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Substance Abuse and Addiction Health Center

Today's Heroin Abusers Often Middle Class: Study

Problem often starts after prescription painkiller use, researchers say
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That profile shifted over time, however -- especially during the 1990s. And by 2010, about 90 percent of recently initiated heroin abusers were white, and half were women. The average age of today's heroin user was 22.9 years old. And, 75 percent lived in "less urban" areas, according to the study.

Three-quarters of people who began abusing heroin after 2000 only did so after they were hooked on prescription painkillers.

In interviews with the researchers, 54 study participants talked about their motivations to switch to heroin: It's cheap and easy to get.

"The heroin dealer has changed from the stereotypical image of a guy on a dark street corner in a bad neighborhood," Cicero said.

Instead, people reported getting heroin from middle-class neighbors or classmates. And the price tag added to the allure.

On the street, OxyContin can run up to $80 for a pill -- while heroin can be as cheap as $6 for a bag, Kleber noted.

What's "scary," Cicero said, is that injecting heroin carries risks beyond those of abusing narcotic pills -- including the risk of infection from sharing needles, and the potentially fatal effects of injecting a substance that may not be pure or sterile.

That said, both Cicero and Kleber stressed that the findings are not a reason to deny painkiller prescriptions to people who need them.

"Very few" people who take the medications for legitimate reasons are going to become heroin addicts, Cicero pointed out. "The average patient doesn't need to worry about that," he said.

Another addiction expert said the study is limited by the fact that it included only heroin abusers seeking treatment at around 150 centers. It's not clear how "socioeconomically diverse" that group of people might be, said Janina Kean, president of the High Watch Recovery Center, a drug rehab facility in Kent, Conn.

However, she agreed that heroin is now entrenched in the suburbs.

The bigger issue, Kean said, is that "in this country, we are still not adequately treating a serious chronic disease, which is addiction."

In this study, some heroin abusers said they didn't, at first, see themselves as addicts because they did not fit the stereotypical "junkie" image. Kean said people need to be educated on what addiction really looks like.

"There's so much stigma around it," she said. "And stigma is a barrier to treatment."

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