Heroin abuse is actually still fairly rare in the United States, that is, when you compare it to painkiller addictions. Heroin use is on the rise, but along with that so is using prescription narcotics. The combination of rising use between the two has led to a new face of addiction. Previously untouched groups are now being affect.
In particular, the use of both heroin and prescription painkillers has increased among whites, especially young white men. Prescription painkiller misuse may serve as a gateway to heroin use with some prescription painkiller misusers transitioning to heroin once painkillers become too expensive or difficult to get.
Interchangeable Addictions: Heroin and Pain Pills
5.1 million Americans abuse painkillers and about 0.3 million Americans use heroin according to the National Institute on Drug Abuse (NIDA.) Because both are opiates there is a natural ability to switch between the two drugs. In almost all cases, the switch is from prescription drugs to heroin. The reason being that drug makers have introduced tamper resistant painkiller pills, which are impossible to crush, liquefy, and inject. Not only that but lawmakers have established more restrictions, such as prescription drug monitoring programs. Together these two things have resulted in greatly reduced access to pain pills.
Yet, even before these things were put in place, many people had become addicted to prescription pills. Then they were left without them right around the same time heroin was cheap and easy to get. Many of these people simply switched drugs.
What Do Heroin Addicts Look Like Today?
Those who only use heroin were the most socioeconomically disadvantaged, least likely to be white, least likely to have children living with them, least connected to religious services, least physically healthy and most likely to live in large urban communities. In fact, the group mirrored exactly what you would picture when you hear the word junkie.
While heroin users had more criminal justice system involvement than prescription drug abusers, those who use both heroin and prescription painkillers reported more mental health problems and higher rates of emergency room visits than those using one drug or the other. Most likely, those using both heroin and pills started using drugs in their teens, plus they were more likely to shoot rather than snort their drug. Using both heroin and prescription drugs was an indicator of a more serious substance abuse problem and potentially worse outcomes. That includes a greater risk of having co-occurring mental disorders, overdose, and/or HIV.
What About the Prescription Painkiller People?
They were the most connected to social institutions (marriage, religion, employment) and least socioeconomically disadvantaged. They had less criminal justice involvement and the best physical and mental health in the group. They had less involvement with the criminal justice system and they were less likely to live in large urban areas.
And now for these people, as the flow of heroin into their small cities and rural areas increase, they begin to switch drugs. Changing the fce not only of addiction but of heroin addiction itself.