically been confined to specific regions of the country. For example, the Crack Epidemic was largely confined to urban cities. (1) The Opioid Epidemic, however, has managed to impact communities across the entire nation. Here we take a look at “hillbilly heroin”.

What is Hillbilly Heroin?

Heroin has historically largely been contained to urban cities, rather than rural areas of the country. The major catalyst for the Opioid Epidemic, however, was prescription painkillers- and not heroin. In many rural areas, such as West Virginia, prescription painkillers have devastated many communities crippled with addiction.

A group of people dance while listening to music

This has led to some prescription painkillers being given the slang “hillbilly heroin” due to their popularity in many rural areas around the Appalachian Mountains, according to the NIH. (2)

So what drugs were given the slang hillbilly heroin?

The slang hillbilly heroin has historically been used for the prescription painkiller OxyContin. In the early 2000s, communities in Kentucky and West Virginia began reporting the devastating effects OxyContin addiction was having on communities. Police chiefs noted major increases in petty theft, prescription fraud, shoplifting, and even drug store robberies. (3)

What is OxyContin?

OxyContin is a medication used for the treatment of moderate to severe chronic pain. OxyContin is an extended-release version of oxycodone, which it releases over the course of 10-12 hours. Oxycontin comes in a variety of doses, ranging from 10mg up to 80mg. (4)

OxyContin and the Opioid Epidemic

OxyContin has frequently been cited as a major contributing factor to the Opioid Epidemic that continues to plague the nation today. The manufacturer Purdue has been accused of significantly downplaying the risks of using the medication long-term. (5) Since 1999, over 200,000 Americans have died of drug overdoses related to prescription painkillers such as OxyContin.

It is estimated that four out of five people who try heroin originally started their addiction with prescription painkillers. (6)

OxyContin is responsible for bringing the Opioid Epidemic to many rural areas. The high rate of injuries and chronic pain amongst the logging and mining regions of the Appalachian

Mountains meant that the number of prescriptions of OxyContin was quite high. In turn, these medications were selling for up to a dollar a milligram on the street. This led to a recipe for disaster in these regions that were devastated by “hillbilly heroin”. (3) (7)

Final Note

This article is intended for those considering a new way of life, free of the pain of drug and alcohol addiction. For more information on recovery and anyone seeking help with addiction and substance abuse problems, please call True Recovery at (844) 744-8783 or visit us online.


  1. https://www.britannica.com/topic/crack-epidemic#ref334574
  2. https://www.ncbi.nlm.nih.gov/pubmed/28678649
  3. https://www.theguardian.com/world/2001/jun/25/usa.julianborger
  4. https://www.rxlist.com/oxycontin-drug.htm#description
  5. https://www.independent.co.uk/news/world/americas/drugs-opioid-oxycontin-drug-addiction-patent-new-drug-richard-sackler-a8529711.html
  6. https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
  7. https://www.latimes.com/archives/la-xpm-2001-jun-17-mn-11349-story.html