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Heroin Overdose Data

Heroin is a synthetic, highly addictive opioid that can produce intense feelings of euphoria.

Heroin Use

From 2010-2016, heroin-related deaths increased by more than five times.

Heroin use 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 During 2015, around 828,000 persons in the United States (12 years or older) used heroin in the past year, which is an estimated rate of 0.3 per 100 persons. And in 2014, more than 11,000 hospitalizations occurred for unintentional, heroin-related poisonings. 2

Heroin-Related Overdose Deaths

As heroin use has increased, so have heroin-related overdose deaths:

  • Heroin-related overdose deaths increased fivefold from 2010 to 2016.
  • From 2015 to 2016, heroin overdose death rates increased by 19.5%, with nearly 15,500 people dying in 2016.
  • 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 2015.3

Risk Factors

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 the transition from prescription opioid non-medical use to heroin use may be part of the progression to addiction.4

  • More than nine in 10 people who used heroin also used at least one other drug. 1
  • Among new heroin users, approximately three out of four report having abused prescription opioids prior to using heroin.5
  • Among people presenting for treatment for addiction to opioids, and who initiated use of an opioid in 2015, about two out of three started with prescription opioids.6

Heroin Overdose Death Rates.  Age-adjusted deaths per 100,000 population for heroin from 2014 to 2015, by census region of residence. Northeast*: 3,461 deaths in 2015. 5.1 in 2014, 6.3 in 2015. Midwest*: 3,959 deaths in 2015, 2.4 in 2014, 3.2 in 2015. South*: 3,722 deaths in 2015, 2.4 in 2014, 3.2 in 2015. West*: 1,847 deaths in 2015, 2.2 in 2014, 2.4 in 2015. United States*: 12,989 deaths in 2015, 3.4 in 2014, 4.1 in 2015. SOURCE: CDC/NCHS, National Vital Statistics System, Mortality. CDC WONDER, Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://wonder.cdc.gov/. *Statistically significant at p<0.05 level.
  • 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.2

 

References

  1. Centers for Disease Control and Prevention. Vital Signs: Today’s Heroin Epidemic – More People at Risk, Multiple Drugs Abused. MMWR 2015.
  2. Centers for Disease Control and Prevention. Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, 2017. Surveillance Special Report 1. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2017.
  3. Seth P, Scholl L, Rudd RA, Bacon S. Increases and Geographic Variations in Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants with Abuse Potential – United States, 2015-2016. MMWR Morb Mortal Wkly Rep. ePub: 29 March 2018.
  4. Compton WM, Jones CM, and Baldwin GT. 2016. Understanding the Relationship between Prescription Opioid and Heroin Abuse. NEJM.
  5. 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. doi:10.1001/jamapsychiatry.2014.366
  6. Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addict Behav. 2017 Nov;74:63-66.
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