Heroin was once the scourge of the urban poor, but today the typical user is a young white suburbanite, a study finds. And their path to addiction usually starts with prescription painkillers.
A survey of 9,000 patients at treatment centers around the country found that 90 percent of heroin users were white men and women. Most were relatively young – their average age was 23. And three-quarters said that they first started abusing prescription opioids like OxyContin.
In contrast, when heroin first became popular in the 60s and 70s, most users were young minority men who lived in cities, the study reports.
"Heroin is not inner-city problem anymore," says Dr. Theodore Cicero, a psychiatrist at the Washington University School of Medicine in St. Louis who led the study.
This study, which was published Wednesday in the journal JAMA Psychiatry, squares with earlier findings that heroin abuse is both growing and spreading beyond urban centers.
In 2007, over 2,000 people died of heroin overdoses, according to the Centers for Disease Control and Prevention. And 200,000 went to the ER after overdosing in 2008.
Earlier this year, a particularly potent batch of the heroin circulating in Pennsylvania brought a string of overdose deaths. Vermont Gov. Peter Shumlin has declared that his state is in the midst of a heroin crisis. And in Rhode Island, state health officials have asked police chiefs to give their officers Narcan and Naloxone – antidote drugs that can reverse the effects of overdose.
Prescription opioids remain among the most popular drugs of abuse. But heroin users interviewed for this study said they turned to heroin because it was cheaper and easier to get than the prescription pills. An OxyContin pill can cost $80 on the street, Cicero says, while a hit of heroin is just 10 bucks.
Heroin gives users the same sort of high as any prescription opioid, Cicero says. But, "the heroin you get on the street is unknown, it's uncertain," he says. "Users don't really have any idea what dose to take."
Better mental health treatment for those at risk of addiction should be a public health priority, Cicero says. And in the medical community, "there needs to be a little more stepping back before prescribing an opioid."
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