First synthesized from morphine in the late 1800s, heroin abuse trends have ebbed and flowed up until the start of the 21st century. Today, the face of heroin looks markedly different from the trends leading up to our time.

According to the U. S. National Library of Medicine, over the past decade, heroin abuse has increased by a whopping 63 percent. Between 2002 and 2004, 1.6 out of every 1,000 persons over the age of 12 used heroin. This number increased to 2.6 out of every 1,000 persons between the years 2011 and 2013.

Heroin’s origin as a morphine derivative accounts for the drug’s incredibly high potential for abuse and addiction. Since morphine exists as the most potent, natural derivative of opium as well as the precursor for scores of prescription pain reliever medications, heroin belongs to an extensive class of drugs known as opiates.

In effect, heroin’s “ancestry” accounts for the face of heroin today as opiate abuse and addiction in general have reached epidemic proportions. The face of heroin has evolved, not because of the drug itself, but because of gateway drugs that paved the way.

The Opiate Addiction Potential

Opiates include over-the-counter medicine as well as heroin.

Opiate drugs range from over-the-counter products to prescription medications to illicit street drugs. Some of the more commonly known opiates include:

• Heroin
• Demerol
• OxyContin
• Dilaudid
• Opium
• Hydrocodone
• Methadone

Whether legal or illegal, these drugs exert the same effects on the brain and body. As a group, opiates carry a high addiction potential partly because of the way these drugs interact with the body’s own opioid chemical system.

The opioid system regulates pain and pleasure sensations and also interacts with a host of other critical bodily functions. Consequently, prescription opiates have become the most effective pain-relieving agents in existence. These similarities between opiates and the body’s opioid system account for the high potential for opiate abuse and addiction.

The Early Days of Heroin Abuse

Demographics

In the late 1800s, heroin was initially marketed as an over-the-counter, non-addictive remedy for morphine addiction. By the 1920s, the dangers of the drug became apparent, at which point heroin was reclassified as an illegal drug under the Heroin Act. Unfortunately, this change did little to quell the growing problem with heroin addiction.

By the 1960s and 70’s, heroin addiction was concentrated in the inner cities with most addicts being young men from minority groups. While rates of heroin abuse remained relatively stable throughout the latter half of the 20th century, greater numbers of people from various socioeconomic groups started experimenting with the drug.

Usage Trends

During the 1950s, injecting heroin was the primary method of use with the number of IV users reaching epidemic proportions after World War II, according to the National Institute of Drug Abuse. Between the 1960s and 1990s, the purity of street heroin increased considerably, which in turn made it possible to smoke and snort the drug as opposed to just injecting. This change made heroin more appealing to people who wouldn’t otherwise take to injecting the drug. This change also accounts for its increased use outside the inner cities.

Today’s Heroin Epidemic

Demographics

Today, people at the highest risk of engaging in heroin abuse include:

• 18 to 25 year old Caucasian males
• The uninsured
• Medicaid recipients
• People with an annual income of $20,000 or less

On the other hand, those most likely to try heroin for the first time include Caucasian males and females in their late 20s residing outside the inner city areas. People within this demographic group carry private insurance coverage and have higher income levels overall. In effect, the face of heroin has changed considerably as the gap between lower and higher socioeconomic groups grows smaller with each passing year.

Usage Trends

According to the U.S. Substance Abuse and Mental Health Services Administration, between the years 2006 and 2013, the number of first-time heroin users nearly doubled from 90,000 to 169,000. An estimated 90 percent of first-time users were Caucasian.

Interestingly enough, 45 percent of those trying the drug for the first time were addicted to prescription opiates between 2011 and 2013. This equals out to double the number of first-time users going from prescription opiates to heroin between the years 2002 to 2004.

Causes

The Gateway Drugs

The advent of new and improved prescription opiates during the first decade of the 21st century has a direct tie-in with the face of heroin use today. Chemically speaking, prescription opiates are legal forms of heroin as both types of drugs act on the brain and body in the same way.

It didn’t take long before prescription opiate addiction rates saw a marked increase, which led to tighter regulations and restrictions over this class of drugs. As prescription opiates became less accessible, regular users switched to heroin, which was easily accessible, offered a more intense high and cost less.

In effect, many of today’s addicts got their start with heroin after having been prescribed pain relief medications. This accounts for heroin’s reach across socioeconomic lines as people with insurance and higher income levels were increasingly exposed to prescription pain medications.

Heroin Distribution & Cost

As tighter regulations limited access to prescription opiates, the heroin market capitalized on these changes throughout the 21st century’s first decade. Heroin distribution networks increased in number while the price of the drug decreased considerably. Distribution channels once restricted to the inner cities found their way into the suburbs and rural areas.

These market changes created the perfect tipping point for today’s opiate epidemic to take root. Ultimately, the face of heroin today stems from smart business practices on the part of the drug traffickers.

Considerations

People addicted to prescription opiates are 40 times more likely to use heroin compared to a 15-fold likelihood for cocaine users and a three-fold likelihood for marijuana users. Opiate drugs in general carry a high propensity for dependence and addiction whether legal or illegal and it’s easy to switch from one type of opiate to another.

As heroin potency levels run considerably higher than most all prescription opiates, the crossover to heroin only creates a more severe addiction. Without tighter laws and restrictions placed on prescribing practices and drug trafficking in general, the face of heroin stands to become the face of America in the very near future.