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Heroin

Today’s Heroin Epidemic

Heroin use has increased sharply across the United States 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.

Photo: upset young woman

How is heroin harmful?

  • Heroin is an illegal, highly addictive opioid drug.
  • A heroin overdose can cause slow and shallow breathing, coma, and death.
  • People often use heroin along with other drugs or alcohol. This practice is especially dangerous because it increases the risk of overdose.1
  • Heroin is typically injected but is also smoked and snorted. When people inject heroin, they are at risk of serious, long-term viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart.2

How big is the problem of heroin overdoses?

Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioids. Nearly all people who use heroin also use at least 1 other drug.3

As heroin use has increased, so have heroin-related overdose deaths – 15,482 people died in 2017 alone. Between 2010 and 2017, the rate of heroin-related overdose deaths increased by almost 400%.4

Since 2010, heroin overdose death rates have more than quadrupled.

Who is most at risk of heroin addiction?  Heroin use is part of a larger substance abuse problem. CDC Vital Signs www.cdc.gov/vitalsigns/heroin

  • People who are addicted to prescription opioid pain relievers
  • People who are addicted to cocaine
  • People without insurance or enrolled in Medicaid
  • Non-Hispanic whites
  • Males
  • People who are addicted to marijuana and alcohol
  • People living in a large metropolitan area
  • 18 to 25 year olds1
Responding to the Heroin Epidemic. Prevent people from starting heroin. Reduce prescription opioid painkiller abuse. Improve opioid painkiller prescribing practices and identify high-risk individuals early. Reduce heroin addiction. Ensure access to Medication-Assisted Treatment (MAT). Treat people addicted to heroin or prescription opioid painkillers with MAT which combines the use of medications (methadone, buprenophrine, or naltrexone) with counseling and behavioral therapies. Reverse heroin overdose. Expand the use of naloxone. Use naloxone, a life-saving drug that can reverse the effects of an opioid overdose when adminstered in time.

What can be done?

Reduce prescription opioid abuse

Prevent people from starting heroin by reducing prescription opioid abuse

  • Improve opioid prescribing practices and help identify individuals at high risk early.1
  • 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

 

Ensure access to prevention services

Ensure that people have access to integrated prevention services, including access to sterile injection equipment from a reliable source, as allowed by local policy.

 

Ensure access to Medication-Assisted Treatment

Reduce heroin addiction by ensuring access to Medication-Assisted Treatment (MAT)

  • Treat people addicted to heroin or prescription opioids with MAT which combines the use of medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies.1
  • People who are addicted to prescription opioids are 40 times more likely to also be addicted to heroin.3

 

Expand the use of naloxone

Reverse heroin overdose by expanding the use of naloxone

  • Use naloxone, a life-saving drug that can reverse the effects of an opioid overdose when administered in time.1
  • From 1999 to 2017, the number of heroin overdose deaths has increased by 7 times.4

References

  1. US Department of Health and Human Services. HHS takes strong steps to address opioid-drug related overdose, death and dependence. Press Release: March 26, 2015. http://www.hhs.gov/news/press/2015pres/03/20150326a.html.
  2. Substance Abuse and Mental Health Services Administration. Alcohol, Tobacco, and Other Drugs: Opioids. http://www.samhsa.gov/atod/opioids.
  3. Centers for Disease Control and Prevention. Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013. MMWR 2015; 64(26):719-725.
  4. Hedegaard H, Miniño AM, Warner M. Drug overdose deaths in the United States, 1999–2017. NCHS Data Brief, no 329. Hyattsville, MD: National Center for Health Statistics. 2018.
  5. National Institute on Drug Abuse. DrugFacts: Heroin. http://www.drugabuse.gov/publications/drugfacts/heroin.
  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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