Heroin Use Increased in U.S. Five-Fold In Last Decade, Addiction Disorders Tripled
New findings published last week in the Journal of American Medical Association Psychiatry revealed that heroin use and disorders related to heroin increased significantly since 2001. Whites and under-educated low-income males are among the hardest hit.
Dr. Silvia Martins, lead author, Mailman School of Public Health at Columbia University:
“The most significant finding is the fact that heroin use increased in individuals of all race/ethnicities, all social class strata, and of all levels of education. Even though increases were larger among whites, males, less-educated, we shouldn’t dismiss the fact that it increased among all those 18 and older.”
The study, which was supported by the National Institute on Drug Abuse, found that heroin use in the U.S. increased five-fold over the last decade, and heroin addiction diagnoses rose three-fold.
Heroin use disorders climbed more among whites, aged 18-44 than among older and non-white adults. Also, from 2001-2002 to 2012-2013 use of heroin increased from .33% to 1.6%, and heroin-related disorders increased from .03% to .21%.
What Abut Women?
“We speculate that men may have been affected more than women by economic stressors and thus turned to heroin use (i.e. unemployed, loss of manual labor jobs — in which there are more men than women typically). However, it is important to point out that use also increased in women.”
Indeed, according to the American Society of Addiction Medicine, women are more likely to have chronic pain, be prescribed prescription painkillers, and be given higher dosages and for a longer duration than men.
These trends may also exacerbate the fact that women may be more vulnerable to painkiller dependency than men. Around 48,000 women died of overdoses related to prescription opioids between 1999-2010.
What Is This Happening?
Martins says that there a few identifiable factors that led to the findings. One, heroin use and related disorders have increased in response to the prescription opioid epidemic.
That is, people are misusing prescription drugs or becoming addicted, and turn to street drugs when they can no longer obtain their drug of choice, or it becomes too expensive.
Moreover, illicit heroin is cheaper than buying prescription drugs on the black market, and the price of heroin use per gram also decreased in the last few years. And finally, illicit heroin markets have expanded in the U.S., as drug cartels likely saw this coming as prescriptions for painkillers began to climb.
More than one-third of white heroin users used prescription opioids for non-medical purposes in 2001-2002. However, more recently over half of white heroin users reported misusing painkillers before initiating heroin use. In fact, according to the CDC’s most recent estimates, as many as 4 in 5 new heroin users of any race/class/age say they began their habit after first becoming addicted to prescription opioids.
Of note, heroin use and disorders related to heroin rose more between 2012-213 among single individuals than married adults and was also significantly higher for whites in the same period (1.9% versus 1.1% for non-white.)
“I hope families learn that it is important to overcome stigma, seek treatment for a family member that has a heroin use disorder, and that treatment and prevention strategies to prevent progression from use to addiction are available, she said. They need to know that they can seek medication–assisted treatment when a family member has a heroin addiction.”
Martins also stressed that family members should not give unused prescription opioids to other family members, because “…one of the most common forms of prescription opioid diversion and misuse happens when family members share their prescribed medication with others. They also should know there is a strong association between prescription opioid misuse and later heroin use.”
The Big Picture On the Opioid Epidemic
More than 33,000 individuals lost their lives in 2015 (the latest year available) due to a fatal overdose of illicit or legal prescription opiates or opioids.
These include street drugs such as heroin and fentanyl (nearly 13,000 overdose deaths) and prescription medication such as oxycodone (more than 20,100 overdose deaths.) Also, number are expected to rise in 2016.
While an estimated two million U.S. residents are currently addicted to prescription painkillers, the National Institute on Drug Abuse states than in 2012, 669,000 persons over age 12 used heroin in the past year. The overdose death rate from opioids in 2008 was nearly four times that of 1999.
Contributing to the deaths by heroin and prescription drugs is the continued presence of synthetic opioids such as fentanyl – a drug that is as much as 100 times the potency of morphine. Additionally, many deaths have been associated with other drug combinations that include opioids, such as those containing benzodiazepines, other central nervous system depressants, cocaine, and even methamphetamine.
~ G. Nathalee Serrels, M.A., Psychology