Heroin use is rising across all demographic groups in the United States, and is gaining traction among groups that previously have been associated with lower use, doubling among women and more than doubling among non-Hispanic whites, Dr. Thomas Frieden , director of the Centers for Disease Control and Prevention, said in a July 7 telebriefing.

Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013, according to the latest Vital Signs report, a combined project from the CDC and the Food and Drug Administration that analyzed data from the 2002-2013 National Survey on Drug Use and Health .

In addition, the gaps between men and women, low and higher incomes, and people with Medicaid and private insurance have narrowed in the past decade, although the most at-risk groups are still non-Hispanic whites, men, 18- to 25-year-olds, people with an annual household incomes of less than $20,000, Medicaid recipients, and the uninsured.

Although people who are addicted to prescription opioid painkillers were 40 times more likely to abuse heroin, the general idea that people gravitating to heroin abuse are doing so because opiates have become harder to get is not true, Dr. Frieden noted. The study identified two factors that were likely responsible for the increase in heroin users – the combination of the increased supply of heroin and higher demand, as well as the number of people already addicted to opioids who are “primed” for a heroin addiction.

However, state agencies have a central role to play in curbing heroin abuse, and will need to increase support for drug monitoring and surveillance programs to make tracking opiate abusers easier and more efficient, Dr. Frieden said.

The CDC is addressing the epidemic by helping to create federal guidelines for pain management, and supporting research and development for less addictive pain medications, he said.

“Improving prescribing practices is part of the solution, not part of the cause,” Dr. Frieden said.

Individual health care providers can help by following best practices for responsible painkiller prescribing to reduce opioid painkiller addiction, and by providing training for ways to adequately and comprehensively address pain beyond simply prescribing painkillers.

“Opiates are very good at curbing severe pain … But for chronic, noncancer pain, you really need to look at the risks and benefits,” said Christopher M. Jones, Pharm.D., the study’s coauthor and a senior adviser at the FDA.


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