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What the Heroin Abuse Crisis Means for Public Health

Sophia Bernazzani is a health care journalist. She has a background in healthcare and previously worked in health marketing and advocacy. She's passionate about nutrition and sustainability and studied global public health at the George Washington University.
America is in the grips of a heroin abuse crisis, and many link it to the over-prescribing and abuse of pain medications. Initially resurfacing in in 2014, this crisis is capturing widespread attention and has led to new policies at the federal level. The impact on affected individuals and their families is certainly significant—as well as the broader impact on society.

Here, we’ll explore how the heroin crisis has evolved, how the discussion is being framed in our country and what it means for public health.

The Evolution of the Heroin Crisis
According to the CDC, heroin use in the US has increased across almost every age group and demographic. In fact, some segments of the population that have had historically low rates of heroin use are now counted among the grim statistics, including women, the privately insured, and those with higher incomes. 

Why has heroin use escalated so rapidly? The CDC faults what it terms “the strongest risk factor for heroin addiction”: an addiction to prescription opioid painkillers. In fact, recent statistics note that 45% of people who use heroin are also addicted to prescription opioid painkillers, and people who are addicted to such opioids are 40 times more likely to be addicted to heroin. According to a report by the National Institutes of Health, an estimated 5 million to 8 million Americans use opioids for chronic pain—a dramatic increase over the past 20 years (up from 76 million prescriptions in 1991 to 219 million in 2011). 

Since heroin is also an opioid, and much cheaper than its prescribed counterparts, individuals who have become addicted to prescription painkillers often turn to it next. As CDC Director Tom Frieden, MD, MPH, said in a US News and World Report story, “The chemical is essentially the same between prescription drugs and heroin. It’s cheaper and widely available—it’s driving this trend.” 

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