Peter Shumlin, the Democratic governor of Vermont, brought heroin addiction to the front burner of national news by devoting his entire State of the State address last week to his state’s dramatic increase in heroin abuse. Shumlin described the situation as an “epidemic,” with heroin abuse increasing 770 percent in Vermont since 2000.
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Vermont is a microcosm of the nation. Across the U.S., heroin abuse among first-time users has increased by nearly 60 percent in the last decade, from about 9o,000 to 156,000 new users a year, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).
At the same time, non-medical prescription opiate abuse has slowly decreased. According to the SAMHSA 2012 National Survey on Drug Use and Health, the number of new non-medical users of pain killers in 2012 was 1.9 million; in 2002 it was 2.2 million. [It bears repeating that these stats are for abuse of non-medical prescription pain killers, not abuse of drugs obtained with a prescription.]
In the same time-frame, abuse of methamphetamine also decreased. The number of new users of meth among persons aged 12 or older was 133,000 in 2012, compared to about 160,000 in 2002.
Cocaine abuse also fell, from about 640,000 new users in 2012 from over 1 million in 2002. Crack abuse fell from over 200,000 users in 2002 to about 84,000 in 2012 (a number that’s held steady for the last three years).
The statistics suggest that heroin has taken up the slack from fall offs among every other major drug (only marijuana and hallucinogens like ecstasy have held steady or slightly increased among new users over the last decade; not surprising since they’re the drugs of choice among the youngest users, and since pot has been angling toward legalization for the last few years).
Most surprising in this sea of stats is the drop in non-medical prescription opiate abuse overlapping with an increase in heroin abuse. The reason may come down to basic economics: illegally obtained prescription pain killers have become more expensive and harder to get, while the price and difficulty in obtaining heroin have decreased. An 80 mg OxyContin pill runs between $60 to $100 on the street. Heroin costs about $9 a dose. Even among heavy heroin abusers, a day’s worth of the drug is cheaper than a couple hits of Oxy.
Laws cracking down on non-medical prescription painkillers have also played a role. The amount of drugs like Oxy hitting the streets has decreased, but the steady flow of heroin hasn’t hiccupped. Many cities are reporting that previous non-medical abusers of prescription pain killers—who are often high income professionals—have turned to heroin as a cheaper, easier-to-buy alternative.
One conclusion that can be drawn from the stats is that prescription opiates are serving as a gateway drug for heroin, not so much by choice but by default. The market moves to fill holes in demand, and heroin is effectively filling fissures in demand opened by legal pressures and cost.
Another interesting stat is that among first-time drug users, the mean age of initiation for non-medical prescription pain killers and heroin is virtually identical: 22 to 23 years old. That would also support an argument that there’s a cross-over effect from drugs like Oxy to heroin (in contrast, the mean age for first-time users of pot and ecstasy are 18 and 20, respectively).
Vermont’s heroin problem would seem to be a foretelling of things to come in the more affluent parts of the country. According to the U.S. Census Bureau, Vermont’s median household income, home ownership rate, and percentage of people with graduate and professional degrees are all higher than the national averages, and Vermont’s percentage of those living at or below poverty level is significantly lower than the national average.
The bottom line: Vermont’s stratospheric heroin increase is happening where the money is, and the national drug abuse trends suggest that the same thing is happening across the country.
You can find David DiSalvo on Twitter @neuronarrative and at his website, The Daily Brain. His latest book is Brain Changer: How Harnessing Your Brain’s Power To Adapt Can Change Your Life.