According to the National Survey on Drug Use and Health (NSDUH), in 2012 about 669,000 Americans reported using heroin in the past year,a number that has been on the rise since 2007.
This trend appears to be driven largely by young adults aged 18–25 among whom there have been the greatest increases. The number of people using heroin for the first time is unacceptably high, with 156,000 people starting heroin use in 2012, nearly double the number of people in 2006 (90,000).
In contrast, heroin use has been declining among teens aged 12–17. Past-year heroin use among the Nation’s 8th-, 10th-, and 12th-graders is at its lowest levels in the history of the Monitoring the Future survey, at less than 1 percent of those surveyed in all 3 grades from 2005 to 2013.
(Johnston, L.D.; O’Malley, P.M.; Bachman, J.G.; and Schulenberg, J.E. Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2013. National Institute on Drug Abuse. 2013.)
Young adults are the most at risk for using heroin. In 2013,
the mean age at first use for heroin among past year initiates
aged 12 to 49 was 24.5 years according to the U.S. Department of Health and Human Services.
That same year that Department of Health and Human Services found the mean age at first use for illicit pain relievers among past year initiates aged 12 to 49 was 21.7.
Why, why, why do young adults begin to use
such an addictive, deadly drug?
It is obvious that no single explanation will that will answer the question. However, let's examine some factors that contribute to using heroin.
Like all generations before them, young adults establish their independence after high school in new college and work environments. So, they meet new friends, engage in new experiences, and establish new habits. Seemingly overnight, they face life-changing challenges, and many of them lack the maturity needed for making good decisions so crucial for independent living.
Researchers at Vanderbilt University in Nashville and Albert Einstein College of Medicine in New York City report in the Journal of Neuroscience that, in risk takers' brains,“there appear to be fewer dopamine-inhibiting receptors – meaning that daredevils' brains are more saturated with the chemical, predisposing them to keep taking risks and chasing the next high: driving too fast, drinking too much, overspending or even taking drugs.” And, these same risk takers get an unusually big hit of dopamine each time they have a novel experience.
The findings support the theory that people who take risks get an unusually big hit of dopamine each time they have a novel experience because their brains are not able to inhibit the neurotransmitter adequately. That blast makes them feel good, so they keep returning for the rush from similarly risky or new behaviors.
Another study found that suburban Chicago youth got a thrill out of driving to the West Side of Chicago to buy heroin without getting caught.
Engaging in other risky activities in young adulthood may affect using heroin for the first time. The National Institute on Drug Abuse reported in 2014 that multiple studies have revealed associations between prescription drug abuse and higher rates of cigarette smoking; heavy episodic drinking; and marijuana, cocaine, and other illicit drug use among adolescents, young adults, and college students in the United States.
The study also found that more than 75 percent of respondents had a concurrent mental health condition, such as depression, ADHD or bipolar disorder, and used heroin to self-medicate. Of critical importance in many of these cases was the entire way of life that went with using heroin.
(Kathleen Kane-Willis et al. “Understanding Suburban Heroin Use. Illinois Consortium on Drug Policy. 2011.)
Drugs of abuse can cause abusers to experience one or more symptoms of another mental illness. But also, mental illnesses can lead to drug abuse. Individuals with overt, mild, or even subclinical mental disorders may abuse drugs as a form of self-medication. Both drug use disorders and other mental illnesses are caused by overlapping factors such as underlying brain deficits, genetic vulnerabilities, and/or early exposure to stress or trauma.
(“Comorbidity: Addiction and Other Mental Illnesses.” The National Institute on Drug Abuse. September 2010.)
Another reason young adults may begin on the path of heroin addiction is that they have adopted this behavior as a means to deal with life’s daily stressors. People subjected to chronic stress or those who show symptoms of PTSD often have hormonal responses that are not properly regulated and do not return to normal when the stress is over. This may make these individuals more prone to stress-related illnesses and may prompt patients to relapse to drug use.
(D.D. Brewer et al. “A meta-analysis of predictors of continued drug use during and after treatment for opiate addiction. Addiction. 1998.)
Many animal studies have shown that stress induces relapse to heroin, cocaine, alcohol, and nicotine self-administration.
Addiction to Prescription Painkillers
People are 40 times more likely to be addicted to heroin if they are addicted to prescription painkillers. Abuse of prescription painkillers is incredibly common – one in 20 Americans age 12 and older reported using painkillers for non-medical reasons in 2014.
(Lindsey Cook. “The Heroin Epidemic, in 9 Graphs.” U.S. News. August 19, 2015.)
"The United States has about 4 percent of the world's population, and we're consuming more than 80 percent of the world's oxycodone supply. We're also consuming more than 99 percent of the world's hydrocodone.”
--Dr. Andrew Kolodny, Chief Medical Officer of Phoenix House, a nonprofit addiction treatment organization, and is a senior scientist at the Heller School for Social Policy and Management at Brandeis University. Dr. Kolodny is also the Executive Director and co-founder of Physicians for Responsible Opioid Prescribing
Experts in addiction say that the use of medications like Vicodin, OxyContin and oxycodone – all opiates like heroin – has altered the landscape of addiction and relapse, in ways that affect both current users and former ones. More people than ever now get a taste of opiates at a young age, and recovering addicts live in a world with far more temptations than there were a generation ago.
Heroin is readily available and offers a cheap alternative to prescription opioids. When addicts of these substances don't have access to legal sources, they turn to the black market for their pills or for the even cheaper heroin. Heroin delivers the same high and costs a lot less.
It's No Big Deal
The most troubling and perhaps most obvious explanation for why young adults use heroin is that it is simply “no big deal.” As ridiculous as this excuse may sound to mature adults who read this blog, it is profound in its simple veracity. Many young adults are prone to assume their own invulnerability or immortality. This shortsighted nature drives them to make mistakes while neglecting to weigh the consequences of their actions.
If you are an adult, think back to the span of years from your late teens to your mid-20s. Were those, in large part, the years when you too craved to experience everything about life? Then, you desired to drink in mass quantities of all types of experiences – many of which were fraught with danger – and, in fact, while doing so, you considered both trial and error “no big deal.” At that time, you believed plenty of tomorrows were left to simulate meanings and find important changes.
Unfortunately, some people who became deeply involved in drug use remained stuck in this immature, self-destructive mind-set. Most of us survived our own immaturity and moved forward – it was “no big deal.” Yet, to what do we owe our good fortune? Was it luck or intelligence? I'll leave that judgment up to you.
One thing I do know is that whatever causes young adults to enter into the minefield of consuming addictive opioids has created the greatest national health epidemic of our time. Every youth is vulnerable, and these “youth” represent people well into their mid-20s. Young adults are becoming addicts at an alarming rate.
If you are one of these youth, please don't take the risk of using these substances. If you are an adult with loved ones of this age, understand that your precious progenies are still immature and require constant guidance and assistance. Education is the key to prevention while resisting all temptations to consume heroin cuts demand, and, of course, cutting demand cuts supply, which saves thousands of young, innocent lives.