A new report just released by the Centers for Disease Control and Prevention (CDC) has stark news about heroin use in the United States. The report, developed by the CDC and the Food and Drug Administration (FDA), found that heroin use has increased among men and women in most age groups and at all income levels. Alarmingly, the greatest increases have occurred in groups with historically lower rates of heroin use, such as women and people with private insurance and higher income.
The report also found that nearly all people who use heroin also commonly use other substances, increasing their risk for overdose and death, and when heroin users overdose, one or more other substances are often found in their bloodstream.
The strongest risk factor for a heroin use disorder, found the new “Vital Signs” report, is having a prescription opioid use disorder. But in a call with reporters following the release of the report, CDC director Tom Frieden, MD, MPH, called attention to lesser-known reasons behind this connection. Dr. Frieden said that while many believe opiate users move to heroin because its cost can be much lower than opiate pills like oxycodone and hydrocodone, this is not the only factor: Researchers have found that many opiate users switch to heroin because the two substances share a common chemical — morphine — and opiate use primes a user’s brain for heroin use, explained Frieden. He stressed that treating opiate addiction lowers the chances that someone who has been addicted to opiates will switch to heroin.
Calling Attention to the Heroin Crisis
Frieden hoped that the new report, published in Morbidity and Mortality Weekly Report, will call more attention to the opioid/heroin crisis now that research is showing that as heroin use increases so are deaths from heroin overdoses. Overdose death from heroin nearly doubled between 2011 and 2013, and over 8,000 people died of heroin overdoses in in 2013. “To reverse this trend we need an all-of-society response – to improve opioid prescribing practices to prevent addiction, expand access to effective treatment for those who are addicted, increase use of naloxone [a drug that can reverse heroin overdoses] and work with law enforcement partners like the Drug Enforcement Administration to reduce the supply of heroin,” Frieden said on the press call.
To compile the report, researchers at the CDC and FDA looked at data from the “2002-2013 National Survey on Drug Use and Health,” a federal report. Key findings included:
- Nearly all (96%) people who reported using heroin also reported using at least one other drug in the past year.
- More than half (61%) who those who responded had used at least three other drugs.
- The report detailed links between heroin and other addicting substances.
People who use:
- prescription opioid painkillers are 40 times more likely to abuse or be dependent on heroin.
- cocaine are 15 times more likely to abuse or be dependent on heroin.
- marijuana are 3 times more likely to abuse or be dependent on heroin.
- alcohol are twice as likely to abuse or be dependent on heroin.
The report’s recommendations for reducing heroin use include:
- Making databases that track the dispensing of opiates easier to use so doctors can quickly see a patient’s prescribing history before giving someone opiates.
- Reviewing state Medicaid worker’s compensation programs to identify and reduce inappropriate opiate prescribing.
- Increasing access to substance abuse treatment services, including medication-assisted treatment for opioid abuse or dependence.
- Expanding access to and training for administering naloxone to reduce opioid overdose deaths.
The CDC plans to offer physician help in 2016 by releasing new prescribing guidelines for opiates with a goal of reducing dependence and addiction.