In the past 50 years, Heroin has predominantly been g snorted, smoked, and injected, usually in that order. As use progresses as well as the need for more of the drug to stave off withdrawal increases, users used to progress from the less aggressive routes to the higher intensity routes of administration (snorting to IV injection). It was rare to see someone who either who moved from initial use of snorting to IV injections quickly and even more rare to see a patient that started using Heroin by injection. Today, due to the level of dependency on opioids caused by prescription drugs and the new social norms that are more accepting of injection use, it is not uncommon for users to mover directly from prescription opioid abuse and dependence, to injecting heroin.
Seventy-five percent of people addicted to heroin say they were introduced to opioids through prescription drugs, and 94% of people in treatment for opioid addiction say they turned to heroin because prescription drugs were more expensive. It’s currently estimated that 600 people in the US try heroin for the first time every day.