Heroin overdose deaths double in U.S.
Deaths from heroin overdoses doubled from 2010 to 2012, U.S. federal health officials reported Thursday.
The new report included data from 28 states that account for 56 percent of the U.S. population.
This big increase in heroin-related deaths is directly tied to the epidemic of narcotic painkiller abuse, according to the U.S. Centers for Disease Control and Prevention.
"There is a growing population of people who are using narcotics, whether the prescription variety or heroin," said study co-author Dr. Len Paulozzi, a medical epidemiologist at CDC's National Center for Injury Prevention and Control.
The overprescribing of narcotic painkillers (such as Oxycontin and Vicodin), which has been going on for 20 years, is responsible for the increase in heroin use and overdoses, he said.
Although deaths from heroin overdoses have increased dramatically, deaths from narcotic painkillers still far outnumber them. In 2012 alone, more than twice as many people died from prescription narcotic overdoses as died from heroin in these states, the report said.
Most people addicted to prescription painkillers don't move on to heroin, according to Paulozzi. However, about three out of four new heroin users began by using narcotic painkillers, he added.
"A fraction of these people are using heroin in addition to narcotic painkillers, depending on price and availability, or have gone over entirely to heroin," Paulozzi said.
In many parts of the country, heroin is easier to get and cheaper than narcotic painkillers, he noted.
Previous research showed that from 2009 to 2012, there was a 74 percent increase in the number of people aged 12 and older using the drug, according to the report.
Overall, the death rate from heroin overdose in the 28 states that reported complete information to the CDC increased from 1.0 to 2.1 per 100,000 between 2010 and 2012. During that same time period, the death rate from overdoses of narcotic painkillers dropped slightly from 6.0 per 100,000 to 5.6 per 100,000, according to the report.
Heroin-related deaths have risen in every state studied, the CDC reported. However, the Northeast and South saw the greatest increases. Heroin overdoses rose 211 percent in the Northeast and 181 percent in the South from 2010 to 2012, the CDC said. At the same time, overdoses from heroin increased 62 percent in the Midwest and 91 percent in the West, according to the report.
Deaths from heroin overdose also vary by age, Paulozzi said. For example, deaths have climbed 120 percent among those 45 to 54 and about 109 percent among those 25 to 34. At the same time, deaths from narcotic painkiller overdose have declined in these age groups, he said.
Solving the problem of deaths from heroin overdose begins with stopping the addiction to narcotic painkillers, Paulozzi said.
"We still have to focus on reducing the prescribing of narcotic pain relievers, because that's really what got us into this situation in the first place," he said.
To help those already addicted, Paulozzi said, improved access to drug treatment is needed. "That reduces the risk of their winding up in a fatal overdose," he said.
Increased availability of the antidote to narcotic overdose, naloxone (Narcan), might also save lives, he said.
Dr. Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, said, "There is very little difference between heroin and oxycodone [Oxycontin] or hydrocodone [Vicodin]."
Since the demand for heroin has increased, it has become more available, and competition has driven down the price, said Kolodny, who is also the chief medical officer of the Phoenix House Foundation.
Moreover, heroin has become more available in non-urban and rural areas, Kolodny said. "That's where you will see most of this epidemic," he said.
"The underlying problem we have in the United States is not about prescription drug abuse or heroin abuse, it's the epidemic of people addicted to narcotics," Kolodny said. "Without treatment, overdose deaths are very common among people with this disease."
Kolodny believes in more and better access to treatment for those addicted and in efforts to prevent addiction to painkillers.
"We need to prevent new cases of addiction. To do that, the medical community has to prescribe more cautiously," he said.
The report was published Oct. 3 in the Morbidity and Mortality Weekly Report.