The proportion of the population using heroin and having heroin use disorder increased over the decade from 2001 through 2013, with the greatest increases among whites, and nonmedical use of prescription opioids before heroin use increased among white users only, according to a new article published online by JAMA Psychiatry.
Heroin use is a public health concern because the risks associated with it include addiction, death, infectious diseases and impaired psychological status.
The study by Silvia S. Martins, M.D., Ph.D., of the Mailman School of Public Health at Columbia University, New York, and coauthors used data from two nationally representative surveys to examine changes, patterns and demographics associated with heroin use.
Among the 79,402 survey respondents, the prevalence (proportion of the population affected) of heroin use increased from 0.33 percent in 2001-2002 to 1.61 percent in 2012-2013 and the prevalence of heroin use disorder increased from 0.21 percent to 0.69 percent, according to the results.
The authors also note:
- The increase in the prevalence of heroin use was higher among whites (0.34 percent in 2001-2002 vs. 1.90 percent in 2012-2013) compared with nonwhites (0.32 percent in 2001-2002 vs. 1.05 percent in 2012-2013).
- The proportion of people who reported initiating the nonmedical use of prescription opioids before starting heroin use increased across time among white users only (from 35.83 percent in 2001-2002 to 52.83 percent in 2012-2013.
The study has limitations, including that the surveys lack biological testing for the substances and individuals who were homeless or incarcerated were excluded.
"The prevalence of heroin use and heroin use disorder increased significantly, with greater increases among white individuals. The nonmedical use of prescription opioids preceding heroin use increased among white individuals, supporting a link between the prescription opioid epidemic and heroin use in this population. Findings highlight the need for educational campaigns regarding harms related to heroin use and the need to expand access to treatment in populations at increased risk for heroin use and heroin use disorder," the article concludes.
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(JAMA Psychiatry. Published online March 29, 2017. doi:10.1001/ jamapsychiatry.2017.0113; available pre-embargo at the For The Media website.)
Editor's Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Related material: The editorial, "The Surge of Opioid Use, Addiction and Overdoses: Responsibility and Response of the U.S. Health Care System," by Bertha K. Madras, Ph.D., of Harvard Medical School, McLean Hospital, Belmont, Mass., also is available on the For The Media website.
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Journal
JAMA Psychiatry