Move over, Lou Reed: there’s a new face of heroin in town. According to a new study, the typical heroin user is now a white, 20-something suburban woman. The study tracked heroin use over the past 50 years and found some dramatic shifts in who’s picking up the needle. It’s not just for rock stars, actors and street kids anymore.
The History of Caucasians and Heroin
Before the 1980s, about half of heroin users were white. Now, that number has shot up to 90%. (See what I did there?) White folks have been chasing the dragon since William S. Burroughs roamed the earth, but the uptick is staggering, especially since whites are an increasingly smaller slice of the American population pie. It’s not that the number of minority users has dropped, though; it’s that the drug has migrated from the city to the lily-white suburbs.
In the past decade, only 25% of first-time heroin users hailed from urban areas.The data show the suburban explosion is really fallout from another rising tide: prescription pills. In the 1960s, when most first-time users tended to be urban teens and 80% were male, heroin was the first opioid most of them tried. Today, 75% get into heroin through prescription drugs like OxyContin, which wasn’t even invented until the 1990s. Suddenly, all the facets of the demographic sea change make a lot more sense—it’s hard to imagine Betty Draper picking up a needle, but pill popping is a sterile-seeming, easy-to-mask alternative for desperate housewives everywhere. Compared to heroin, pills are far less stigmatized and “dirty” —you can even get them from that nice old doctor. They’re also easy to use: no sketchy paraphernalia required, no track marks to hide from the kids. You’d think anything Rush Limbaugh got his paws on would be permanently uncool, but apparently not.
Don’t Go Organic, Go Wholesale
The trouble is that pills are the priciest addiction around. When an upper-middle-class suburbanite gets deep enough down the addiction rabbit hole and has to choose between staving off withdrawal or making payments on the Prius, a cheaper alternative looks pretty appealing. That alternative is heroin, the narcotic equivalent of shopping at Costco instead of Whole Foods.
Once people “graduate” to heroin, they seldom go back to pills, and it’s not just because of the costs. For some, heroin provides a better high than its semi-legal kin. Others claim heroin is neither stronger nor more addictive than pills; it’s just easier to shoot—and shooting anything heightens the high. Unsurprisingly, the study showed that users who had begun snorting or injecting prescription opoids were the most likely to move on to heroin. After all, crushing up those little buggers is so much work.
Understanding and Minimizing the Heroin Appeal
The JAMA study revealed numerous other trends, though few were as surprising. 86% of study participants used heroin at least once a day, and 98% had abused other substances in the past month. After all, once you’re on the Big H, everything else is basically small potatoes.
Obviously, this trend is disturbing, not least because of heroin users’ increased risk of overdose. While pills are obviously far from safe, it’s a lot easier to know what’s in them and how much you’re really taking. “We need to figure out what makes these drugs so attractive,” said the study’s lead author, Washington University neuropharmacologist Theodore Cicero, who has clearly never tried heroin. In the meantime, we can at least hope that this change in demographic shift will help alter the national perceptions of what a junkie looks like—and maybe help erode enough of the stigma so that more people get the help they need.
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