Heroin has long been considered a problem of poor minorities. But with the current overdose epidemic, this study takes a second look at this assumption of who does, and does not, use heroin.
Heroin has long been considered a problem of poor minorities. But with the current overdose epidemic, this study takes a second look at this assumption of who does, and does not, use heroin.
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According to mainstream media reports, heroin use disorder was once considered a problem that was confined to poor, inner city, minority populations. In recent years, heroin use disorder has become more visible among populations who reside in affluent suburban and rural areas. This study empirically tested if epidemiological trends that people noticed over the previous years remain true today.
This study analyzed data from the ongoing nationwide Survey of Key Informants’ Patients (SKIP) Program.
The SKIP Program consists of more than 150 publicly and privately funded treatment centers located in 48 states that recruit adult patients to complete an anonymous survey.
Patients in the SKIP program must meet DSM-IV criteria for an opioid use disorder (prescription opioid drug or heroin). Patients were included in the analysis if they entered the program between 2010-2013 and had a primary heroin use disorder which resulted in 2,797 participants. At the time of survey completion, the majority of participants included in the analysis were in their early 30’s, white (79.5%), and male (56%). Using retrospective reports, the researchers assessed if heroin versus prescription opioids were the first opioid ever used by the patient and if this trend changed over the decades. The researchers also assessed whether there were differences in terms of sex, race, and age of first use, depending on what decade the person first began using opioids.
In addition, to obtain a more detailed perspective on these trends, a subset of 54 patients who currently have a heroin use disorder plus a lifetime history of prescription opioid use disorder responded online to a series of open-ended questions about their opioid use. The researchers sought to determine:
1) why they chose to use heroin more frequently than prescription opioids, and
2) whether they prefer to use heroin or prescription opioids in a hypothetical world where cost and accessibility would not limit drug selection.
This study showed significant demographic differences between patients with heroin use disorder who initiated using opioids 40-50 years ago versus patients who initiated use in recent decades.
Patients with a heroin use disorder who began regular opioid use 40-50 years ago often initiated use with heroin (compared to prescription opioids), were about 16 years old when they first used an opioid, predominantly male, and equally likely to be white or nonwhite.
VS.
Patients who began regular opioid use in recent decades often initiated use with prescription opioids, were almost 23 years old when they first used an opioid, equally likely to be male or female, overwhelmingly white, & living in small urban or non-urban areas.
These findings can be compared to mainstream media reports suggesting individuals suffering from heroin use disorder are from the inner city, poor, & of ethnic minority background.
Contrary to media speculation which may have racialized heroin use disorder as minority problem, this data suggests that ethnicity was not a factor among treatment seeking individuals who began their first regular opioid use prior to the 1980’s.
In fact, prior to the 1980’s individuals were equally likely to be white or nonwhite. Since then, the percentage of treatment seeking individuals who experienced their first regular opioid use were significantly more likely to be white.
This represents a change in the last 40-50 years. This may be because prescription opioids are more readily available to individuals, particularly as an initial opioid to use given the common perception that since prescription opioids are legal, they are considered more trustworthy and predictable if used. The availability of opioids has created an additional pathway into heroin and prescription opioid addiction.
The three main reasons why individuals have chosen heroin as their primary drug of choice:
Half the participants would prefer prescription opioids over heroin if there were no limiting factors to consider such as price and availability. Participants reported that prescription opioids produce a “cleaner” high and are more safe than heroin given it is more difficult of overdose.
Cicero, T. J., Ellis, M. S., Surratt, H. L., Kurtz, S. P. (2014). The changing face of heroin use in the United States a retrospective analysis of the past 50 years. JAMA Psychiatry, 71(7), 821-826.
l
According to mainstream media reports, heroin use disorder was once considered a problem that was confined to poor, inner city, minority populations. In recent years, heroin use disorder has become more visible among populations who reside in affluent suburban and rural areas. This study empirically tested if epidemiological trends that people noticed over the previous years remain true today.
This study analyzed data from the ongoing nationwide Survey of Key Informants’ Patients (SKIP) Program.
The SKIP Program consists of more than 150 publicly and privately funded treatment centers located in 48 states that recruit adult patients to complete an anonymous survey.
Patients in the SKIP program must meet DSM-IV criteria for an opioid use disorder (prescription opioid drug or heroin). Patients were included in the analysis if they entered the program between 2010-2013 and had a primary heroin use disorder which resulted in 2,797 participants. At the time of survey completion, the majority of participants included in the analysis were in their early 30’s, white (79.5%), and male (56%). Using retrospective reports, the researchers assessed if heroin versus prescription opioids were the first opioid ever used by the patient and if this trend changed over the decades. The researchers also assessed whether there were differences in terms of sex, race, and age of first use, depending on what decade the person first began using opioids.
In addition, to obtain a more detailed perspective on these trends, a subset of 54 patients who currently have a heroin use disorder plus a lifetime history of prescription opioid use disorder responded online to a series of open-ended questions about their opioid use. The researchers sought to determine:
1) why they chose to use heroin more frequently than prescription opioids, and
2) whether they prefer to use heroin or prescription opioids in a hypothetical world where cost and accessibility would not limit drug selection.
This study showed significant demographic differences between patients with heroin use disorder who initiated using opioids 40-50 years ago versus patients who initiated use in recent decades.
Patients with a heroin use disorder who began regular opioid use 40-50 years ago often initiated use with heroin (compared to prescription opioids), were about 16 years old when they first used an opioid, predominantly male, and equally likely to be white or nonwhite.
VS.
Patients who began regular opioid use in recent decades often initiated use with prescription opioids, were almost 23 years old when they first used an opioid, equally likely to be male or female, overwhelmingly white, & living in small urban or non-urban areas.
These findings can be compared to mainstream media reports suggesting individuals suffering from heroin use disorder are from the inner city, poor, & of ethnic minority background.
Contrary to media speculation which may have racialized heroin use disorder as minority problem, this data suggests that ethnicity was not a factor among treatment seeking individuals who began their first regular opioid use prior to the 1980’s.
In fact, prior to the 1980’s individuals were equally likely to be white or nonwhite. Since then, the percentage of treatment seeking individuals who experienced their first regular opioid use were significantly more likely to be white.
This represents a change in the last 40-50 years. This may be because prescription opioids are more readily available to individuals, particularly as an initial opioid to use given the common perception that since prescription opioids are legal, they are considered more trustworthy and predictable if used. The availability of opioids has created an additional pathway into heroin and prescription opioid addiction.
The three main reasons why individuals have chosen heroin as their primary drug of choice:
Half the participants would prefer prescription opioids over heroin if there were no limiting factors to consider such as price and availability. Participants reported that prescription opioids produce a “cleaner” high and are more safe than heroin given it is more difficult of overdose.
Cicero, T. J., Ellis, M. S., Surratt, H. L., Kurtz, S. P. (2014). The changing face of heroin use in the United States a retrospective analysis of the past 50 years. JAMA Psychiatry, 71(7), 821-826.
l
According to mainstream media reports, heroin use disorder was once considered a problem that was confined to poor, inner city, minority populations. In recent years, heroin use disorder has become more visible among populations who reside in affluent suburban and rural areas. This study empirically tested if epidemiological trends that people noticed over the previous years remain true today.
This study analyzed data from the ongoing nationwide Survey of Key Informants’ Patients (SKIP) Program.
The SKIP Program consists of more than 150 publicly and privately funded treatment centers located in 48 states that recruit adult patients to complete an anonymous survey.
Patients in the SKIP program must meet DSM-IV criteria for an opioid use disorder (prescription opioid drug or heroin). Patients were included in the analysis if they entered the program between 2010-2013 and had a primary heroin use disorder which resulted in 2,797 participants. At the time of survey completion, the majority of participants included in the analysis were in their early 30’s, white (79.5%), and male (56%). Using retrospective reports, the researchers assessed if heroin versus prescription opioids were the first opioid ever used by the patient and if this trend changed over the decades. The researchers also assessed whether there were differences in terms of sex, race, and age of first use, depending on what decade the person first began using opioids.
In addition, to obtain a more detailed perspective on these trends, a subset of 54 patients who currently have a heroin use disorder plus a lifetime history of prescription opioid use disorder responded online to a series of open-ended questions about their opioid use. The researchers sought to determine:
1) why they chose to use heroin more frequently than prescription opioids, and
2) whether they prefer to use heroin or prescription opioids in a hypothetical world where cost and accessibility would not limit drug selection.
This study showed significant demographic differences between patients with heroin use disorder who initiated using opioids 40-50 years ago versus patients who initiated use in recent decades.
Patients with a heroin use disorder who began regular opioid use 40-50 years ago often initiated use with heroin (compared to prescription opioids), were about 16 years old when they first used an opioid, predominantly male, and equally likely to be white or nonwhite.
VS.
Patients who began regular opioid use in recent decades often initiated use with prescription opioids, were almost 23 years old when they first used an opioid, equally likely to be male or female, overwhelmingly white, & living in small urban or non-urban areas.
These findings can be compared to mainstream media reports suggesting individuals suffering from heroin use disorder are from the inner city, poor, & of ethnic minority background.
Contrary to media speculation which may have racialized heroin use disorder as minority problem, this data suggests that ethnicity was not a factor among treatment seeking individuals who began their first regular opioid use prior to the 1980’s.
In fact, prior to the 1980’s individuals were equally likely to be white or nonwhite. Since then, the percentage of treatment seeking individuals who experienced their first regular opioid use were significantly more likely to be white.
This represents a change in the last 40-50 years. This may be because prescription opioids are more readily available to individuals, particularly as an initial opioid to use given the common perception that since prescription opioids are legal, they are considered more trustworthy and predictable if used. The availability of opioids has created an additional pathway into heroin and prescription opioid addiction.
The three main reasons why individuals have chosen heroin as their primary drug of choice:
Half the participants would prefer prescription opioids over heroin if there were no limiting factors to consider such as price and availability. Participants reported that prescription opioids produce a “cleaner” high and are more safe than heroin given it is more difficult of overdose.
Cicero, T. J., Ellis, M. S., Surratt, H. L., Kurtz, S. P. (2014). The changing face of heroin use in the United States a retrospective analysis of the past 50 years. JAMA Psychiatry, 71(7), 821-826.
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