Heroin is a derivative from opium created in the late 19th century. Because it was twice as effective as morphine, its use spread widely as an analgesic for tuberculosis, pneumonia, acute injuries or childbirth.
Patients treated with heroin soon revealed severe addictions. They either experiences harsh withdrawal symptoms or continued taking heroin after healing from their initial condition.
Because heroin was added to freely available medicine in pharmacies, it rapidly caused an addiction epidemic. The first patient treated for heroin dependency was admitted in 1910 in the New York Bellevue Hospital.
Ever since the number of heroin and related opioid painkillers users continues to grow. In the last decade, its consumption expanded in most age groups and all income levels. And so did heroin-related overdoses and death rates.
Demographics Of Heroin Users
In 2014, 21.5 million U.S. citizens aged 12 or more struggled with some form of drug addiction.
The 2013 use of opioids, mainly heroin, is estimated as 0.4 percent of the population aged 15-64. 586,000 out of 900,000 people aged 12 or more that used heroin in 2013 suffers from heroin addiction.
According to the Centers for Disease Control and Prevention (CDC), the rates of heroin use increased from 2002-2004 to 2011-2013 by 62.5%.
This alarming change is mainly due to young adults aged 18-25. Their heroin use more than doubled since 2002, increasing by 108.6%.
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Who Is Most At Risk of Heroin Addiction?
- Young adults aged 18-25
- Residents of main metropolitan areas (over 1 million inhabitants)
- Those that are addicted to other substances, mainly to marijuana and alcohol
- People who are addicted to prescription opioid painkillers
- Individuals who are addicted to cocaine
- Persons with no insurance or enrolled in Medicaid
- Although heroin use increased in all annual household income levels since 2002, people with less than $20,000 per year are the most at risk.
- Heroin abuse in non-Hispanic whites 114.3% from 2002-2004 to 2001-2013 with 1.4 per 1,000 to 3.0 per 1,000.
Adolescents (Aged 12-17)
Rising prescription rate. An alarming sign is an increase in prescriptions for opioid painkillers for teenagers. The number doubled from 1994 to 2007.
- Use of opiate painkillers in 2014. Almost half a million teens used them for recreation, with 168,000 addicted to prescription painkillers.
- Use of heroin. 28,000 kids had used heroin in 2013, from which more than a half continued in 2014. 18,000 adolescents were estimated to be addicted to heroin in the year 2014.
- Ignorance. In most cases, young people did not seek for drugs. They are often unaware of the addictive potential of painkillers they share with each other or get from oblivious family members and friends.
Men vs. Women
- Chronic pain in women. Women suffer more often from chronic pain as compared to men. They are therefore more likely to get pain reliever prescriptions and in higher doses. Women also tend to use for a longer time than men. All these factors make women more vulnerable to dependency on painkillers than men.
- Narrowed gender gap. Heroin use is growing for both men and women since 2002. The heroin abuse rate was 2.4 per thousand for men and 0.8 per thousand for women in 2002-2004. In 2013 these numbers increased to 3.6 per 1,000 for men and 1.6 per 1,000 for women. That constitutes a 50% increase for men and a 100 % for females during that decade.
Addiction Factor: Use of Other Drugs
- Over 90% of heroin consumers also abuse one or more other substances.
- Heroin-abuse percentage increased from 2002-2004 to 2011-2013 from 17.8 per 1,000 to 42.4 per 1,000.
- That number was unusually high among those, that also consumed cocaine: 5 per 1,000.
Main Addiction Factor: Opioid Painkiller Consumption
- In 2014, almost 2 million abused a prescribed opiate medication, whereas over 500,000 were heroin addicts. According to estimates, nearly one-fourth of heroin users also develop addictions to opioid medications.
- In 2012, 259 million single prescriptions were given for opioid pain relievers. That is enough to distribute a prescription to 75% of the U.S. population.
- According to estimations, four out of five new heroin consumers started with opioid prescription pain relievers.
- 45% of the general heroin-using population was already addicted to prescription opioid pain relievers when starting using heroin.
- A 2014 survey of people in heroin addiction treatment confirmed that trend. 94% of the respondents said they switched to heroin because it was easier and cheaper to obtain.
Dangers Of Heroin Overdose
- In 2011, 258,482 emergency room visits involved heroin overdose.
- About 14% of all drug-related emergency room visits involve heroin.
- After cocaine and marijuana, it is the third drug leading to emergency intervention.
- The most frequent emergency hospital visitors are between 21-24 years old with 266.1 visits per 100,000.
Death From Heroin
- From 0.7 per 100,000 during 2002-2006, heroin-related deaths increased to 1.1 per 100,000 in 2009, 1.1 per 100.000 in 2011, and to 2.7 per 100,000 in 2013. That is a 286% increase since 2002.
- In the U.S., 47,055 people died from drug overdose in 2014. 20% was due to prescription painkillers and 10% due to a heroin
- 10,574 heroin-related deaths were noted in 2014, which is a 26% increased from 2013.
- Multi-substance use. In 2013, at least one additional drug abuse was linked to 60% of total 8,257 deaths related to heroin
- Death of women from painkillers. Between 1999 and 2010, almost 50,000 women died from a prescription painkiller overdose. In that decade, this number quadrupled for women, compared to an increase of 237% in men.
- Death of women from heroin. Similarly, between 2010 and 2013, deaths due to heroin overdose tripled. For every 100,000 overdoses,2 women died in 2013.
Heroin in A Broader Context
Abuse of opioid painkillers seems to be the most reliable factor leading to heroin addiction.
- 96% of heroin users reported in 2014 to use at least one different drug the past year.
- 61% of these people used at least three drugs.
- The percentage of heroin users addicted to opioid painkillers increased from 20.7% from 2002-2004 to 45.2% in the period between 2011-2013.
- Since 2013, the use of opioid pain relievers become more common among heroin users than alcohol, cocaine or marijuana abuse.
Heroin In The World
- In 2008 it was estimated that 13.5 million people used opium-derived substances worldwide.
- That includes 9.2 million users of heroin.
- In 2013, 16.4 million people used opiates, according to estimations.
- The worldwide illicit cultivation area for opium counted 296,720 hectares in 2013.
- 560 tons of opioid substances were produced in 2013.
- In 2007 Afghanistan supplied 93% of the world demand for opium. From $4 billion of its total value, 75% went to heroin traffickers and the rest to Afghan farmers.
- Currently, Afghanistan handles 80% of the world’s heroin supply with 209,000 hectares used for opium cultivation.
- The next coming largest illicit opium farming areas include 3,900 ha in Laos, 57,800 ha in Myanmar and 265 ha in Thailand.
- Mexico is the leading opium producer in the Americas with 12,000 ha of cultivation area.
- Despite producing 30 times less opium than Mexico, Columbia is the primary supplier of heroin to the United States.
How To Respond To The Heroin Epidemic?
The CDC recommends the following actions to stop the heroin use and related risks of overdose:
- Prevent Heroin Consumption
Avoid the highest risk factor for heroin addiction by decreasing the prescription of opioid painkillers. Initiation to these substances should be limited and controlled, and health professionals provided with appropriate guidelines and alternative tools. High-risk patients should be able to be identified.
- Decrease Heroin Addiction
Therapy for heroin addiction should be more accessible. Medication-assisted substance abuse treatments should be more available. Combined with behavioral therapies and support groups, they are an effective way to battle against the drug.
- Stop Heroin Overdose
Consequences of overdoses can be prevented with naloxone, by reversing the potentially fatal opioid effects. Use of this medication should expand and proper training administered to medical staff.
Health agencies, medical professionals, and local jurisdiction agencies should work together to ensure these practices.