Heroin: Study About Why People Use

The "Understanding Suburban Heroin Use" study by the Robert Crown Center for Health Education reportedly explains why suburban Chicago people use heroin and what leads them to try it. The study was the first part of a three-year project commissioned by a $340,000 grant from the Hruby family of Burr Ridge, Illinois, who lost their grandson, Reed, to a heroin overdose. The research was conducted by a team from Roosevelt University's Illinois Consortium on Drug Policy.

As we know, heroin use has crossed all boundaries and infiltrated every type of community in America -- the epidemic now knows no demographic bounds. Federal and state authorities have devoted enormous time and effort toward stopping addiction and saving lives.

Heroin use among young, white suburban users has been rising drastically in the last decade. The "Understanding Suburban Heroin Use" study found that while hospital discharges for heroin among Chicago residents aged 20 to 24 declined 67 percent between 1998 and 2007, heroin discharges in that same age range increased more than 200 percent in the collar counties. The study found that young suburban users demonstrate distinctive, divergent use patterns -- in some cases, more extreme than their urban counterparts.

Nonetheless, so many people are very puzzled about how such a dangerous, addictive substance could gain such widespread popularity. This study may help answer that vexing question. Here are the major findings from the 10-month study of suburban students, parents, and heroin users that shed light upon the increase in heroin use by children and by adults.

1. Lack of Knowledge

The study concluded that most people have little knowledge about heroin when they first use it. Researchers suspect this greatly contributes to the suburban epidemic and stems from young people's relationships with their parents--many of whom don't know how to broach the topic with their kids.

"When my dad found my pot bowl [pipe], he said 'this is for crack' and I laughed," female participant C, 27, said. "They sent me to my room and that was it...my parents missed an opportunity then."

The study also found that widely-accepted risk and protective factors often lull suburban parents into a false sense of security

2. Misuse of Opioid Prescription Pills

Poly drug-users fall victim to heroin's disproportionately high addiction rate compared to other commonly-abused drugs

Kathie Kane Willis, Director of the ICDP, said pain pill addiction can happen very easily to people without a history of drug abuse. She says 70 percent of people who initiate to heroin use start with legal pain medications. One-third of those surveyed starting using it after being addicted to or misusing prescription pain pills such as OxyContin or Vicodin.

"I remember thinking that I was scared to try it because it was heroin, but then I remember thinking that it was the same as oxys so it was OK...I loved oxy and I had been told that heroin was similar," a participant identified in the study as M told researchers.

3. Concurrent Mental Health Conditions

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.

4. Sensation-Seeking Behaviors

Two-thirds of those surveyed displayed "sensation-seeking behaviors," which researchers translated to mean they got a thrill out of driving to the West Side of Chicago to buy heroin without getting caught. The study also found that the suburban heroin user is white, and the average age of first use is 18.

(Jamie Sotonoff. "Study explains why people use heroin."

Chicago Daily Herald. October 19, 2011.)

(Lizzie Schiffman. "Study On Suburban Heroin Use Dispels Myths About Protective And Risk Factors." Huff Post Chicago. October 21, 2011) 

5. Genetic Factors and Family Relationships

Do genetics and the family increase a person's likelihood of being addicted to heroin? The research finds evidence of a great degree of influence.

According to a well-respected, older study in the Archives of General Psychology, there is increasing evidence that substance use disorders are familial (of established friendship) and that genetic factors explain a substantial degree of their familial aggregation. The doctors performed a controlled family study of probands (individuals or members of a family being studied) with several different predominant drugs of abuse, including opioids, cocaine, cannabis, and/or alcohol.

There was an 8-fold increased risk of drug disorders among the relatives of probands with drug disorders across a wide range of specific substances, including opioids, cocaine, cannabis, and alcohol, which is largely independent from the familial aggregation of both alcoholism and antisocial personality disorder. There was also evidence of specificity of familial aggregation of the predominant drug of abuse.

The study concluded that elevation in risk of this magnitude places a family history of drug disorder as one of the most potent risk factors for the development of drug disorders. These results suggest that there may be risk factors that are specific to particular classes of drugs as well as risk factors that underlie substance disorders in general.

(Kathleen R. Merikangas, PhD; Marilyn Stolar, MA; Denise E. Stevens, PhD; et al. "Familial Transmission of Substance Use Disorders." Arch Gen Psychiatry. 1998, 55.)
 

Take Action Now

Despite arguments about how to treat those who suffer from heroin addiction, we cannot deny our obligation to better understand the substance and how to combat its growing use. Failure to do so will only exacerbate the problems associated with heroin -- violent crime, crippling addiction, and deadly overdose.

The National Institute on Drug Abuse (NIDA) reports addiction to opiates is recognized as a chronic, relapsing brain disease with a wide range of serious medical consequences. Findings from brain imaging studies in humans, along with basic cellular and behavioral research in animals, have identified profound disruptions in the specific brain circuits and cells that underlie addiction.

Broader acceptance that heroin addiction is a chronic brain disease will help erase stigma, permit a more accurate assessment of disease prevalence, identify those with increased vulnerability, and improve the rate of treatment seeking. By moving forward with this multi-pronged approach, we will close the heroin treatment gap: currently, only about 20 percent of the estimated 810,000 heroin addicts seek or receive any form of treatment for their addiction. 

 ("Heroin Addiction." National Institute on Drug Abuse. March 29, 2013.)

Why Your "Good Kid" Takes Heroin

So now that the "good kids" are also using heroin (Tongue in cheek -- Who really cared when children in so-called "marginal groups" were dying?), we are religiously searching for an answer to the ultimate question: "Why?" It doesn't make sense does it? Why would our finest, brightest young people dive headlong into the deep end of drug use and risk the terrible outcomes?

Yes, America, heroin use among young, white suburban users has been rising drastically in the last decade. Research is lacking, but some does exist. It seems even "good kids" can go bad.

A study, believed to be the first of its kind, explains why people use heroin, what leads them to try it, and attempts to paint a picture of a suburban Chicago heroin users. The research was conducted for the Robert Crown Center for Health Education’s Reed Hruby Heroin Prevention Project.

Their findings were the result of an unprecedented series of case studies examining 15 suburban heroin users, eight females and seven males, ages 22 to 31. The extensive interviews, led by researchers from the Illinois Consortium on Drug Policy (ICDP), were anonymous, conducted with disposable cell phones and unnamed Gmail accounts.

These are the findings in the "Understanding Suburban Heroin Use" study from Illinois.

This research was a 10-month study of suburban students, parents and heroin users. It concluded that most people have little knowledge about heroin when they first use it or about the withdrawal syndrome associated with it.

The case studies identified three repeated, predictable paths that are consistently leading suburban youth to heroin dependency:


1. Cocaine users who rely on heroin to soften the effects of cocaine ("come down" or sleep) but eventually become dependent,


2. Poly drug-users who fall victim to heroin's disproportionately high addiction rate compared to other commonly-abused drugs, and


3. Prescription pain pill users, abusive or otherwise who eventually replace opioid pills (OxyContin, Vicodin, etc.) with heroin.

The third camp is particularly troubling, said Kathie Kane Willis, Director of the ICDP, because pain pill addiction can happen very easily to people without a history of drug abuse. She says 70 percent of people who initiate to heroin use start with legal pain medications.

Here are some key findings from the study:

* Young suburban users demonstrated distinctive, divergent use patterns -- in some cases, more extreme than their urban counterparts. The ICDP reports that 74 percent of 18 to 24 year old suburban users in publicly-funded treatment were injection users.


* Suburban heroin users believed when they “snorted or sniffed” heroin they were less likely to become addicted.


* More than 75 percent of respondents had a concurrent mental health condition, such as depression, anxiety, ADHD or bipolar disorder, and they used heroin to self-medicate.


* Two-thirds of those surveyed displayed "sensation-seeking behaviors," which researchers translated to mean they got a thrill out of driving to the West Side of Chicago to buy heroin without getting caught.


* The suburban heroin user is white, and the average age of first use is 18. But, 20% of the group reported their first heroin use at age 15

* Several of the subjects surveyed expressed a reduction in their aversion to heroin use when they realized it was chemically similar to medications legally prescribed by doctors.


"I remember thinking that I was scared to try it because it was heroin, but then I remember thinking that it was the same as oxys so it was OK...I loved oxy and I had been told that heroin was similar," a participant identified in the study as "M" told researchers.

* Many of the young people had somewhat distant relationships with their parents -- research found many of the parents didn't know how to broach the topic with their kids.

"When my dad found my pot bowl [pipe], he said 'this is for crack' and I laughed," female participant C, 27, said. "They sent me to my room and that was it...my parents missed an opportunity then."

* Widely-accepted risk and protective factors often lull suburban parents into a false sense of security, where individualized experiences prove that subtle nuances within those umbrella categories matter.

"Two-parent households are a protective factor, but not when the parents are involved in an abusive relationship with each other, or not when they are abusing their child," Kane Willis said during the community forum. "Sports and engagement are a protective factor, but not so much when the outside activities include cheerleading and using drugs, or playing sports and using drugs, or having a job and using drugs. It's complicated."

(Lizzie Schiffman. "Study On Suburban Heroin Use Dispels Myths About Protective

And Risk Factors." Huffington Post Chicago. October 21, 2011)

(Jamie Sotonoff. "Study explains why people use heroin."

Chicago Daily Herald. October 19, 2011)

("Study Sheds Light on Young Suburban Heroin Users – Research Points to Ineffective and Incomplete Drug Education as Factor in Heroin Initiation."

Robert Crown Center for Health Education. October 18, 2011)

For more information contact:
Joan Drummond Olson
Director of Communications
(630) 325-1900 ext. 10, jdolson@robertcrown.org