Here's How Clinicians Can Slow Down Rising Heroin Use Disorder
the Clinical Pain Advisor take:
Understanding how to curb rising heroin use disorder can assist clinicians with tackling today's heroin epidemic.
Not only is heroin use increasing in the country, but overdoses are increasing, too. According to the Centers for Disease Control and Prevention (CDC), more than 8,200 people died from heroin-related overdose deaths in 2013.
To respond to this growing concern, there are several ways physicians can assist with preventing additional cases from arising: prevent, reduce and reverse.
The CDC believes there are several steps to diminishing heroin-related overdose deaths:
-- To prevent people from starting heroin, reduce prescription opioid painkiller abuse.This can be achieved by improving opioid painkiller prescribing practices and identifying high-risk individuals early.
-- Reducing heroin addiction can be accomplished by ensuring access to medication-assisted treatment (MAT). Treat people addicted to heroin or prescription painkillers with MAT. This method combines the use of medications with counseling and behavioral therapies.
-- To reverse heroin overdose, expand the use of naloxone. Using naloxone, a drug that can reverse the effects of an opioid overdose when administered in time, can save lives.
Those who are most at risk of heroin addiction include people who are addicted to prescription opioid painkillers (45% of people who used heroin were also addicted to prescription opioid painkillers); people who are addicted to cocaine; people withour insurance; non-HIspanic whites; males; people who are addicted to marijuana and alcohol; and people living in a large metropolitation area.
Also worth noting, heroin has more than doubled among young adults ages 18 to 25 in the past decade.
Ninety-six percent of people who reported heroin use also reported using at least one other drug in the past year; more than half (61%) using at least three other drugs.
A new report in the Centers for Disease Control and Prevention's (CDC) Vital Signs outlines key findings associated with heroin use disorders, including demographics and the need for comprehensive treatment strategies.
The CDC and the Food and Drug Administration (FDA) reviewed data from the 2002–2013 National Survey on Drug Use and Health to compare trends among demographic and substance-using groups, including characteristics associated with heroin use disorders.
The report included the following statistics:
- Ninety-six percent of people who reported heroin use also reported using at least one other drug in the past year; more than half (61%) using at least three other drugs.
- Individuals at the greatest risk of heroin abuse or dependence included non-Hispanic whites, men, 18-to-25 year-olds, people with an annual household income less than $20,000, Medicaid recipients, and the uninsured.
- Significant increases in heroin use were found among women and people with private insurance and higher incomes, despite these groups previously having low rates of heroin use. Gaps between men and women, low and higher incomes, and those with Medicaid and private insurance narrowed in the past decade.
- From 2002 through 2013, the rate of heroin-related overdose deaths nearly quadrupled.
People who abused or were dependent on:
- prescription opioid painkillers were 40 times more likely to abuse or be dependent on heroin.
- cocaine are 15 times more likely to abuse or be dependent on heroin.
- marijuana were three times more likely to abuse or be dependent on heroin.
- alcohol were two times more likely to abuse or be dependent on heroin.
The report also encourages healthcare providers to:
- Follow best practices for responsible pain medication prescribing to reduce opioid addiction, the strongest risk factor for heroin addiction.
- Use prescription drug monitoring programs and ask patients about past or current drug and alcohol use prior to considering opioid treatment.
- Prescribe the lowest effective dose and only the quantity needed for each patient.
- Link patients with substance use disorders to effective substance abuse treatment services.
- Support the use of FDA-approved MAT options (methadone, buprenorphine, and naltrexone) in patients addicted to prescription opioid painkillers or heroin.
For more information call (800) 232-4636 or visit CDC.gov.
1. CDC, et al. Vital igns. 2015; In press.