Opioid use in the United States has made frequent headlines in recent years, becoming such a substantial concern that public health officials consider it an epidemic. As you work toward your masters in public health online, this issue is important to understand, as it is one you will likely learn more about in your coursework and could likely contend with in your career as a public health official.
Learn some of the recent statistics regarding this epidemic and understand why it is such a serious public health concern:
Learn Which Patients Are at the Highest Risk
In the U.S., heroin use has increased dramatically during the past decade, with five times as many people using the drug today compared to the decade before. A Columbia University study revealed that heroin addiction tripled from 2002 to 2013, with about 1 percent of study participants reporting addiction. During this relatively short period of time, specific groups have emerged as the highest at risk.
While heroin studies have long focused on the effect on middle-aged white women, young, white men tend to be at the highest risk of heroin addiction. In fact, the Washington Post reports that heroin users reveal a growing gender gap, with comparatively more men using or overdosing on the drug. Frontline explains that while heroin-related death rates have increased for every racial demographic, white and Native American users have experienced a much more significant rise than either Latino or African-American users.
Once considered an urban problem, the National Institutes of Health (NIH) reports that heroin addiction and overdose now affects users in all parts of the country. In fact, in recent years, some suburban and rural areas have experienced greater numbers of deaths and drug seizures than nearby urban areas.
In addition, heroin use has increased most in disadvantaged populations. Columbia University researcher Dr. Silvia Martins explains that these groups historically had a higher risk of addiction because they traditionally had fewer ties to social institutions.
In more recent years, people of all social classes have become heroin users. However, those with less education and fewer resources tend to be less able to get the help they need to combat addiction. Since heroin is less expensive and more readily available today than it has been in the past, fewer barriers exist to prevent use or addiction.
Comprehend the Results of Addiction
Addiction to heroin is a serious matter with grave results. While cocaine was once the main cause of overdose deaths, opioids are now the most common cause of drug-related deaths. The Chicago Tribune states that overdoses kill an average of 78 people per day. In 2015, over 33,000 people died due to opioid overdoses.
As the Washington Post reports, men aged 25 to 44 are most likely to die from heroin use or overdose, with a death rate of 13.2 per 100,000 people. This figure may not sound particularly high, but it signals a 22 percent increase from 2014 to 2015.
A report from Frontline gives even more perspective to this epidemic. Nearly 20 years ago, motor vehicle fatalities outnumbered drug-related deaths by two to one. By 2014, however, those figures had reversed. Fewer people die in car accidents today than they did in 1999. However, the number of people who die from overdoses and other drug-related issues is about twice the number who experience vehicle-related deaths.
Understand Potential Reasons for This Epidemic
Epidemics often stem from a handful of converging causes. The Chicago Tribune reports that an increase in prescriptions for certain opioids has contributed significantly to the addiction problem. Drastically increased prescriptions for powerful opioid painkillers such as Percocet, Vicodin, and OxyContin may be largely responsible for a subsequent increase in heroin use.
Researchers can easily trace the origin of prescription opioids back to their source. Over the past 20 years, opioid prescriptions have tripled, largely due to a series of 1980s-era medical studies that suggested the relative safety of opioids for long-term pain management.
Many white users, who belong to the group that has demonstrated the greatest increase in heroin use, began using the drug after using prescription opioids for non-medical reasons. In fact, the Chicago Tribune states that nearly 80 percent of heroin users transitioned from opioid painkillers.
Many heroin users initially may have had legitimate painkiller prescriptions from their doctors before becoming addicted. Since purchasing opioid prescriptions can be expensive, many have opted to use less expensive alternatives, such as heroin, which drug traffickers import at significantly reduced rates.
Learn About Public Health Strategies to Combat The Issue
Since the heroin epidemic is relatively new, public heath officials are still actively researching and testing strategies to curb use and prevent addiction. Some experts have suggested that younger users, many of whom are at highest risk of addiction and overdose, may respond best to prevention or intervention initiatives. These may include programs that provide medication designed to help users beat addiction as well as initiatives that help to prevent overdoses.
The Centers for Disease Control and Prevention (CDC), which often guides public health initiatives at both the federal and community levels, suggests numerous ways for states to assess risks and design strategies to reduce the number of heroin-related deaths. First, the CDC recommends addressing addiction to prescription opioids, which often leads to heroin use. Health care providers can make better use of prescription drug monitoring programs, which could limit the number and extent of opioid prescriptions.
In addition, the CDC recommends that states provide greater access to substance abuse options, which could include Medication-Assisted Treatment (MAT), as well as resources and training related to naloxone administration. These initiatives could limit opioid-related overdoses and deaths. Finally, the organization suggests that community public health groups offer better-integrated prevention services, which may include needle exchange programs. When used together, these approaches can prevent users from starting heroin, reduce addiction to this dangerous drug, reverse overdose, and decrease overdose-related deaths.
The heroin epidemic shows no signs of slowing in the U.S., and public health officials will need dedicated professionals equipped with the knowledge and skills necessary to implement innovative programs. With a graduate degree in public health from Keck School of Medicine of USC, you may have the opportunity to gain a more complete understanding of this public health crisis and put your experience to work making a difference.