Posts Tagged ‘heroin addiction’

Heroin Epidemic versus Pain Pill Addiction Epidemic

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I’m surprised at all the coverage heroin addiction has received in the past few months. Breathless headlines are appearing in all forms of media about our “new” addiction problem. Friends send me links to articles about addiction since they know that’s the field I work in. I’m as surprised to see all the media coverage now as I used to be puzzled about the lack of coverage five years ago. I’ve been treating opioid addiction for the last fourteen years, and the opioid addiction epidemic isn’t new. It’s been very well established for years.

Perhaps the idea of using heroin jolts people more than the idea of using prescription opioids. Maybe people don’t understand that prescription opioid addiction has the same physiologic process as heroin addiction. Manufactured pain pills have less variation in content than balloons of black tar heroin, so there may be less risk of overdose. However, the body responds the same to both types of opioids. The body develops addiction and physical dependency in the same way to both heroin and prescription opioids, and withdrawal symptoms and cravings are the same. Both overdose and death happens with both types of opioids.

Perhaps heroin is perceived as the hardest of hard drugs, and therefore data about heroin addiction captures more attention than pain pill use. Maybe the use of heroin crosses a line that’s not perceived by prescription opioid addiction.

Can it be that there are still people who believe if it is a prescription medication, that it’s safe? Or is it just easier to justify the misuse of a pain pill? Communities with years of rampant pain pill addiction are only now wringing their hands because of heroin addiction. These communities are now demanding action from our government.

I’m glad for the attention to the problem of opioid addiction because I’ve seen way too much complacency about this issue for way too long.

I’m also irritated.

In 2009, I wrote a book about pain pill addiction. I was extremely lucky to get an agent, and she shopped my book to four or five mid-level publishing houses. They weren’t interested because they felt the book didn’t have a broad enough appeal. I ended up self-publishing, and sold around 500-600 copies. That’s not too bad for a self-published book, but distribution could have been much broader through a publishing house. Having my book turned down by publishers with an utter lack of interest in the subject matter undoubtedly causes some of my irritation.

I went to the ASAM conference where the head of the CDC pledged to get involved in the treatment and prevention of opioid addiction. Don’t get me wrong; that’s a wonderful thing to hear. The problem is, that was in 2012.

For all who’ve just joined the movement to help opioid addicted people get help, welcome. I’m glad you’re here, and we can use your help. And forgive me for wishing you had been interested in this problem ten years ago.

NSDUH Data Released

NSDUH Data on Heroin Use

NSDUH Data on Heroin Use

Each fall, the National Survey on Drug Use in Households releases data from their yearly survey, and data from 2013 is now being released. It’s a gradual process, with more information released as data is analyzed and compared to years past.

The NSDUH report compiles data collected about drug and alcohol use in the nation and in individual states. This annual survey of around 70,000 people in the U.S. over age 12 also collects data on mental health in the U.S. This research information is collected from phone calls to individual households and is the primary source of data on the abuse of drug including alcohol in the U.S. Data can be compared to past years to look at drug use trends, among other information.

Since this survey is conducted on household members, some scientists say the data underestimates drug use since its methods exclude populations living in institutions such as prisons, hospitals and mental institutions. Such populations are known to have the highest rates of drug use and addiction. But the annual NSDUH report is still one of the best sources of information we have at present. This data can be evaluated for new trends of drug use and abuse, and can help direct funding toward problem areas. Researchers use this data to assess and monitor drug use, as well as the consequences.

Data from 2013 shows that around 9.4% of U.S. citizens use illicit drugs at least monthly. This includes marijuana, cocaine, heroin, hallucinogens, and misused prescription medication. This rate of use hasn’t changed much over the past two years, but it’s a little higher than it was ten years ago.

Of the people who used illicit drugs at least monthly, two thirds used marijuana as their only illicit drug. Marijuana, not surprisingly, is still the most frequently used illicit drugs in the nation. This percentage of people using marijuana has been slowly but steadily increasing over the past ten years. Interestingly, the number of people surveyed who said they were daily or near-daily users of marijuana increased from 5.1 million in 2007 to 8.1 million in 2013.

I do not see this as a good thing, but my blog is dedicated to opioid addiction and its treatment, so I’ll let you make up your own minds about marijuana.

I was happy to see that non-medical use of all prescription medication continued to drop, though slowly, down to 2.5% of the population. Non-medical use of prescription opioids specifically has also shown a slight drop from 2009 to 2013. I hope this means people (and their doctors) are beginning to understand the dangers of illicit opioid use. Tranquilizer use also has shown a slow decline over the past three years, a trend I hope will continue.

Of the group of people who said they were non-medical users of opioids, over half still said they obtained their drug from friends or family, for free. Around 11% bought their drug from a friend or family member, and 21% got the drug from one doctor. Only 4.3% said they got their prescription opioid pills from a drug dealer or a stranger, and only .1% bought them off the internet.

This data tells us – again this year – that the main suppliers of illicit opioids aren’t drug dealers on the corner or dealers over the internet. Main suppliers are friends and family members of the user.

Why is this still a thing people do?? This has got to stop. Sharing medication, controlled substance or not, is dangerous – not to mention illegal. Sharing medication causes harm. You aren’t helping anyone by sharing.

The youngest age group surveyed, aged 12 to 17, showed a drop in the non-medical use of prescription opioids over the last decade, from 3.2% in 2003 to 1.7% in this 2013 survey. That’s reason to hope that youngsters now either have less opioids available to them or that they know how damaging opioid addiction can be. I hope this drop forecasts an overall drop in the number of people addicted to opioids in the coming years.

Now for the bad news: NSDUH shows that heroin use continues to rise, from around 373,000 people in 2007 to 681,000 people in 2013. That’s not quite a doubling over the past six years, but pretty close. That strongly correlates with what I see at my work; people addicted to opioid pain pills tell me it’s harder to find opioids, and also more expensive. Mexican drug cartels have seen this, and moved in to supply heroin as an alternative to opioid pain pills.

It’s an unintended and unfortunate consequence of efforts to limit illicit prescription opioid use.

This 2013 survey showed that there were an estimated 2.8 million new users of illicit drugs in people over age 12. Over 70% of these new illicit drug users started with marijuana. Only about 13% of new users started with non-medical use of opioid pain pills, and this is a lower percentage than in past NSDUH surveys.

This NSDUH data will be released in other reports as more analysis is done on this information.