A report released this week by the Centers for Disease Control and Prevention (CDC) confirms what many in the addiction treatment field have observed in their communities for some time: Heroin use is increasing, is cutting across demographic lines, and is associated with use of other substances, including prescription opioids.
Published in Morbidity and Mortality Weekly Report, the analysis of 2002-2013 data from the National Survey on Drug Use and Health and the National Vital Statistics System found that annual average rates of past-year heroin use increased from 1.6 per 1,000 persons ages 12 and older in 2002-2004 to 2.6 per 1,000 persons in 2011-2013. Young adults ages 18 to 25 showed the steepest increase in use rates. Heroin overdose death rates nearly quadrupled nationally from 2002 to 2013, including a doubling in the 2011-2013 period.
The report stated that these characteristics were associated with higher risk of past-year heroin abuse or dependence: male gender; 18-to-25 age group; non-Hispanic white race; urban residence; annual income under $20,000; coverage by Medicaid or no health insurance; and past-year abuse or dependence on alcohol, marijuana, cocaine or prescription opioids. Yet heroin initiation rates have generally been increasing across most demographic groups.
CDC director Thomas Frieden, MD, attributed the overall increases in heroin use to its wider availability at lower prices and to increased susceptibility to use by individuals who have been prescribed pain relievers.
The report offers three suggestions for enhancing the public health response to the growing heroin problem: reducing inappropriate opioid prescribing and use through the efforts of prescription drug monitoring programs (PDMPs) and other initiatives; improving access and insurance coverage for evidence-based treatments that include medications; and expanding overdose recognition training and access to the overdose reversal medication naloxone.