What is the scope of heroin use in the United States?
According to the National Survey on Drug Use and Health (NSDUH), in 2012 about 669,000 Americans reported using heroin in the past year,1 a number that has been on the rise since 2007. This trend appears to be driven largely by young adults aged 18–25 among whom there have been the greatest increases. The number of people using heroin for the first time is unacceptably high, with 156,000 people starting heroin use in 2012, nearly double the number of people in 2006 (90,000). In contrast, heroin use has been declining among teens aged 12–17. Past-year heroin use among the Nation’s 8th-, 10th-, and 12th-graders is at its lowest levels in the history of the Monitoring the Future survey, at less than 1 percent of those surveyed in all 3 grades from 2005 to 2013.6
Past Month and Past Year Heroin Use Among Persons Aged 12 or Older: 2002-2012
Source: National Survey on Drug Use and Health: Summary of National Findings, 2012.
It is no surprise that with heroin use on the rise, more people are experiencing negative health effects that occur from repeated use. The number of people meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for dependence or abuse of heroin doubled from 214,000 in 2002 to 467,000 in 2012.1 The recently released DSM-V no longer separates substance abuse from dependence, but instead provides criteria for opioid use disorders that range from mild to severe, depending on the number of symptoms a person has.7 Data on the scope and severity of opioid use disorders in the United States are not yet available for these new criteria.
The impact of heroin use is felt all across the United States, with heroin being identified as the most or one of the most important drug abuse issues affecting several local regions from coast to coast. The rising harm associated with heroin use at the community level was presented in a report produced by the NIDA Community Epidemiology Work Group (CEWG). The CEWG is comprised of researchers from major metropolitan areas in the United States and selected foreign countries and provides community-level surveillance of drug abuse and its consequences to identify emerging trends.3
Heroin use no longer predominates solely in urban areas. Several suburban and rural communities near Chicago and St. Louis report increasing amounts of heroin seized by officials as well as increasing numbers of overdose deaths due to heroin use. Heroin use is also on the rise in many urban areas among young adults aged 18-25.8 Individuals in this age group seeking treatment for heroin abuse increased from 11 percent of total admissions in 2008 to 26 percent in the first half of 2012.
This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.