'Alarming' New Stats on US Heroin Epidemic

Megan Brooks

July 08, 2015

Heroin use in the United States jumped 63% between 2002 and 2013, with increases seen among men and women, most age groups, and all income levels, according to new data released today by the Centers for Disease Control and Prevention (CDC).

The biggest increases have occurred in groups with historically lower rates of heroin use, including women and people with private insurance and higher incomes, according to the CDC's Vital Signs report.

As heroin use has increased, so have heroin-related deaths. From 2002 through 2013, the rate of heroin-related overdose deaths nearly quadrupled. Between 2011 and 2013, heroin-related overdose deaths nearly doubled. In 2013 alone, more than 8200 people died from heroin overdoses, the report says.

Heroin use is part of a larger substance abuse problem, with users using other drugs, especially prescription opioids, the report notes.

"Heroin use is increasing at an alarming rate in many parts of society, driven by both the prescription opioid epidemic and cheaper, more available heroin," CDC Director Tom Frieden, MD, MPH, said in a news release.

"To reverse this trend, we need an all-of-society response ― to improve opioid prescribing practices to prevent addiction, expand access to effective treatment for those who are addicted, increase use of naloxone to reverse overdoses, and work with law enforcement partners like DEA [Drug Enforcement Agency] to reduce the supply of heroin," he said.

The new data stem from the 2002-2013 National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration and the National Vital Statistics System.

Need for Drug Monitoring Programs

People at greatest risk for heroin use or dependence are non-Hispanic whites, men aged 18 to 25 years, those with an annual household income of less than $20,000, Medicaid recipients, and the uninsured, the report says.

The vast majority (96%) of people who use heroin also use at least one other drug, and more than half (61%) use at least three other drugs.

Heroin use or dependency is 40 times more likely in people who abuse or are dependent on prescription opioid painkillers; 15 times more likely in cocaine users; three times more likely with marijuana use; and two times more likely with abuse of alcohol, according to the report.

"Approximately 120 people die each day in the United States of a drug overdose," DEA Acting Administrator Chuck Rosenberg said in the news release.

"The CDC's Vital Signs illustrates two significant factors partly fueling that alarming number ― the misuse of prescription drugs, and a related increase in heroin use. We will continue to target the criminal gangs that supply heroin, and we will work to educate folks about the dangers and to reduce demand. In this way, we hope to complement the crucial efforts of the CDC and our nation's public health agencies," he added.

Michael Botticelli, director of National Drug Control Policy, said the NDCP "is working with federal, state, and local partners to increase access to effective treatment, while reducing overdoses and other consequences of the opioid epidemic, including the spread of hepatitis C and HIV. It is not enough to simply reverse overdoses. We must also connect overdose victims and people struggling with prescription drug and heroin use disorders to treatment facilities and doctors that offer medication-assisted treatment."

The CDC says that states have a major role to play in combating the heroin epidemic. In particular, states need to work to reduce abuse of prescription opioid painkillers, the strongest risk factor for heroin use.

The CDC encourages states to create prescription drug monitoring programs that are easy to use so that providers can analyze patient prescription-drug history and make informed decisions before prescribing opioid painkillers.

States can also increase access to substance abuse treatment services, including medication-assisted treatment (MAT) for opioid abuse or dependence, work with Medicaid and other insurance companies to provide coverage for MAT, and support adoption of MAT in community settings.

The CDC also supports expanding access to and training in use of naloxone to reduce opioid overdose deaths.

In March, the US Health and Human Services announced a targeted initiative aimed at reducing prescription opioid- and heroin-related overdose, dependence, and death, as reported by Medscape Medical News.

The Obama administration is also committed to the effort. The President's fiscal year 2016 budget includes $133 million in new funding to combat the prescription drug and heroin epidemic.

MMWR Morb Mortal Wkly Rep. Published online July 7, 2015. Full text

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