White Opioid Users Most Likely to Turn to Heroin
Heroin use has increased significantly in the U.S. in the 21st century. Much of the rise in use has been fueled by misusers of prescription opioid medications who transition into heroin consumption. In a study published in April 2015 in the journal Drug and Alcohol Dependence, researchers from two American universities used data from a large-scale project called the National Survey on Drug Use and Health to help determine which prescription opioid misusers have the highest chances of initiating consumption of heroin.
Prescription Opioid Misuse
Some prescription medication misusers have legitimate prescriptions for a given medication, but for recreational or misguided medical purposes begin consuming that medication in a manner not sanctioned by the prescribing doctor. Others don’t have a prescription for the medications they consume; instead, they obtain medications free of cost through relatives, friends or acquaintances who hold legitimate prescriptions. In addition, a relatively small number of misusers without legitimate prescriptions gain access by purchasing medications from a drug dealer or some other third party.
In the U.S., prescription opioid medications are misused far more often than other medications such as prescription stimulants, prescription sedative-hypnotics classified as tranquilizers or prescription sedative-hypnotics classified as sedatives. Public health officials trace the origins of the boom in opioid medication misuse to the early 1990s. From 1991 to 2011, the annual number of opioid prescriptions issued by U.S. doctors rose steadily from 76 million to 219 million, and Americans currently consume more opioid medications than any other national population in the world. The rise in opioid medication prescribing and misuse has been accompanied by a rise in harmful outcomes for individuals who improperly consume prescription opioids. The number of misusers seeking emergency room treatment more than doubled in the first decade of the 21st century. In addition, the number of people dying from prescription opioid overdoses increased by more than 200 percent between 1990 and 2010.
Link to Heroin Use
Heroin produces a mind-altering effect that, in its essence, differs very little from the effect produced by prescription opioid medications. However, since heroin consumption never takes place in a monitored medical context, the drug has a well-gained reputation as a public health danger. Evidence gathered by the National Institute on Drug Abuse indicates that people who misuse prescription opioid medications are generally at risk for transitioning into heroin consumption. Two main factors largely account for this risk: the declining cost of heroin throughout the U.S. and the relative difficulty of obtaining a reliable supply of prescription opioids. Many opioid medication misusers who initiate heroin consumption eventually become injection drug users, and thereby steeply increase their range of severely negative health outcomes.
Who Will Start Using Heroin?
In the study published in Drug and Alcohol Dependence, researchers from Columbia University and Brown University used National Survey on Drug Use and Health (NSDUH) figures from two separate timeframes—2002-2005 and 2008-2011—to track changes in the nationwide rate of transition from opioid medication misuse to heroin consumption. In addition, they used data from the 2008-2011 timeframe to determine which prescription opioid misusers have the greatest chances of initiating heroin use. All told, the researchers included data from 448,597 NSDUH participants.
After completing their analysis, the researchers concluded that NSDUH respondents who misused prescription opioids in the 2008 to 2011 timeframe were 89 percent more likely to transition into heroin use than respondents who misused prescription opioids just a few years earlier in the 2002 to 2005 timeframe. For people of all racial/ethnic backgrounds, rising levels of opioid medication misuse in the 2008 to 2011 timeframe were associated with heightened chances of ever using heroin, qualifying for a heroin-related diagnosis of opioid use disorder (opioid abuse and/or addiction) and initiating some form of heroin injection. However, in comparison to all other racial/ethnic groups, prescription opioid misusers with Caucasian ancestry experienced the largest spike in their odds of transitioning into heroin consumption.
While the study’s authors note the particular susceptibility to heroin consumption found among Caucasian Americans who misuse prescription opioids, they emphasize the fact that misusers of all racial/ethnic backgrounds have clearly elevated chances of initiating intake of the powerful street drug. For this reason, they urge public health officials to target intervention and prevention campaigns at all misusers of prescription opioids, regardless of racial/ethnic factors.