The Changing Face of Heroin Use in the United States

May 29, 2014

A new study published in JAMA Psychiatry highlights a dramatic shift in heroin use over the few past decades. The study found that over the past several years there has been a shift in heroin abuse from low-income urban areas with large minority populations to more affluent suburban and rural areas with primarily white populations. Also of note are the shifts in gender and average age of heroin users, with a larger percentage of female users and a higher average age among all users in the 2000s compared to the 1960s. Below you can read a Washington Post article summarizing the study and the full study can be accessed in full on the JAMA Psychiatry website.

The dramatic shift in heroin use in the past 50 years: Whiter, more suburban
The Washington Post - May 28, 2014

There are plenty of recent signs of heroin's move away from cities into the suburbs and rural areas. Vermont Gov. Peter Shumlin (D) even devoted his entire 2014 state of the state address to what he labeled a "full-blown heroin crisis" after the state saw treatment for the drug increase by 250 percent since 2000.

Now a new study in JAMA Psychiatry underscores just how dramatically heroin abuse has shifted away from predominately minority men living in cities. Compared to 50 years ago, heroin users today are older, live in nonurban areas, and are almost evenly male and female. Perhaps most strikingly, these users probably came to heroin after taking a prescription opioid, the study shows.

Theodore Cicero, vice chairman of research at the Washington University School of Medicine, analyzed survey responses of patients in a treatment program spanning 150 publicly and privately funded centers across the country. Some participated in further interviews for the study.

The shifting demographics are quite dramatic, according to Cicero's research:

  • While 82.8 percent of heroin users in the 1960s were men, about an equal rate of men and women are now seeking treatment.
  • The rate of heroin users seeking treatment who are white increased from just above 40 percent in the 1960s to 90.3 percent by 2010.
  • And the mean age of those seeking treatment increased from 16.5 years old in the 1960s to 22.9 years old in 2010.

How people come to use heroin has also greatly changed. In the 1960s, more than 80 percent said heroin was the start of their opioid use. In the 2000s, though, that had reversed dramatically, with 75 percent reporting they used a prescription opioid before turning to heroin.

Early data from the current decade shows that trend is starting to reverse, with heroin becoming more and more the first opioid of abuse. People who had past or current opioid use but indicated heroin was their primary drug overwhelming said they preferred the high heroin gave them (98.1 percent), and that the drug was cheaper and easier to obtain (94 percent) than prescription opioids.

Continue reading at The Washington Post...

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