Heroin — street-named dope, smack, China white or dozens of other monikers — remains one of the most addictive and deadly drugs worldwide. Despite decades of concerted efforts to get it off our streets and reduce heroin use among our most at-risk people, heroin statistics show that it continues to be a public health crisis in the United States and around the globe. This article provides an in-depth look at heroin use trends, key statistics on abuse and fatalities, the demographics most affected, correlations between heroin and other drug use and the far-reaching consequences on public health and society.
Overview of Heroin Statistics and Use Trends
Heroin, derived from morphine, is a powerful opioid known for its fast and intense high. While heroin abuse has been an issue for decades, the last 2 decades have seen substantial changes due to the addition of synthetic opioids such as fentanyl. Even a tiny amount of fentanyl added to heroin dramatically increases the risk of an overdose. While it’s impossible to know how often heroin has added fentanyl, the NYU School of Global Public Health recently published a study showing that 80% of people who inject drugs test positive for fentanyl, despite a preference for heroin. Also, did you know that one not-so-fun fact about heroin is that snorting and smoking don’t reduce your chances of addiction at all?
Prescribing practices for opioids have had a direct impact on heroin use. As of the end of 2022, opioid prescriptions were down 46.4% compared to 2016, which has also been mimicked in lower heroin mortality rates. Between 2016 and 2022, heroin overdose deaths decreased from 15,469 to 5,871. In recent years, fentanyl-laced heroin has fueled a new wave of overdose deaths, as the potency of fentanyl dramatically increases the risk of fatal overdose.
Rates of Heroin Use and Overdose Deaths
The rates of heroin use have dropped, but overdose deaths have skyrocketed. According to data from the National Center for Drug Abuse Statistics, approximately 900,000 people in the United States reported using heroin in the past year. Shockingly, this represents only a fraction of those affected by the broader opioid epidemic. The addition of fentanyl to heroin has dramatically increased the fatality risk when taking any street opioid.
Demographics Most Affected by Heroin Abuse
Heroin abuse affects individuals across a wide range of demographic groups, but certain populations are disproportionately impacted by its effects:
- Middle-aged adults (ages 25-54). Adults in this age range are more likely to have chronic pain and may have been introduced to opioids through prescription pain relievers before transitioning to heroin. In total, 80% of heroin users started with prescribed opioids.
- Racial and ethnic minorities. Recent trends show an alarming rise in heroin abuse and overdose rates among Black and Hispanic communities.
- Rural community members. Rural areas, particularly regions like Appalachia, have seen some of the highest rates of heroin and opioid abuse.
- Individuals with mental health disorders. Those with co-occurring mental health disorders, such as depression and anxiety, are at higher risk for heroin abuse. The 2021 National Survey on Drug Use and Health (NSDUH) reveals that 33.5% of those with a mental health disorder also struggle with substance use disorder.
Correlation Between Heroin and Other Drug Use
Polydrug use, or the simultaneous use of multiple substances, is a common pattern among heroin users, particularly because heroin is often cut with other substances. Many people who abuse heroin also misuse other drugs, including alcohol, cocaine, benzodiazepines and, increasingly, fentanyl. Prescription opioids might start someone seeking alternatives when the doctors turn off the supply, but most people who want heroin don’t want fentanyl. Some more desired — and dangerous — combinations might include:
- Cocaine and other stimulants. Cocaine is often used alongside heroin in a combination known as a speedball, which mixes the high-energy effects of cocaine with the depressant effects of heroin. This combination is particularly dangerous, as the contrasting effects can mask symptoms of overdose until it’s too late.
- Alcohol. Alcohol use is also common among heroin users, and the depressant effects of both substances can lead to compounded respiratory depression, resulting in overdose.
Polydrug use complicates treatment for heroin addiction and increases the risk of fatal outcomes.
How Heroin Impacts Public Health, Economic Costs and Communities
The impacts of heroin abuse extend far beyond individual users, affecting public health, the economy and entire communities. In the public health sphere, hospitals and emergency rooms face tremendous pressure when attempting to provide high-quality care to patients when resources are stretched to the wire. A heroin overdose may tie up an ICU bed for weeks, and treatment often means long-term admission to a rehabilitation program and mental health support. The combination is expensive in terms of dollars and resources.
Every year, the public spends billions of dollars on support services that help prevent and treat addiction. The cost is staggeringly high, from the criminal justice system and hospitals and health care to education and prevention efforts. And that’s before you look at the human cost.
Heroin addiction has a profound impact on communities, particularly in areas with high rates of abuse. In Appalachia, in poor urban areas and all across the country, neighborhoods struggle under the burden of higher crime rates, the presence of drug-related paraphernalia in public spaces and strained social services, all while property values decrease due to visible changes in the area.
While the whole community bears some of the burden, families shoulder the direct effort of emotional support and the financial burden of caring for a loved one with a heroin addiction. Broken families, foster care systems and blighted communities are just a part of the toll that heroin extracts from everyday Americans.
When to Seek Help for Heroin Abuse
Seeking out help and support can be a life-saving measure. Whether you need help getting treatment or information about resources available for a loved one, early action saves lives.
For immediate support and resources, reach out to the National Rehab Hotline. Help is available, and support is just a call away to guide you or your loved one toward recovery and a healthier future.