Magazine article Clinical Psychiatry News

Marked Shift Seen in Demographics of Heroin Users

Magazine article Clinical Psychiatry News

Marked Shift Seen in Demographics of Heroin Users

Article excerpt


The demographics of heroin users have shifted profoundly in recent years, according to a retrospective analysis involving more than 2,700 people.

Heroin has migrated out of young minority populations in lower-class city neighborhoods, and users are now far more likely to be white, middleclass men and women in their late 20s living in suburban, small-town, or rural areas, wrote Theodore J. Cicero, Ph.D., of the department of psychiatry, Washington University in St. Louis (JAMA Psychiatry 2014 May 28 [doi: 10.1001/jamapsychiatry.2014.366]).

Noting the paucity of systematic studies of the demographics of today's heroin users, Dr. Cicero and his colleagues analyzed data from the ongoing Survey of Key Informants' Patients (SKIP) program, in which 150 publicly and privately funded treatment centers (the key informants) recruit patients/ clients to complete anonymous surveys about their substance use. The surveys cover all 48 contiguous states.

Dr. Cicero and his colleagues reviewed the survey responses of 2,797 self-reported heroin users entering treatment in 2010-2013. Most (86.4%) said they used heroin at least once a day, and many (66%) said they had concurrently abused prescription opioids during the preceding month.

Three-fourths of the respondents who began heroin use during the past decade said they had begun by abusing a prescription opioid, usually OxyContin. In contrast, about 80% of those who began using heroin in the 1960s and 1970s said they initiated their drug use with heroin itself. Fifty years ago, the average age at first use of heroin was 16 years; now it is 23 years.

A subset of 54 respondents who agreed to more detailed online interviews explained why they progressed from prescription opioids to heroin. A total of 98% said they considered the 'high" from heroin to be superior to that from prescription opioids, and 94% said that heroin was far less expensive and far easier to obtain. …

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