U.S. heroin use nearly doubled over two decades

(HealthDay)—Nearly twice as many people in the United States used heroin in 2018 as did in 2002, a new government study shows.

"I think the rise in heroin use is probably precipitated by prescription opioid abuse. People tend to move from prescription opioids to heroin because it's cheaper and easier to obtain," said Dr. Lawrence Brown Jr., an addiction treatment specialist. He's CEO of START Treatment and Recovery Centers in New York City, and wasn't involved in the new study.

During the same time period, deaths from heroin overdoses also jumped, from just under 2,100 deaths in 2002 to more than 15,000 deaths in 2018, according to background information in the study.

Heroin is an illegal and highly addictive opioid, according to the U.S. Centers for Disease Control and Prevention. The CDC has reported that those most at risk for heroin addiction include people addicted to prescription opioids; people addicted to cocaine, marijuana or alcohol; men; white people; people aged 18 to 25; and people living in urban areas.

People who are addicted to prescription opioids may turn to heroin as a replacement drug if they have difficulty getting their prescriptions, Brown said. People usually start by smoking heroin, then snorting it, and finally injecting it to increase the high.

Every day, an average of 130 Americans dies due to an opioid overdose (including heroin), the CDC said.

Data for the latest study came from a national survey of adults aged 18 and older. More than 800,000 people responded during the 17-year study.

The researchers found that:

• Heroin use increased from 0.17% in 2002 to 0.32% in 2018.
• Heroin injections went up from 0.09% in 2002 to 0.17% in 2018.
• Heroin use disorder jumped from 0.10% in 2002 to 0.21% in 2018.

One possible bright spot: The researchers noted that the rise in heroin use appeared to plateau between 2016 and 2018.

The findings were published Feb. 11 in the Journal of the American Medical Association.

According to Dr. Soteri Polydorou, medical director of addiction services at Northwell Health in New Hyde Park, N.Y., "Findings such as these continue to support the importance of ensuring access to evidence-based medications utilized to treat opioid use disorder."

Polydorou, who was not involved with the new study, noted that there are effective therapies, including medications to treat those with heroin addiction or other opioid disorders.

"Patients open to considering treatment for an opioid use disorder should have prompt access to initiating and continuing treatment with the use of medications in various clinical settings, such as ambulatory clinics, emergency departments, inpatient settings, as well as when seeking treatment from specialty addiction services," Polydorou advised.

Brown said there needs to be greater availability of medications to treat opioid addiction, as well as the medications to treat overdose.

"We haven't come as far in providing treatment as we need to. It's not always easy to find an accredited program in your area. It's changing, but not fast enough," Brown said.

The researchers—from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. National Institutes of Health—said the findings point to the need for greater access to HIV and hepatitis testing and treatment, as well as for programs that provide free sterile needles. These viruses can be spread when people share needles.

Medications that can treat opioid use disorder also need to be made more available, Dr. Beth Han of SAMHSA, and her colleagues said. And efforts to prevent opioid misuse and abuse need to be stepped up, too.

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