Heroin use, addiction up sharply among US whites

While the latest research does not unpick the cause of the rise in heroin use, the authors point to multiple factors, including recent policies created to crack down on overprescription of opioids and their misuse. Past-year prevalence of heroin use increased between 2001-2002 (0.03 percent) and 2012-2013 (0.21 percent).

The researchers analyzed data from 43,000 Americans on lifetime heroin use who were long-term heroin users and met the DSM-IV heroin use disorder using the National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002) and the National Epidemiologic Survey on Alcohol and Related Conditions (2012-2013).

These are concerning trends because increases are occurring among vulnerable people who have few resources to overcome the problems associated with heroin use, she added.

Those who use prescription opioid painkillers are 40 times more likely to abuse or be dependent on heroin, according to the Centers for Disease Control and Prevention.

"There are more people in the USA using heroin, there are more people that meet criteria for heroin addiction, and we are seeing increases in all different social strata, in different age groups, in both sexes", said Silvia Martins, lead author of the research from Columbia University Mailman School of Public Health. Whites are now almost twice as likely to use heroin as non-whites, and users tend to be white, poor, unmarried men who haven't gone to college.

Approximately 80,000 adults were interviewed in-person by researchers and were asked questions about whether or not they had ever used heroin in their life and whether or not they had a heroin-use disorder. "However, if the prevalence of heroin users continues to rise, it is likely that the numbers of those with heroin use disorders will rise as well". Another possibility is that heroin has become more socially acceptable, so a wider swath of Americans are willing to try it.

While the boom in heroin use is widespread, the study reveals that the rise is steeper for particular groups. While 1.05 percent of non-white people reported heroin use, that number was 1.9 percent for white people.

The growing epidemic of prescription opioid and heroin abuse in the United States is a crisis that has alarmed politicians, healthcare providers and the public alike.

"Because the effects of heroin seem so similar to widely available prescription opioids, heroin use appears to have become more socially acceptable among suburban and rural whites", noted Dr. Martins.

Research showed the percentage of adults with a heroin-use disorder increased from 0.2 percent in 2001 to 2002 to 0.7 percent in 2012 to 2013.

This suggests that more than 3.8 million USA adults have tried heroin at least once, and 1.6 million have abused it, they said.

Whites aged 18 to 44 accounted for the biggest rise in heroin addiction, which has been fueled in part by the misuse of opioid prescription drugs. One possibility: numerous 2013 heroin users were new to the drug. This drug is known to provoke the worst type of addiction and the most unpleasant withdrawal symptoms.

However, this may have had a knock-on effect in boosting heroin use, as former non-medical users of opioids struggle to access them and instead turn to illicit drugs for a similar high, the authors suggest.

Martins said that the study reflects the need for better training among medical professionals including the use of recent guidelines published by the CDC on the prescription of opioids.

  • Joanne Flowers