This week the CDC has released an MMWR early release, and Vital Signs report, on the growing heroin crisis in the United States. Although its use had been in decline in the United States for several decades - supplanted by cocaine, meth, and prescription opioids - heroin use and overdose deaths are once again on the rise.
The easy availability of prescription opioids – like hydrocodone and oxycodone – during the early 2000s led to an increase in opioid addiction nationwide, and when crackdowns on their sale drove prices up and supplies down, heroin once again became an attractive alternative.
While cheaper, injecting heroin is more dangerous than injecting prescription opioids, as the strength and quality of heroin varies greatly on the street, making overdoses more likely. The result is, we are seeing a major increase in the number of drug overdoses from heroin.
And whether heroin or prescription opioids, the dangers of injecting drugs go well beyond drug overdoses, as illustrated by the epidemic of HIV and HCV infections reported this spring and summer in Scott County Indiana (see CDC HAN Advisory & MMWR: HIV & HCV Among Injectable Drug Users).
Our first stop is the CDC’s MMWR early release entitled:
- Heroin use in the United States increased 63% from 2002 through 2013. This increase occurred among a broad range of demographics, including men and women, most age groups, and all income levels.
- As heroin use, abuse, and dependence have increased, so have heroin-related overdose deaths. From 2002 through 2013, the rate of heroin-related overdose deaths nearly quadrupled.
- Persons often use heroin with other substances, including marijuana, cocaine, alcohol, and opioid pain relievers. This practice is especially dangerous.
- Groups with an increased risk for heroin abuse or dependence include men, persons aged 18–25 years, non-Hispanic whites, persons with annual household income less than $20,000, Medicaid recipients, and the uninsured.
- States play a key role in addressing heroin use, abuse, dependence, and overdose. States can implement strategies to reduce the abuse of opioid pain relievers, the strongest risk factor for heroin abuse or dependence. They can also improve access and insurance coverage for medication-assisted treatment for opioid use disorders and expand access and training for naloxone administration to reverse overdoses.
- Additional information is available at http://www.cdc.gov/vitalsigns.
On Tuesday CDC Director Dr. Thomas Frieden held a 30-minute press briefing on this month’s Vital Signs report – the transcript and link to the audio recording follow:
Press Briefing Transcript
Tuesday, July 7, 2015 at 13:00 E.T.
And our last stop, a link and some excerpts from this month’s Vital Signs report:
More people at risk, multiple drugs abused
Heroin use has increased across the US among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes. Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioid painkillers. As heroin use has increased, so have heroin-related overdose deaths. Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013. States play a central role in prevention, treatment, and recovery efforts for this growing epidemic.
- Address the strongest risk factor for heroin addiction: addiction to prescription opioid painkillers.
- Increase access to substance abuse treatment services, including Medication-Assisted Treatment (MAT), for opioid addiction.
- Expand access to and training for administering naloxone to reduce opioid overdose deaths.
- Ensure that people have access to integrated prevention services, including access to sterile injection equipment from a reliable source, as allowed by local policy.
- Help local jurisdictions to put these effective practices to work in communities where drug addiction is common.
Want to learn more? www.cdc.gov/vitalsigns/heroin