The face of heroin in the US is changing. As the drug becomes more commonly abused among new racial, geographic and socioeconomic groups, the profile of those users is also evolving.
The change is, in part, because heroin is becoming more accessible, increasing its usage, a new Penn State University study finds. At the same time, more people are abusing prescription painkillers, getting addicted and switching to heroin (both drugs are opiates).
Heroin Comes to Small Town America
The mitigating factors are contributing to a rise in heroin use among new segments of the population, particularly among whites, middle/upper-class people and in rural areas, said Dr. Shannon Monnat, assistant professor of rural sociology, demography, and sociology at Penn State.
More white people – young, white men in particular – are using heroin and prescription painkillers simultaneously, said Monnat and her co-author, Dr. Khary K. Rigg, assistant professor of mental health law and policy, University of Southern Florida.
Prescription painkillers, which are highly addictive opiates, now seemingly serve as a “gateway” drug to heroin, another opiate that is cheaper and much easier to obtain.
The Undeniable Data
In their latest research, Monnat and Rigg examined three groups of people who had reported using heroin and/or prescription opiates (via the 2010-2013 National Survey on Drug Use and Health). These participants were broken down into three groups:
- The first group had used strictly heroin (179 total users)
- The second group had used strictly prescription painkillers (9,516 total users)
- The third group had used both (506 total users)
The researchers found distinct differences among the socioeconomic, racial, health and geographic factors among all three groups. Those differences included:
The heroin-only group tended to be the most socioeconomically disadvantaged, were more likely to be minorities, had more physical problems, and more likely to live in large urban communities. They were also more likely to have gotten in trouble with the law.
Those who used both heroin and prescription painkillers reported more mental health problems and were more likely to visit the ER than either of the other groups. People in this group were also most likely to have started using drugs in their teens and experience more severe substance problems overall, “including greater risk of having a co-occurring mental disorder, an overdose, and/or HIV,” the authors wrote.
Researchers found that the group who only used prescription painkillers were more likely to be married or employed, were the least socioeconomically disadvantaged and had less criminal justice involvement. They also showed the greatest physical and mental health and were least likely to live in large urban areas.
Opiate Painkiller Addiction Holds Strong
Despite the spike in heroin addiction, painkiller abuse is still far more common. In fact, an estimated 5.1 million Americans are currently abusing pain pills, as compared to 0.3 million Americans who use heroin, according to data from the National Institute on Drug Abuse.
But experts are quick to point out that this is a statistic that could very easily shift.
There are increasing reports of crossover abuse between both forms of opiates, with most people switching from prescription drugs to heroin instead of the other way around. This is mainly because the pills are expensive and hard to get.
Also, drug-makers in recent years have stepped up efforts to make painkillers difficult to abuse, developing tamper-resistant pills that cannot be crushed, liquefied or injected.
Lawmakers have also reduced access to pills by pushing for stricter regulations on their distribution, and establishing drug-monitoring programs. But for many Americans, these restrictions came too late, going into effect long after they were hooked on opiates.
As a result, heroin is now impacting a completely different segment of the nation – white communities, rich people and suburbs – whereas in the past, urban communities, poor people and minorities were most at risk, leading to the stereotype of “urban junkie.”
As heroin use increases in small cities and rural areas, Monnat and Rigg note that it is important to keep tabs on prescription painkiller users who are most likely to turn to heroin. And, because of the very distinct differences between the three groups, Monnat and Rigg also suggest that three unique intervention programs should be developed to address the particular needs of each group.
Additional Reading: Opiates, Overdose and Permanent Brain Damage
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