Heroin use in the United States has seen some wild ups and downs over the decades—like a rollercoaster nobody asked to ride. Before the late 1960s, self-reported heroin initiation was as rare as a unicorn sighting. Data from those years? Sparse.
Then came the early 1970s, and bam! Initiation peaked sharply in 1972. But, surprise, surprise, it fell by almost half after that peak. From 1978 to 1994, things stabilized. It was like a calm before the storm.
The early 1970s saw a sharp rise in heroin initiation, peaking in 1972 before plummeting almost 50%. A calm before the storm!
Fast-forward to the late 1990s. Initiation shot up 75%. A marked change after two decades of stability. This wasn’t just random; it coincided with a shift in opioid prescribing practices. People began trading in their prescription opioids for heroin. What a twist!
The patterns of initiation post-2000 were nothing like those from the previous decades. Then came the 2010s, and the surge continued. By the early 2010s, initiation rose another 85%. Historical trends show that by 2010, 80% of individuals who initiated heroin reported prior misuse of prescription opioids.
Now, hold on—80% of those new initiators had misused prescription opioids before even trying heroin. Talk about a slippery slope! Notably, initiators over 40 years old made up 10% in 2012 but skyrocketed to 40% by 2020-2021. In 2013, an estimated 681,000 individuals aged 12 or older used heroin in the past year, highlighting the ongoing crisis.
Past-year use rates also rose markedly. From 1.6 per 1,000 in 2002-2004 to 2.6 per 1,000 in 2011-2013. Not to mention, overdose deaths were stable until they spiked to 15,469 in 2016.
