Heroin Use Skyrockets in U.S.


Prescription painkillers are often a gateway to abuse of the drug, the CDC says.

Drugs are prepared to shoot intravenously by a user addicted to heroin on February 6, 2014 in St. Johnsbury Vermont.

A man prepares heroin in Vermont in 2014. Heroin-related overdose deaths increased 286 percent from 2002 to 2013, according to a new report.


By + More

Heroin-related overdose deaths in the U.S. have increased by nearly 300 percent in recent years, and a new report from the federal government shows people who use the drug are not confined to a particular income level or age group.

From 2002 to 2013, heroin overdose deaths in the country increased by 286 percent, according to a report from the Centers for Disease Control and Prevention and Food and Drug Administration. Most deaths involve the use of multiple drugs, and more than 8,200 people died of a heroin-related overdose in 2013 alone. The annual average rate of past-year heroin use in the U.S. also increased by more than 62 percent in roughly the past decade.

Health officials say the trend stems in part from doctorsprescribing opioids to treat chronic pain. The report found those who are addicted to prescription opioid painkillers – which can include Vicodin, OxyContin and morphine – are 40 times more likely to be addicted to or abuse heroin, and that 45 percent of people who used heroin were also addicted to painkillers. Because heroin, also an opioid, is cheaper than these drugs, those who begin with prescription painkillers often turn to it, while often using other drugs such as cocaine, alcohol or marijuana as well.


A heroin overdose can cause slow and shallow breathing, coma and death. Using alcohol or other drugs with heroin is especially dangerous, as it can increase the risk of an overdose. 

Heroin addiction and overdose deaths are climbing in the U.S.
Heroin addiction and overdose deaths are climbing in the U.S. 

"The chemical is essentially the same between prescription drugs and heroin," CDC Director Dr. Tom Frieden said Tuesday in a call with reporters. "It's cheaper and widely available – it's driving this trend."

Though people sometimes can get prescription painkillers from a friend or family member's medicine cabinet, Christopher Jones – a senior adviser in the Office of the Commissioner at the FDA – says the vast majority of people who become addicted first get the pills from a doctor.

Officials say some physicians appear to lack an understanding about the long-term effects that prescription painkillers can have on patients.

"When I went to medical school, I had one lecture on pain," Frieden said. "I was told that someone who went on an opioid would not get addicted."

Doctors, Frieden said, need to work with patients who have chronic pain on alternative treatments.

"Often the path of least resistance is to write a prescription rather than address some of the root causes of the patient's pain," he said. "It may be that an individual doctor does not see the long-term consequences for that individual of addiction, overdose, death, and the social and medical costs it could have."

[OPINION: America Is Neglecting Its Addiction Problem]

Heroin use has increased across multiple demographic groups.
Heroin use has increased across multiple demographic groups.

This overprescribing of painkillers appears to have helped increase heroin use among demographics that were not as affected previously. Those most at-risk of abusing heroin include 18- to 25-year-old white males and those who make less than $20,000 a year and do not have health insurance, officials said. But significant increases in heroin use from 2002 to 2013 were seen among women, people with private health insurance and people with higher incomes – groups that historically have had lower rates. The report also said heroin use has more than doubled among young adults ages 18 to 25.

Nearly all those who reported using heroin – 96 percent – also reported using at least one other drug in the past year, and 61 percent reported using at least three other drugs. The likelihood of developing a dependence on heroin or abusing the drug is 15 times higher for those who abuse or are addicted to cocaine, three times higher for those who abuse or are dependent upon marijuana and double for those who have problems with alcohol.

Though heroin is most commonly injected, it also can be snorted. Injection carries more health risks, as it can expose someone through an infected needle to HIV, hepatitis C and hepatitis B, as well as bacterial infections of the skin, bloodstream and heart.

Officials recommended that doctors ask more questions of patients about drug use and addiction before prescribing opioid painkillers, and that they record the use of such drugs through monitoring programs. States also can help curb the problem by increasing access to drugs that can help wean a person off his or her heroin addiction, such as methadone, buprenorphine or naltrexone.

Another drug, naloxone, can help reduce overdose deaths, and health officials recommended it also should be made more readily available. In some states, police officers have used it to save lives.