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Heroin chemical compound
September 30, 2018

Heroin Addiction Facts

Heroin chemical compoundAddiction is a chronic, relapsing brain disease characterized by compulsive use and drug seeking that persists despite mounting negative consequences. Substance use disorders (SUDs) affect millions of Americans. Heroin addiction is one of the deadliest SUDs today, accounting for dramatic increases in current users, numbers of heroin users needing treatment, and escalating heroin overdose deaths.

HEROIN ADDICTION AND ABUSE 

The National Institute on Drug Abuse (NIDA) states that about 4-6 percent of those who misuse prescription opiate drugs (primarily painkillers) transition to heroin. Heroin addiction statistics from the 2016 National Survey on Drug Use and Health (NSDUH) show that about 475,000 people age 12 and older were current heroin users in 2016. That equates to 0.2 percent of the population. Current (past month) heroin users segmented by age groups:

  • 3,000 adolescent users (age 12-17)
  • 88,000 young adult users (age 18-25)
  • 383,000 adult users (age 26 and older)

Heroin Use Disorder

Clinically significant impairment caused by the chronic use of heroin is called heroin use disorder or heroin addiction. The disorder is characterized by increasing or persistent use, health problems, physical withdrawal, and difficulties at home, work, or school. In 2016, an estimated 626,000 people age 12 and older had a heroin use disorder. That means they met diagnostic criteria for heroin dependence or abuse.

Among the 626,000 people in 2016 with a heroin use disorder, 1,000 were adolescents, while 152,000 were young adults, and 473,000 were adults age 26 and older.

HEROIN OVERDOSE DEATHS CLIMBING

heroin overdose deaths in America increased 533 percent from 2000-2016According to heroin use statistics compiled by the National Center for Health Statistics and the Centers for Disease Control and Prevention (CDC), heroin overdose deaths in the United States are on a steep upward trajectory. A study in the journal Pain Physician reported that heroin overdose deaths in America increased 533 percent from 2000-2016. Provisional data for 2017 show 15,958 deaths from heroin overdose. For the period 2002 through 2017, there has been a 7.6-fold increase in the total number of heroin overdose deaths.

Deaths from heroin overdose continue to be predominantly male, although heroin overdose deaths among males and females has continued to increase since 2010. The increase is much sharper among males for that period. In 2016, about 12,000 males died from heroin overdose, compared with about 3,000 females.

States with Highest Drug and Heroin Overdose Deaths

Provisional data from 22 reporting jurisdictions on drug overdose deaths for the 12-month ending period (Jan. 2016 vs, Jan. 2017) compiled by the CDC’s National Center for Health Statistics, National Vital Records System, show some dramatic increases.

Reporting jurisdictions with the highest drug overdose deaths (including all drugs, not just heroin) include:

  • Delaware – 309 drug overdose deaths in the 12-month period ending Jan. 2017 – +71 percent change
  • Maryland – 2,171 drug overdose deaths — +67 percent change
  • Florida – 5,167 drug overdose deaths — +55 percent change
  • New York City – 1,478 drug overdose deaths — +50 percent change
  • Virginia – 1,387 drug overdose deaths — +38 percent change
  • Maine – 359 drug overdose deaths — +33 percent change
  • Illinois – 2,518 drug overdose deaths — +33 percent change

Jurisdictions showing a decrease in drug overdose deaths include Nebraska, down 8 percent, Wyoming and Washington, each down 3 percent.

Heroin overdose deaths in the U.S. and seven jurisdictions, Jan. 2016 vs. Jan. 2017:

  • S. – 13, 219 vs. 15,446
  • Alaska – 35 vs. 50
  • Iowa – 40 vs. 52
  • Maine – 49 vs. 54
  • Maryland – 418 vs. 679
  • New York City – 421 vs. 595
  • Virginia – 339 vs. 451
  • Washington – 323 vs. 285

Of particular note is the continuing increase in drug overdose deaths in Delaware. State officials say proximity to Interstate 95 allows heroin to flow into Delaware from New Jersey, Pennsylvania, Maryland and other states. The DEA identified Philadelphia as the main supplier of Delaware heroin. According to CDC records, Delaware emergency room doctors reported a 105 percent increase in opiate overdose visits from July 2016 to September 2017. By mid-August 2018, 167 people died from suspected opiate and heroin overdose in Delaware. In 2017, about 61 percent of the overdose deaths were due to fentanyl, while 40 percent involved heroin.

The state of Alaska, which had shown progress in the reduction of overdose deaths due to prescription opiates and heroin, has seen gains nearly wiped out with the proliferation of fentanyl use in recent years. In 2017, about 1 in 30 of all deaths in Alaska were associated with opiates. Officials say they’re now seeing clusters of deaths, with many users unaware they’re using fentanyl, believing the illicit drug to be heroin.

Another consequence of injected drug use in Alaska is the increase in hepatitis C virus (HCV) infection among users under the age of 30 since 2015. Self-injection, say officials, is the main driver behind the surge in HCV in the state.

According to statistics published by NIDA from various research reports and studies:

  • Opiate overdoses increased 30 percent in 52 areas in 45 states from July 2016 through September 2017.
  • During that same timeframe, opiate overdoses in the Midwestern region increased 70 percent.
  • Opiate overdoses in large cities increased by 54 percent in 16 states.

HOW HEROIN FITS INTO THE LARGER SUBSTANCE ABUSE PROBLEM

The number, variety, potency and availability of substances of abuse proliferating in the United States today has never been greater. Despite increasingly stringent controls, DEA seizures of illicit drugs and pill mill-dispesed prescription drugs, tighter laws and enforcement, an emerging awareness of the need for nonaddictive pain medications, more treatment facilities, greater availability of life-saving Narcan to reverse opiate overdoses, and massive funding requests and grants pending, the problem of substance abuse continues to wreak havoc in society. From rural America to metropolitan cities, highly addictive, illegal, and potentially deadly heroin is among the most destructive drugs of abuse.

Heroin’s History

Heroin abuse and addiction has been a growing issue for more than 100 years. Ironically, heroin was once seen as a wonder drug in the U.S.— a safer and more effective prescription drug for all illnesses for which morphine or codeine was prescribed. Heroin was also considered effective in treating addiction to morphine and codeine, although reports in 1899 surfaced that heroin was a toxic poison and was addicting. Heroin addiction was first reported in New York in the early 1900s, where 98 percent of all drug addicts at the time were heroin addicts.

Due to its addictive properties, increase in crime and other factors, congressional law in June 1924 prohibited crude opium importation for the purposes of production of heroin. Commercial production of heroin ceased shortly thereafter. Seizures of illicit heroin in the U.S. mostly declined during the period 1930-1950. Yet heroin has enjoyed a storied history with phases of intense popularity and falls from favor.

Between 8-12 percent of those prescribed opiate drugs for painThe opiate crisis in the U.S., however, has seen a resurgence in heroin use, misuse, addiction and overdose deaths. Most reports identify the over prescription of pain-relieving drugs as a significant contributing factor to heroin’s dramatic return.

Indeed, about 80 percent of new heroin users say they started using heroin after being unable to obtain a supply of the prescription opiates they were misusing. Heroin is also cheaper than prescription opiate drugs, which adds to the appeal of street heroin. Between 8-12 percent of those prescribed opiate drugs for pain and misuse them develop an opioid use disorder (OUD), a specific type of SUD.

The 2016 NSDUH estimates that 20.1 million people 12 and older had a SUD that year, including 15.1 million with an alcohol use disorder (AUD), and 7.4 million with an illicit drug use disorder. The two most common disorders were for marijuana (4 million) and prescription pain relievers (1.8 million).

Regarding need for treatment for SUD, about 1 in 13 people in 2016 required treatment, or about 21 million people. That represents 1.1 million adolescents, 5.3 million young adults, and 14.5 million adults age 26 and older.

Receipt of needed SUD treatment, however, is woefully inadequate. In 2016, only about 2.2 million people obtained SUD treatment at a specialty facility: 89,000 adolescents, 383,000 young adults, and 1.8 million adults age 26 and older.

For related information, see these articles:

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CDC. National Center for Health Statistics. National Vital Statistics System. “Provisional Counts of Drug Overdose Deaths, as of 8/16/2017.” Retrieved from https://www.cdc.gov/nchs/data/health_policy/monthly-drug-overdose-death-estimates.pdf

Centers for Disease Control and Prevention. “Morbidity and Mortality Weekly Report (MMWR).” “Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas – United States.” Retrieved from https://www.cdc.gov/mmwr/volumes/66/ss/ss6619a1.htm?s_cid=ss6619a1_w

Centers for Disease Control and Prevention. “Morbidity and Mortality Weekly Report (MMWR).” “Increases in Drug and Opioid Overdose Deaths – United States, 2000-2014.” Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm?s_cid=mm6450a3_w

Centers for Disease Control and Prevention. “Today’s Heroin Epidemic Infographics.” Retrieved from https://www.cdc.gov/vitalsigns/heroin/infographic.html

Contagion Live. “Infections Diseases on the Rise Amid the Opioid Epidemic.” Retrieved from https://www.contagionlive.com/news/infectious-diseases-on-the-rise-amid-the-opioid-epidemic

Get Smart About Drugs. “Growing Up Drug-Free: A Parent’s Guide to Prevention.” Retrieved from https://www.getsmartaboutdrugs.gov/content/dos-and-donts-talking-your-kids-about-drugs

National Institute on Drug Abuse. “Drugs, Brains and Behavior: The Science of Addiction.” “Drug Abuse and Addiction.” Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

National Institute on Drug Abuse. “Opioid Overdose Crisis.” Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#ten

National Institute on Drug Abuse. “Overdose Death Rates.” “National Overdose Deaths: Number of Deaths Involving Heroin.” Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

Pain Physician. “Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30045589

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.” “Substance Use Disorders in the Past Year.” “Heroin Use Disorder.” Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#opioid2

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.” “Illicit Drug Use in the Past Month: Heroin Use.” Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#opioid2

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.” “Opioid Misuse in the Past Year.” “Past Year Heroin Use.” Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#opioid2

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.” “Need for Substance Use Treatment.” Retrieved from Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.”

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.” “Receipt of Substance Use Treatment.” Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#sud

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.” “Substance Use Disorder (Alcohol or Illicit Drugs).” Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#sud

United Nations Office on Drugs and Crime. “History of Heroin.” Retrieved from https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1953-01-01_2_page004.html

WHYY. “Another spike in Delaware overdose deaths.” Retrieved from https://whyy.org/articles/another-spike-in-delaware-overdose-deaths/

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