Heroin users 90% white, living outside urban areas

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NEW YORK -- The image of the heroin user is changing, according to researchers who say the great majority are now white men and women who mostly live outside the cities.

Their study, published Wednesday in JAMA Psychiatry, tracked data from almost 2,800 heroin users and found that first-time users are now generally older than those who began taking the drug in the 1960s. About 90 percent are white, according to the study, and 75 percent now live in non-urban areas.

The research also confirmed a link between the rise of opioid abuse and the growing use of heroin that had been noted in earlier studies. Heroin use has jumped 80 percent to 669,000 users from 2007 to 2012, according to the National Survey on Drug Use and Health, after being relatively stable since 2000.

Heroin "is not confined to inner-city areas," said Theodore Cicero, the lead author and vice chairman for research at Washington University School of Medicine in St. Louis. "It's now a mainstream problem."

The uptick in usage is attributed to users waning off of prescription opioids and turning to heroin because it's cheaper and more readily accessible than prescription drugs, the researchers said in their report.

After widespread prescription drug abuse in the 1990s, prices for prescription drugs have surged. Companies have also made the pills more difficult to manipulate, leading users to choose heroin as an alternative even though it carries a lot of risk, Mr. Cicero said in a telephone interview.

"It doesn't have the safety of a prescription drug," he said. Because heroin is often cut with other chemicals, and injected through non-sterile solutions, users are prone to infections that can be fatal as well as deadly overdoses.

"There's a lot of interest in how whites are getting so many opioids," said Meghan Ralston, harm reduction manager for the Drug Policy Alliance. "That reflects what research shows -- that blacks and minorities are not even prescribed opioids at the same rates."

The study found most people who began using the drug in the last decade were 23-years-old on average. That compares with the 1960s, the researchers wrote, when users were 16-years-old on average.

The majority of heroin users surveyed in the study, 94 percent, said that if there were given the choice, they would prefer prescription pills to heroin.

Mr. Cicero said it's likely that most people are using the drug as self-medication to treat depressive tendencies. Knowing this, better mental health and depression treatments in schools and communities could curb rates of heroin use.



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