Heroin Overdose Data
Heroin is a semi-synthetic, highly addictive opioid that is made from morphine, a substance taken from opium poppy plants, and can produce intense feelings of euphoria.
The use of heroin has been increasing in recent years among men and women, most age groups, and all income levels. Some of the greatest increases have occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes.1 In 2016, nearly 948,000 people in the United States (12-years old or older) reported using heroin in the past year, which is an estimated rate of 0.4 per 100 persons. And in 2015, 81,326 emergency department visits occurred for unintentional, heroin-related poisonings in America, which is an estimated rate of almost 26 per 100,000 people.2
Past misuse of prescription opioids is the strongest risk factor for starting heroin use, especially among people who became dependent upon or abused prescription opioids in the past year. This indicates that widespread opioid exposure and increasing rates of opioid addiction have played a major role in the growth of heroin use.
- In 2013, more than nine in 10 people who used heroin also used at least one other drug. 1
- Among new heroin users during 2000 to 2013, approximately three out of four report having misused prescription opioids prior to using heroin.3
Heroin-Related Overdose Deaths
As heroin use has increased, so have heroin-related overdose deaths:
- During 2016, almost 15,500 people died from drug overdoses involving heroin in the United States, a rate of almost 5 deaths for every 100,000 Americans.5
- Heroin-related overdose deaths increased five-fold from 2010 to 2016.4
- From 2015 to 2016, heroin overdose death rates increased by almost 20 percent6
- In 2016, males aged 25-44 had the highest heroin death rate at 15.5 per 100,000, which was an increase of 17.4% from 2015.5
2015-2016 Overdose Map
Large central metro—Counties in metropolitan statistical areas of 1 million or more population that:
- Contain the entire population of the largest principal city
- Have their entire population contained in the largest principal city
- Contain at least 250,000 inhabitants of any principal city
- Large fringe metro—Counties of 1 million or more population that did not qualify as large central metro counties.
- Medium metro—Counties of populations of 250,000 to 999,999.
- Small metro—Counties of populations less than 250,000.
- Micropolitan—Counties in micropolitan statistical areas that have a population of at least 10,000 but less than 50,000.
- Noncore—Nonmetropolitan counties that did not qualify as micropolitan.
Categories of 2013 NCHS Urban-Rural Classification Scheme for Counties (https://www.cdc.gov/nchs/data_access/urban_rural.htm)
Age-adjusted death rates for heroin are plotted above by urbanization classification of residence for 2015 to 2016. Rates increased significantly for all areas – large central metro (20.5%), large fringe metro (22.0%), and medium metro (14.0%), small metro (15.6%), micropolitan (12.5%), and noncore (23.8%) areas. The heroin overdose death rate also increased in the United States overall—a statistically significant 19.5% increase from 2015 to 2016, with a total of 15,469 deaths in 2016. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug overdose deaths are identified using underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Drug overdose deaths, as defined, that have heroin (T40.1) as a contributing cause. Age-adjusted death rates were calculated using the direct method and the 2000 standard population.7
- Jones CM, Logan J, Gladden RM, Bohm MK. Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013 (https://wwwdev.cdc.gov/mmwr/preview/mmwrhtml/mm6426a3.htm?s_cid=mm6426a3_w). MMWR 2015; 64(26):719-725.
- Centers for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States. Surveillance Special Report 2. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2018.
- Cicero TJ, Ellis MS, Surratt, HL. The Changing Face of Heroin Use in the United States. A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry 2014; 71(7):821-826.
- Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addict Behav. 2017 Nov; 74:63-66.
- Seth P, Scholl L, Rudd RA, Bacon S. Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants – United States, 2015-2016 . MMWR Morb Mortal Wkly Rep. March 2018; 67(12): 349–358.
- Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov .
- Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.