Data just released by the Centers for Disease Control reveal that 2014 marked the first year on record in which the total number of deaths caused by heroin reached five figures, at 10,754. This was more than 2008, 2009, and 2010 combined. In response to these worrying numbers, we have graphed figures from multiple government agencies to look for the causes behind America’s growing heroin epidemic.
One of the clearest signs that the use of heroin in recent years has escalated to epidemic proportions comes from the law enforcement agencies that witness its devastating effects on individuals and communities on a daily basis.
We can see one of the reasons so many law enforcement agencies have reported an increased threat from heroin by looking at data from the National Seizure System.2
It’s a somewhat different story for non-medical psychotherapeutics, though. 2004 saw the highest number of initiates (2.8 million) in the time period covered above, but since then the yearly number of new users has dropped. 2013 saw the lowest total in the last 13 years, at 2 million, and in 2014 there were marginally more at 2.1 million. On its face, fewer people using strong prescription drugs in non-medical ways seems like good news. In reality, though, what it amounts to is more people using heroin instead of opioid painkillers. We can examine this trend by specifically looking at people who said that they abused or had a dependence on heroin and pain relievers in the past year.
The connection between heroin and painkillers is made clearer by an NSDUH study that examined data from 2002 to 2011. It found that heroin use was 19 times higher among people who had previously abused pain-relieving controlled prescription drugs. It also found that, while the percentage of people abusing painkillers then moving to heroin was fairly low (3.6%), they represented 79.5% of new heroin initiates.5 The connection makes sense. After all, prescription painkillers and heroin are both opioids, which means that users are not choosing between two completely different types of drugs. They are in fact choosing between two variations of the same drug, based on factors like availability and price. As regulations controlling opioid painkillers have tightened in recent years, they have become more expensive and less available. Certain companies have also changed their pill formulations in ways that make them harder to break up and abuse. These factors, and others, have resulted in people turning to the other main opioid option: heroin.6 The result of this is more people suffering the consequences of heroin use. We only have to turn back to the National Survey on Drug Use and Health to see what some of those consequences are.
Taking heroin, let alone other hard drugs, takes a toll on the body. 29.9% of non-heroin users said they had been treated in an E.R. in the last year. For heroin users, it was 56.9%. Heroin users were also 6.4 times more likely to say they had ever had hepatitis, and 2.3 times more likely to say they had HIV/AIDS. On the subject of HIV, in trawling through the data, we checked what percentage of past-year heroin users said that the last needle they used had been used by someone else. The figure has fluctuated over the years, but not much. In 2004, 26% said someone else used their last needle before them. In 2006, the number had risen to 34.9%. In 2013, it was down to 21.3% (still a very worrying 1 in 5). Also, 1 in 5 said that someone else used their last needle after them. These numbers provide some explanation for why intravenous drug users are at such high risk of contracting serious illnesses. The UCLA Dual Diagnosis Program estimates that up to 89% of injectable substances sold on the street contain at least one pathogen, such as bacteria or fungi.7 Of course, the most serious outcome of using heroin is death. And, as we saw at the start, fatalities caused by heroin are at an all-time high. Here, they are compared with some other common causes of death.
West Virginia, which was second-highest for heroin overdoses, was first for opiate overdoses. In October 2015, President Obama traveled to Charleston, West Virginia – which The New York Times described as a “hotbed of one of the deadliest epidemics in American history”10 – to speak about the problem that is plaguing the nation: particularly the difficulties so many people have had finding treatment for their opiate addictions. The wait time for federally funded rehab is currently as long as 18 months in Maine, a month in Florida, and several weeks in Massachusetts.11 This is a serious problem, especially given the fact that when people join rehab waiting lists, they will only tolerate four weeks on average before dropping off.
In the face of impossible-to-ignore and ever-rising figures, more light than in the past is being shed on the dark problem of heroin abuse, addiction, and overdose. There is also an increasing awareness of painkillers acting as a gateway to heroin (the highly publicized death of actor Philip Seymour Hoffman was reportedly caused by a heroin overdose, which itself was precipitated by a problem with prescription pills).12 Turning the heroin mountain into a molehill won’t be easy, though, given that half a million Americans are now addicted to it.13 However, adopting certain key strategies, such as prioritizing treatment over punishment and emphasizing a preventative approach to tackling the problem (such as catching the abuse of painkillers before it transitions into a heroin addiction) are important first steps.
As public awareness grows concerning the separate issues of both heroin addiction and prescription opiate abuse – and, indeed, the startling interplay between the two – the undeniable need for adequate treatment and prevention strategies remains. Heroin.net works to provide site visitors with information about heroin abuse and various heroin treatment options. Search our national heroin rehabilitation directory, or call 1-888-496-8059 Who Answers? to speak with a caring recovery advisor about treatment that could save your life or that of someone you love struggling with a heroin addiction.
Sources & References
Used throughout: National Survey on Drug Use and Health via http://www.icpsr.umich.edu/icpsrweb/ICPSR/series/64
1. 2015 National Drug Threat Assessment - http://www.dea.gov/docs/2015%20NDTA%20Report.pdf
2. National Heroin Threat Assessment Summary, 2015 - http://www.dea.gov/divisions/hq/2015/hq052215_National_Heroin_Threat_Assessment_Summary.pdf (Page 4)
3. Risk and Protective Factors and Initiation of Substance Use: Results from the 2014 National Survey on Drug Use and Health - http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR4-2014%20(1)/NSDUH-DR-FRR4-2014.htm
4. Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013 - http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a3.htm
5. Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States - http://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm
6. U.S. National Library of Medicine - https://www.nlm.nih.gov/medlineplus/news/fullstory_155391.html
8. CDC Wonder - Multiple Cause of Death, 1999–2014 - http://wonder.cdc.gov
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