The increasing availability of heroin, combined with efforts aimed at preventing prescription painkiller abuse, may be re-arranging the field of opiate addiction in the U.S., according to a new study published online in the journal Addictive Behaviors.
Not only is the use of heroin growing, but it is now being coupled with the abuse of prescription painkillers. The heroin-prescription drug combination is also showing up in groups that were not traditionally viewed as at-risk populations.
“One of the things we’ve found is that the simultaneous use of heroin and prescription painkillers together has increased dramatically among whites and especially among young white men,” said Shannon Monnat, assistant professor of rural sociology, demography, and sociology at Pennsylvania State.
She describes the recent trend as a domino effect of addiction that began in the 1980s and 1990s when the over-prescription of painkillers led to an increase in addiction to those drugs.
“Over the last several years there have been more restrictions put in place, including prescription-drug monitoring programs and the introduction of a tamper-proof opioid, making it difficult to crush, liquefy, and inject the substance,” said Monnat.
“What this has done is restrict access to prescription painkillers for people who previously became addicted to them. These people sometimes transition into heroin, which has become incredibly cheap and easily accessible.”
On the other hand, former heroin users are now being introduced to prescription painkillers and are using both at the same time. While most opiate addicts are still addicted to only painkillers, the number of addicts using heroin and the number of users who are addicted to both painkillers and heroin are increasing faster than painkiller-only abusers.
“You don’t eliminate the addiction simply by eliminating access to the drug,” said Monnat. “People who are addicted to the morphine substance will find a substitute.”
For the study, the researchers used data from the 2010-2013 National Survey on Drug Use and Health. Respondents in the survey were grouped in three categories: heroin only users, prescription painkiller only users, and combination heroin and prescription painkiller users.
Prescription painkiller-only users were the largest group, with 9,516 respondents. Combination heroin and prescription painkiller users were the next largest group, with 506 respondents, followed by 179 heroin-only respondents.
Physicians should be aware of the changing patterns of opiate addiction and that heroin use is on the rise in different populations.
“It’s not enough to know whether someone is just using a prescription painkiller, but the practitioner would also want to know if they are using heroin,” Monnat said. “The use of heroin puts the patient at risk of all kinds of other complications, such as HIV and sexual risk-taking behaviors and a very high risk of overdose.”
Monnat worked with Khary K. Rigg, assistant professor of mental health law and policy at the University of Southern Florida.
Source: Pennsylvania State