It’s the Same, Only It’s Not: Perceptions of the Prescription Drug Market in Comparison With Other Illicit Drug Markets

Given the rapid rise of prescription (Rx) opioid overdoses in the United States, it is crucial to understand how people acquire Rx drugs. Prior research suggests individuals obtain Rx drugs through both legal and illegal channels, but there has been limited qualitative research focused upon the intersections between Rx drug markets and other drug markets. To understand the similarities and differences, we interviewed 40 incarcerated women about their experiences with both markets. Based upon these conversations, we find that few women received pills exclusively through doctors and 90% of them had used illicit markets or informal social networks to acquire Rx drugs. Although there is extensive overlap between the users, dealers, and operations between Rx and illicit drug markets, these women draw attention to how certain agents, processes, and social reactions differ in meaningful ways that are crucial to an effective public health response.