Heroin use and overdose deaths are increasing rapidly in the United States, according to a recent report by the Center for Disease Control (CDC) summarizing data from a number of public health-related datasets.
According to the 2013 National Survey on Drug Use and Health (NSDUH), 4.9 million Americans have used heroin, with 656,188 reporting use in the last year and 184,310 reporting use in the last month. Nearly three-fourths (73 percent) of past-year heroin users are between the ages of 18 and 34 and 70 percent of past-month users are in this age group.
The CDC’s review of NSDUH data indicates that heroin use among those 18 to 25 has increased 109 percent in a comparison of the years 2002 to 2004 and the years 2011 to 2013. Use among those 26 and older has also increased by 58 percent.
A National Health Center (NHC) Brief reviewed by the CDC reported that the rate of heroin-related deaths have quadrupled from 0.7 deaths per 100,000 in 2000 to 2.7 deaths per 100,000 in 2013, with most of the increase coming after 2010.
The NHC Brief reports that drug overdose is the leading cause of injury-related death in the United States. There were 43,982 such deaths in 2013. Data from 28 states indicates the death rate from heroin doubled from 2010 to 2013.
One of the leading causes of the increase in heroin use and related overdoses has been the more widespread use of prescription opioid painkillers such as Vicodin and Oxycontin. The CDC reports that “45 percent of people who have used heroin were also addicted to prescription opioid painkillers.”
According to the CDC, “Heroin use is part of a larger substance abuse problem,” and “people who are addicted” to alcohol are two times more likely to be addicted to heroin. Those “addicted” to marijuana are three times more likely to develop a heroin addiction. Cocaine addicts are 15 times more likely. And people addicted to opioid painkillers are 45 times more likely to be addicted to heroin.
However, with respect to marijuana, the 2013 NSDUH reports 184,310 past-month heroin users had also used marijuana in the past month. When this is compared to the total number of past-month marijuana users (19.9 million), you can see that only 0.92 percent (less than one percent) of monthly marijuana users also use heroin.
The CDC recommends that state governments—which play a central role in responding to prevention, treatment and recovery issues—take additional steps to respond to this growing public health problem.
The first step is to “address the strongest risk factor… addiction to prescription opioid pain killers.” Other steps include increasing access to treatment programs, expanding access to naloxone (which emergency medical technicians use to reduce overdose-related death) and making sure that people have more access to “integrated prevention services, including access to sterile injection equipment.” In other words, the CDC is recommending a greater emphasis on harm reduction policies, including needle exchange programs.
The growing acceptance of the medical use of marijuana is also relevant to this problem, as cannabis therapeutics provide a safe alternative to the use of prescription opioid pain relief drugs. Marijuana has proven pain-relief properties, however unlike opiates, it does not affect the medulla—the part of the brain that controls heart rate and breathing.
The impact of opioid drugs on the medulla is what causes overdose deaths from heroin. Hopefully increased access to medical marijuana will help reduce the overuse, abuse and fatalities causing this latest epidemic in both opioid prescription drug and heroin use.
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