Heroin is illegal in America, while methadone and opiates such as oxycodone and hydrocone along with pharmaceutical names as in codeine or oxycontin, are opiates that are legal in America, if prescribed by an attending physician. It is important to realize, that despite heroin being typically vilified as a dangerous street drug, that substitutes to heroin as in methadone and oxycontin all have as their primary basis the opium poppy, and while it is true that heroin as a street drug is almost never pure, as it is often cut with other substances, along with the fact that the purity of heroin or the quality of the heroin dosage, will vary considerably because it is not manufactured inside pharmaceutical labs with stringent quality control, that heroin is, in essence, basically the same in its effect as the other legally prescribed opiates.
While, government officials are quick to point out that methadone and other opiates that are legal do not provide the intense euphoric rush of a typical heroin dosage, the overall effect of legal opiates in their acting upon the receptors of the subject's brain are quite similar. Additionally, all opiates prescribed or not, are quite addictive, so essentially, the demonization of heroin as contrasted to other legal prescribed opiates is that the later are regulated by government bureaucrats whereas the former are not. This, then leads to the somewhat cynical conclusion that in America, it's OK to be addicted to opiates for pain management or whatever, as long as your addiction is sanctioned by medical authorities in conjunction with governmental oversight.
As might be expected, because heroin is illegal, there are penalties for both possession of heroin, for the usage of heroin, and significant penalties for the selling of heroin, whereas for those that have an authorized prescription, they are permitted legally to use their opiods as long as they have a valid prescription. While, no doubt, there are times when opiod usage is a prudent medical decision to make on behalf of a patient suffering pain, the thing about pain is that it is very difficult for a doctor to know for an absolute certainty in many cases as to whether a given patient is really suffering from debilitating pain or instead craves opiate use because they simply like the feeling.
To put things in proper perspective, as reported by allgov.com: "Studies have shown that the United States, with less than 5% of the world’s population, uses 80% of the global supply of opioid drugs." This statistic, clearly and unequivocally points to the fact, that in America it's just fine to be addicted to opiates, just as long as you play the game by the rules, which means, that you as a patient, must convince the prescribing physician that you are suffering pain perhaps from a car collision, or a fall, or whatever, and by answering the pertinent questions correctly you will be rewarded with your well deserved prescription; whereas for those that want to feel more warmth, peace, and feelings of blissfulness, overcoming whatever chaos is going around them or in their life, via a street drug such as heroin, or illegally taking a prescription drug which is not prescribed for them, this is highly illegal, and is punishable by jail time and fines.
In America, it is simple, opiate usage is just fine, as long as the governmental authorities, doctors, and pharmaceutical companies are paid proper homage to and most importantly are able to make easy money from servicing a steady clientele, but opiate usage is not OK, when you try to subvert these entities and bypass their rules and regulations, in those cases, you are a criminal.