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Heroin Use Higher in New Jersey's Suburbs, Rural Areas

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WebMD Health News
Reviewed by Gary D. Vogin, MD

May 17, 2001 -- Injection drug use has declined steadily in America's inner cities, but New Jersey's public health officials have detected a disturbing new trend. Since 1993, the use of injectable heroin and cocaine has increased -- raising concerns about spread of HIV and other infections.

And the increased use was in young adults outside the urban areas -- a group not previously thought to be at high risk, says the new CDC study.

"We found an increase in injection heroin use in younger age groups -- 18 to 25 -- in all ethnic groups across the state," says lead author Anna Kline, PhD, director of research in the division of addiction services of the New Jersey Department of Health. "We also noticed an expansion into the suburbs and rural areas."

In her study, Klein looked at data on persons admitted to New Jersey addiction outpatient treatment centers who reported using injectable drugs from 1992 to 1999. She also analyzed data on users of injectable heroin and cocaine from 1980 to the early 1990s. The numbers of injectable users declined from the 1980s through the early 1990s, says Kline.

In 1995 the trend shifted, with 43% of patients reporting use in 1993 compared with 45% in 1999. The largest increases were among those 18 to 25 years old, says Kline. That number rose from 22% in 1993 to 46% in 1999.

Total numbers of injectable drug users increased substantially among suburban/rural residents from 1993 to 1999 while it declined among urban residents.

"Quite bluntly, that can't be good news," says George DiFerdinando, MD, deputy commissioner for the New Jersey Department of Health and Senior Services. DiFerdinando is a co-author of the CDC study.

But can local drug use patterns give an idea of what's going on nationally?

"Not really," says DiFerdinando. "To a surprising extent, drug use patterns can be very local or even regional. Methamphetamine is extremely popular in other parts of the country, but we haven't had too much of that problem in New Jersey. We have a substantial problem with ecstasy while some parts of country don't."

It's the age group that he's most concerned about, DiFerdinando tells WebMD.

"We see it in this study and others -- high-risk behaviors in the 18- to 25-year-old group have greatly increased. The message isn't getting through. We have to keep pushing the prevention message with the same intensity that we did at the beginning of the HIV epidemic 15 years ago. It was a crisis atmosphere, and we felt we had to do everything possible."

Not all experts agree with the CDC data. In fact, national studies show that since 1995 heroin use in young adults -- 19- to 29-year-olds -- has remained "amazingly constant," says Lloyd Johnston, PhD, principal investigator of the Monitoring the Future study from the University of Michigan Institute for Social Research. His studies are funded by grants from the National Institute on Drug Abuse, an arm of the National Institutes of Health.

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