Heroin deaths increased sharply in many states, according to a report of death certificate data from 28 states published by the Centers for Disease Control and Prevention in this week’s Morbidity and Mortality Weekly Report. Despite these findings, still more than twice as many people died from prescription opioid overdoses as died from heroin in these states in 2012. Though not directly addressed by this study, two things appear to be driving the increase in heroin overdoses: (1) widespread prescription opioid exposure and increasing rates of opioid addiction; and (2) increased heroin supply. While the majority of prescription opioid users do not become heroin users, previous research found that approximately 3 out of 4 new heroin users report having abused prescription opioids prior to using heroin. This relationship between prescription opioid abuse and heroin is not surprising; heroin is an opioid, and both drugs act on the same receptors in the brain to produce similar effects. Heroin often costs less than prescription opioids and is increasingly available.

“Reducing inappropriate opioid prescribing remains a crucial public health strategy to address both prescription opioid and heroin overdoses,” said CDC Director Tom Frieden, M.D., M.P.H. “Addressing prescription opioid abuse by changing prescribing is likely to prevent heroin use in the long term.”

Key Findings:

•This new study examined changes in heroin and prescription opioid death rates in 28 states between 2010 and 2012. The 28 states represented 56 percent of the U.S. population.

•From 2010-2012, the overall heroin death rate across the 28 states doubled.

•The sharp heroin overdose increase extends the trend observed in the 2011 national mortality data.

•Five states had increases in prescription opioid death rates, seven states had decreases, and sixteen states had no change.

•Of the 18 states with reliable heroin overdose death rates examined individually in this study, 15 had statistically significant increases in heroin death rates. No state had a decrease in the heroin death rate.

•The increases in state heroin death rates from 2010-2012 were associated with increases in prescription opioid death rates.

“This study is another reminder of the seriousness of the prescription opioid overdose epidemic and the connection to heroin overdoses,” said Grant Baldwin, Ph.D, M.P.H, Director, Division of Unintentional Injury Prevention. CDC and other federal agencies are working to promote a smart, coordinated approach to reduce inappropriate prescribing and help people addicted to these drugs.”

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Published: Oct. 23, 2014 - Volume 13 - Issue 28