28 States See Heroin Death Rates Double in Two Years
Investigating Opioid Overdose Rates
In February 2014, the CDC invited state health departments to submit mortality files from 2008 to 2012. As well as counts of all overdoses, the data included documentation of the specific substance involved, allowing researchers to identify prescription opioid and heroin deaths specifically (although 22 percent of overdose reports didn’t include this data). The analysis covered 28 states, representing 56 percent of the U.S. population. The data showed a broad increase in heroin deaths from 2010, so the CDC focused on 2010 to 2012 for the purposes of the report.
Heroin Overdose Rate Doubles in Two Years
The core finding is that for the 28 states, the heroin death rate went from 1 to 2.1 per 100,000 people from 2010 to 2012. Increases in heroin deaths were present in every subgroup considered in the research (both sexes and age groups), as well as in all racial and ethnic groups (except for Native Americans and Alaska Natives). There were some differences, though. For example, in 2012, almost four times as many men as women died from heroin overdose, and the highest overdose rate was seen in 25- to 34-year-olds. The death rate didn’t decrease in any state, but the increases were larger in the Northeast and South. The overall rate for drug overdose deaths also increased slightly, from 13 to 13.6 per 100,000.
Prescription Pills and Heroin Deaths
Prescription opioid medicines like OxyContin and Vicodin interact with the brain in the same way as heroin, and they’re chemically very similar. Now some medicines are using abuse-deterrent formulations (to prevent crushing or decrease solubility), and states are cracking down on “doctor shopping” via prescription drug monitoring programs, so some users are starting to struggle to get high from prescription meds. Heroin, by comparison, is both cheaper and easier to obtain, explaining why a relationship between opioid medication abuse and heroin abuse is to be expected. In fact, three-quarters of new heroin users report prior abuse of prescription opioids.
Although this study found an overall decrease in opioid painkiller-related deaths, from 6 to 5.6 per 100,000 between 2010 and 2012, it must be noted that this is still considerably higher than the number of deaths from heroin. Opioid painkiller deaths decreased by 12.4 percent in men over the study period, but the death rate among men was still 1.4 times that seen in women. For all ages under 45, the opioid painkiller death rate decreased, but for 55- to 64 year-olds it increased, indicating that the issue is especially pronounced in older Americans. Regionally, only the South saw a decrease in painkiller overdose deaths.
It may be expected that increases in heroin overdose deaths would be associated with decreases in opioid painkiller overdoses, as users switched over from medication to the illicit drug, but the data don’t suggest that is the case. There was actually a positive association between the two, meaning that increases in heroin overdose rates happened alongside increases in opioid painkiller deaths. This suggests that although some users are switching to heroin from pills, there are always new prescription pill users to take their place, and that increased addiction leads to more deaths from both licit and illicit opioids.
The authors comment, “The findings in this report indicate a growing problem with heroin overdoses superimposed on a continuing problem with [opioid pain reliever] overdoses.”
A Still-Growing Problem
The increase in heroin overdoses is the continuation of the prescription medication abuse problem that’s been on the increase in the U.S. in recent decades. As more Americans get hooked on opioids, ordinarily after being prescribed narcotic painkillers for a legitimate medical reason, more of them become addicted, make the switch to heroin and potentially die of an overdose. As well as documenting the rise in prevalence of the latter steps in this trajectory, this research also reminds us that more people die from overdose of the legal, doctor-prescribed form of the drug than the street-corner variety. In any form, opioids are causing havoc across America.