Heroin Use Among Women Has Doubled In A Decade

Photographed by Jessica Nash.
What does a heroin addict look like? The disease calls to mind media examples like Philip Seymour Hoffman and Cory Monteith — a.k.a. images of men as the primary sufferers of this addiction. But, as a new report released yesterday by the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration shows, young women in the U.S. are rapidly becoming a much larger part of that dangerous group.

According to the report, heroin use has surged between 2002 and 2013 across almost all demographics — including nearly all ages and income levels. But women, people between the ages of 18 and 25, and those with lower incomes are among the groups that have seen the most staggering increases. In fact, the rate of heroin use among women has doubled from an average of 0.8 per 1,000 women in 2002 to 1.6 in 2013.

"From a national standpoint, the face of heroin use is changing from inner-city male to more suburban, more rural, more young female — and more caucasian," says Joshua D. Lee, MD, assistant professor at New York University School of Medicine's Department of Population Health. This means heroin addiction is popping up in areas that haven't yet had to deal with it substantially.

Tom Frieden, MD, director of the CDC, said yesterday at a press briefing that there are two major factors contributing to the rise. One, he explains, is "an increasing number of people primed for heroin addiction because they're addicted to or exposed to prescription opioid painkillers," which work very similarly in the brain. The second, and related, factor is that heroin has become more accessible and much cheaper. So, people may switch from pills to heroin or begin supplementing a prescription opioid addiction with an illicit heroin habit.

This may be an emerging problem for women in particular because they are more likely to experience chronic pain and therefore potentially more likely to be prescribed painkillers than men are. Indeed, since the '90s, the CDC estimates the rate of deaths from prescription opioid use among women has gone up by more than 400% (compared to 265% in men). And, as one might expect, deaths related to heroin overdose have increased as well — the rate for all users has nearly quadrupled since 2002.

"As a doctor who started my career taking care of patients with HIV and other complications from injection drugs," Dr. Frieden added, "it's heartbreaking to see injection drug use making a comeback in the U.S."

Solving the issue, explains Dr. Frieden, comes down to preventing addiction in the first place by tracking opioid prescriptions. But it also means increasing access to treatments that help those who are already addicted kick the habit (including medication such as methadone or suboxone), cracking down on heroin sales, and ramping up the use of naloxone to reverse overdoses.

These are the traditional "bread and butter basics" of tackling addiction, says Dr. Lee. "That’s all good, proven stuff that we might need to encourage broader use of, particularly in parts of the country that haven’t had to cope with this, or consider [options like] a needle exchange."

As we saw in Indiana earlier this year, these measures may require an extraordinary amount of time, effort, and persuasion before they're actually implemented. But we shouldn't have to lose lives in order to be ready to save them.
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