Title: Background information

Context:
Concurrent with the increase in prescription opioid use, the rate of heroin overdose deaths increased  nearly four-fold between 2000 and 2013. According to a survey of patients entering SUD treatment for  heroin use, the prescription opioid epidemic has resulted in a marked shift in how and which opioids are  abused. In the 1960s, 80% of people entering treatment for heroin use started using heroin as their first opioid, while in the 2000s, 75% of people entering treatment for heroin use started using prescription opioids as their first opioid. This increase in the use of opioids, as well as associated morbidity, mortality, and other adverse outcomes, has called attention to the need for a paradigm shift in pain and in the way it is treated. Consult the VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders (VA/DoD SUD CPG) for further information.

Question: What was the first opioid used by most of the people entering SUD treatment for heroin use in the 2000s?

Answer: prescription opioids