Heroin: Usage trends
Last modified: Sunday, 31. May 2009 - 4:10 pm
Every government agency that has sought to quantify Usage trends of heroin in the United States over the last several years has come to one inescapable conclusion: heroin use across the country is climbing dramatically, especially among young people.
In 2000, heroin was second only to cocaine in the number of drug-related emergency room episodes reported to a national registry run by the Drug Abuse Warning Network. Heroin, listed as a principal agent in respiratory and cardiac emergencies, went from 33,884 episodes nationwide in 1990 to 94,804 in 2000 — an increase of nearly 180%.
Locally the numbers are even more dramatic. In a similar eight-year period (between 1991 and 1998), the rate of heroin-related incidents at area hospitals increased by 413% in Miami, 288% in Chicago, and 238% in St. Louis.
Scope and severity
The Office of National Drug Control Policy’s (ONDCP) study of 21 major metropolitan areas in the United States revealed that the most likely user of heroin is over 30 years old. However, younger adults (18-30) comprise a substantial portion of those believed to be experimenting with heroin use. In the South, younger adults are more likely than adults over 30 to be regular users of the drug.
Figures compiled by the U.S. Department of Health and Human Services National Household Survey on Drug Abuse (NHSDA) estimate that there were approximately 104,000 new heroin users in 1999. Among these new users, 87,000 were between the ages of 12 and 25 and 34,000 of them were under age 18. The average age at first use among these new heroin users was 19.8 years.
The same study found that the number of people who had used heroin in the last month, an indication of more regular use, had climbed from 68,000 in 1993 to 208,000 in 1999.
Nationwide, the NHSDA released estimates in 1999 that said approximately 2.7 million Americans (1.2% of the population) are thought to have used heroin at least once in their lifetimes.
Age, ethnic, and gender trends
According to the National Institute on Drug Abuse (NIDA), among high-school-age teens, rates of heroin use remained relatively stable and low from the late 1970s until the start of 1990s.
After 1991, however, use began to rise among tenth-and twelfth-graders, and after 1993, among eighth-graders as well. In 1999, prevalence of heroin use was roughly the same for all three grade levels. Although the number of students who reported using heroin in the last year remain under 2% in 1999, the rates are about two to three times higher than those reported in 1991.
The NIDA released figures showing 1.7% of eighth graders, 1.7% of tenth graders, and 1.8% of high school seniors (twelfth graders) reported using heroin at least once. The results are remarkably static as respondents leave school and enter college, suggesting a strong adolescent culture of drug experimentation. Among college students, 1.7% reported using heroin at least once in their lifetime, while 1.8% of young adults aged 19-28 reported lifetime heroin use.
When asked about heroin use in the last 30 days, 0.6% of eighth graders, 0.3% of tenth graders, and 0.4% of twelfth graders reported using heroin at least once, compared to 0.2% of college students and 0.1% of young adults.
In a separate report issued by the Centers for Disease Control (CDC), the indications of heroin experimentation among teens in high school were even higher. In the CDC report, 2.4% of sampled high school students reported having tried heroin at least once.
Drawing on data supplied by individual states, estimates of teen use varied between a low of 1.7% to a high of 5.2%. The CDC report also looked at specific metropolitan areas and these estimates mirrored state data; surveys pegged teen prevalence with a low of 1.0% and a high of 5.3%.
In a 2001 study entitled Epidemiologic Trends in Drug Abuse conducted by the Community Epidemiology Work Group (CEWG), a branch of NIDA, the number of men who abused heroin strongly outweighed the number of female users.
These trends appear to be established early on. Male high school students who report trying heroin, for example, outnumber female students in the CDC study by a ratio of almost three to one.
According to the ONDCP, which conducts in-depth drug usage profiles in 21 American cities, heroin users are most likely to be white and male. Whites and blacks are equally represented among heroin users in Birmingham, Alabama, and Columbia, South Carolina; and Hispanics are the dominant user group in El Paso, Texas, and Los Angeles, California. In Denver and Philadelphia, white users predominate, but Hispanics are overrepresented relative to their percentage of the general population. Similarly, in Boston, whites are more numerous among heroin users, but blacks are overrepresented.