Young men in the big city. This is the group we often associate with heroin abuse. Until fairly recently, this was the most common demographic for the highly addictive opioid.
A new study from Washington University shows how the face of heroin abuse has changed in the past decade and is now often a drug used after becoming addicted to prescription opioids.
For this study, published in JAMA Psychiatry, 2,800 American heroin users who had entered treatment facilities were surveyed about their past heroin use and how it came to be their drug of choice.
Users who began taking heroin during the 1960s were primarily young men from the inner city using heroin as their first opioid. Both white and non-white individuals were represented equally at that time.
However, for more recent users, the demographics shifted to include older men and women from outside large urban centres who first used prescription opioids. In the last decade, 90 per cent of new heroin users were white.
Individuals who first used prescription opioid medications often cited cost and availability as reasons for transitioning from prescription drugs to heroin use.
Some believe addicts were compelled to switch after the introduction of abuse-resistant formulations of many opioid medications in 2010. This may have compelled existing addicts to switch to heroin as a more accessible alternative.
Some good news on opioid addiction is that numbers of youth and young adults using prescription drugs have fallen in the past few years. Also, numbers of people using buprenorphine to treat heroin addiction has gone up 400 per cent in recent years.
In Kelowna I certainly see a lot more heroin addiction now than I did 30 years ago. It is amazing to see how nonchalantly many people take up heroin use these days. This then becomes part of a downward spiral into criminal activity, prostitution and homelessness that is devastating to watch.
The other face of heroin addiction that I see very frequently is when parents of addicted women are put in the position of raising their grandchildren because of heroin’s effects. It is difficult enough that these grandparents are trying to raise young children well into their 60s, but they are usually doing it with a lot of opposition from their addicted children who often resent their involvement. There is usually Ministry involvement mandating that the children cannot be with their addicted parent and yet that parent may resist all interference. The addicted parents lack insight into how ill-equipped they are to look after their children on their own or how inappropriate their addicted partners are to be involved in the raising of children.
The grandparents I see are often depressed. They are in constant conflict, burdened with the extra responsibilities and often financially stressed. It is hard to abandon your grandchildren to a life of deprivation and they usually try everything in their power to help but often with only limited success.
It is a miserable life for everyone concerned. The parents, children and grandchildren sometimes have other psychiatric issues that complicate their lives beyond the addictions.
The cost of heroin addiction is large when you look at the cumulative costs of medical care, counselling, Ministry involvement, social services, legal, penal and policing costs over at least three generations.
I hope to see more research and strategies that will work to prevent and treat these damaging addictions.