Why Are So Many Young Suburban Whites Using Heroin?

The prescription-drug abuse epidemic has caused a seismic shift in opioid addiction.

National Journal
Clara Ritger
May 28, 2014, 12:34 p.m.

Sixty years ago, the typ­ic­al heroin ad­dict was a young black man who lived in the in­ner city and star­ted us­ing the drug when he was 16. Today, the typ­ic­al heroin user is a mid-20s white man or wo­man who lives in the sub­urbs and star­ted his or her habit by ab­us­ing pre­scrip­tion paink­illers, such as Oxy­Con­tin, ac­cord­ing to a new ana­lys­is in JAMA Psy­chi­atry.

“The pat­tern seems to have shif­ted en­tirely,” said lead re­search­er Theodore Cicero, a pro­fess­or at the Wash­ing­ton Uni­versity School of Medi­cine in St. Louis. “It ap­pears that, over time, the sup­ply of pre­scrip­tion opioids be­came a little less abund­ant, the price rose, and the ex­pense for a drug habit meant these people had to shift to something else.”

Cicero and his col­leagues ana­lyzed data from 2,800 pa­tients at more than 150 treat­ment cen­ters na­tion­wide. They found that 75 per­cent of today’s heroin users were in­tro­duced to opioids through pre­scrip­tion drugs, com­pared with re­search find­ings from the 1960s that 80 per­cent of users star­ted their habit with heroin.

The Cen­ters for Dis­ease Con­trol and Pre­ven­tion clas­si­fied pre­scrip­tion-drug ab­use as an epi­dem­ic a few years ago, but some ad­dicts are shift­ing to heroin be­cause it is cheap­er and easi­er to get.

Mean­while, the demo­graph­ics of oth­er drug users have re­mained re­l­at­ively stable over time, with the ex­cep­tion of marijuana, Cicero said. Marijuana has be­come more per­vas­ive, giv­en the leg­al­iz­a­tion of the drug in Col­or­ado and Wash­ing­ton, and the avail­ab­il­ity of med­ic­al marijuana in a hand­ful of oth­er states. Meth con­tin­ues to be a prob­lem among the rur­al poor, he said, while co­caine has high use among young urb­an and sub­urb­an pro­fes­sion­als.

“When [heroin] was in the cit­ies, it was something we could ig­nore,” Cicero said. “Now it’s a prob­lem of main­stream Amer­ica. It’s hit the middle class.”

He says that the find­ings show that drug policy still must ad­dress the root of the prob­lem: why people take drugs at all.

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