A new report from the Centers for Disease Control and Prevention (CDC) suggests that even though abuse of prescription opioids seems to be leveling off in America, heroin use has risen dramatically, with increasingly fatal results.
Data collected from 28 U.S. states shows the death rate for heroin overdose as nearly tripling from 2010 to 2013, so that in 2013 it reached 8,275. While that’s just over half the number of deaths that year from opioid poisoning, fatalities from heroin had been less than a fifth of that number in 2010 — the year when opioid overdose deaths reached their peak at 16,651.
What’s causing the spike in heroin deaths? “Unfortunately, we don’t know the reason why. That’s the big question,” said Holly Hedegaard, MD, an injury epidemiologist at the National Center for Health Statistics and a co-author of the report, in comments to Aljazeera America.
From Prescription Opioids to Heroin
Some experts outside the study believe that as restrictions on prescription opioids have increased, drug abusers have turned to heroin as a cheaper, more readily available alternative.
“Heroin’s cheaper and easily available, and we’re seeing increases in places that traditionally haven’t had much heroin use,” said Kelly Dunn, PhD, an assistant professor of Behavioral Pharmacology at Johns Hopkins University School of Medicine. “Once people are dependent on prescription drugs,” Dr. Dunn told U.S. News, “it’s very rare for them to stop on their own with no treatment. If the drugs are suddenly less abusable, they will switch to something else that will alleviate withdrawal.”
“We are seeing heroin deaths sky-rocketing because we have an epidemic of people addicted to opioids,” said Andrew Kolodny, MD, chief medical officer of the non-profit drug and alcohol rehabilitation organization, Phoenix House, in comments to Time. “There are new markets like suburbs, where heroin didn’t used to exist.”
Heartland Hit the Hardest
The CDC report found deaths from heroin overdose rising in all regions of the U.S. from 2000 to 2013, with the Midwest being the hardest hit and the Northeast a close second. In 2000, the 285 heroin overdose deaths accounted for only about 0.4 out of every 100,000 deaths in the heartland, but by 2013 it was nearly 10 times that, directly blamed in nearly 2,791 fatalities.
In the Northeast in 2000, deadly heroin overdoses numbered slightly less than 1 per 100,000 deaths there, but had more than quadrupled by 2013, causing 2,141 fatalities. Meanwhile, the death rates in the South more than tripled — from 0.5 of every 100,000 deaths to 1.7 — while those in the West doubled.
At the same time, the profile of the typical heroin overdose victim also shifted. In 2000, those dying from heroin overdose most often were non-Hispanic blacks between the ages of 45 and 64. By 2013, most heroin overdose victims were non-Hispanic whites aged 18 to 44, who died at a rate of 7 per 100,000 deaths.
However, none of the demographic groups studied showed any slowdown. Increases in heroin fatalities were seen among all whites, blacks and Hispanics in the 18-to-64 demographic.
Men, Women and Heroin Death: Who’s at Risk?
Men were especially vulnerable to heroin overdose, dying at nearly four times the rate of women in 2013, though according to the numbers since 2000, men have typically been at more risk. But at the dawn of the century, that rate was barely above 1 per 100,000 deaths, while fatalities among women were only about a fifth of that.
Despite the still greater risk for men, the death rate among women has risen alarmingly. While men were about four times as likely to die of a heroin overdose in 2013 as in 2000, with fatalities increasing from 1,563 in 2000 to 6,525 in 2013, women were six times as likely, with their number of deaths jumping from 279 in 2000 to 1,732 in 2013.