The face of drug addiction within the U.S. has changed considerably over the past 50 years, according to a new study. Heroin use has spread to the suburbs and rural areas from urban centers, the study found, sparked in large part by the rise in prescription opioid use seen over the last decade.
The study, published online Monday in JAMA Psychiatry
, analyzed nearly 2,800 patients ages 18 and over across 48 states between 2010 and 2013 who reported having heroin dependence. Of those, 75% resided in small urban or non-urban areas, and nearly 90% who began using heroin over the past decade were white men and women with an average age of 23.
The findings indicate a stark shift from traditional perceptions regarding the demographics surrounding heroin use. Heroin use among minorities has decreased since the 1970s when they accounted for half of all users. By 2010, non-whites made up around 10% of heroin users surveyed.
Heroin use among women has steadily increased since the 1960s, from less than 20% to just more than half by 2010 compared with a steady decline among men during the same period, who went from making up more than 80% of heroin users in the 1960s to nearly half by 2010.
The way users were initiated into opioid drugs also has changed over time, the study found, with more than 80% of those who started their drug use in the 1960s reporting they began with heroin compared with 75% of users who started in the 2000s who said they started their abuse by taking prescription drugs.
By 2010, however, the trends began to shift as an increasing number of first-time users started with heroin while the number of first-time prescription drug users has gone down.
The use of opioid drugs has climbed dramatically over the past decade, with the number of overdose deaths within that time frame increasing from 4,000 in 1999 to more than 16,000 by 2010. In 2010, the amount of pain relievers sold in the U.S. could have medicated every adult with a 5 mg dose of hydrocodone every four hours for a month, according to the Centers for Disease Control and Prevention
Researchers cite the high cost for prescription painkillers as a possible reason for heroin’s growing popularity among white non-urban populations. The drug is often seen as a cheaper and more accessible alternative.Follow Steven Ross Johnson on Twitter: @MHsjohnson