Article Provided by: Alan Stevens, MSW, LSW, ACSW ~ CEO of Behavioral Health of the Palm Beaches
For almost three decades, the United States has been in the midst of a deadly and pervasive prescription drug addiction epidemic. The Centers for Disease Control estimates that 60% of fatal drug overdoses are now caused by prescription drugs[i].
It is reported that prescription opioids are now responsible for more deaths than cocaine and heroin combined. As intervention by law enforcement strengthens and prevention and treatment efforts continue to evolve, many victims of prescription abuse have turned to heroin as a more accessible and comparatively cost-effective alternative.
The recent scarcity of prescription painkillers has caused individuals from all backgrounds to gravitate toward heroin as a substitute.
Similarity of Effects and Symptoms
Prescription opioids and heroin have incredibly similar effects on the brain’s chemistry. Both drugs bind to receptors in the brain and increase levels of dopamine, which is ultimately responsible for the coveted euphoric feeling that most people experience their first time using heroin.
This is what makes prescription opioids so effective in the treatment of severe pain. Abusers quickly develop a tolerance for and require larger and more frequent doses of the drugs in order to emulate that same initial effect.
These larger doses slow down breathing, often to the point of cessation, and cause patients to fall into respiratory failure. This is one of the most common causes of prescription-related death.
Populations at Highest Risk
Communities all over the country are reporting rises in heroin-related deaths. In Florida – a state once regarded by many as the prescription drug addiction capital of the United States – heroin-related fatalities nearly doubled in 2012[ii].
According to a recent report released from the Florida Medical Examiner, this 88% increase in heroin-related fatalities corresponds to a noticeable statewide decline in OxyContin abuse.
As prescription drug abuse has impacted practically every single demographic, new groups of people who may have been previously insulated from heroin are now on the hunt for an alternative for the pills they can no longer acquire. This includes individuals of all backgrounds, income-levels and practically every age group.
The Resurgence of Heroin in the United States
Once regarded as a decidedly urban drug threat, heroin’s recent resurgence has had a particularly devastating impact on suburban teenagers. Many teens that started off purchasing illegal prescriptions from friends or stealing them from their parents’ medicine cabinets are now turning to heroin because it has become too difficult or costly to procure pills.
According to a recent report from the Centers for Disease Control, 3 in every 100 teenagers have used heroin at least once[iii].
Almost half of all young people who have admitted to using heroin reported abusing prescription painkillers first. Over 25% teenagers have revealed that they could easily obtain heroin[iv].
Though it has spread to the suburbs at an alarming rate, heroin is still a pervasive and deadly problem in urban communities as well. A 2012 study from the Illinois Consortium of Drug Policy solidified Chicago’s continued standing as the top-ranked city for heroin overdoses, citing 24,630 heroin-related hospital admissions in 2010[v]. The report also forecasted a continued increase in statewide heroin abuse based upon current data and increasing incidents in the city’s suburbs.
Heroin Use in Urban Areas
Other urban areas, such as New York City have also experienced a sharp spike in heroin abuse. According to a September report issued by the New York City Department of Health and Mental Hygiene, New York City heroin-related fatalities have been on the rise since 2010, increasing 71% from 2010 to 2012[vi].
Also in 2012, heroin was the drug most commonly involved in New York City overdose deaths. Additionally, heroin deaths increased 90% among New York City residents who under 34 years of age[vii]. This trend corresponds to a decrease in deaths related to opioid painkillers in the area.
Prevention, Treatment and Education
Patients have the best chance of recovering from heroin addiction through inpatient care. Treatment must include a blend of medically assisted detoxification and behavior modification to give patients the best chance at not only getting clean, but staying that way. Outpatient programs offer comparatively little in the way of relapse prevention skills or adequate preparation for life after treatment.
The institutional crackdown on illegal prescription painkiller abuse has left a void easily filled by heroin. As time goes on and heroin’s presence becomes more and more pervasive, it is critical that the treatment and law enforcement communities recognize this startling correlation.
Article Published December 4, 2013
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on June 5th, 2014
Published on AddictionHope.com, Help for Addictions Online