Heroin Addiction Trends

Heroin addiction indicators show mixed trends.

Heroin addiction deaths was increasing notably in three areas (Detroit, Minneapolis/St. Paul, and Phoenix), declining in two (Miami and Seattle), and stable in two. ED indicators were also mixed, with 10 cities showing decreases (2 significant-Miami and Baltimore) and 10 cities showing increases (2 significant-San Francisco and Washington, DC). Heroin is the predominant drug of choice among addiction treatment admissions in three reporting sites, excluding Baltimore, where cocaine and heroin admissions are evenly distributed, and Seattle, where heroin addiction and marijuana addiciton admissions to addiction treatment are even distributed. Opiate-positive urinalysis levels among adult males remained relatively low (ranging from 3.4 to 20.1 percent-positive) and stable in most cities, except for Atlanta and Washington, DC, where opiate-positive levels increased, and in Philadelphia and Seattle, where levels declined. Conversely, among adult females, opiate-positive levels increased substantially in six cities (Chicago, Minneapolis/St. Paul, New Orleans, Phoenix, San Diego, and Washington, DC); they declined notably in Detroit.

Heroin purity ranges from 10.7 percent in Miami to 72 percent in Philadelphia. Purity trended mostly upward or remained stable: increases were particularly steep in five cities (Detroit, Los Angeles, Newark, New Orleans, and Phoenix); a decline was notable in Denver (by 22.4 percentage points). Price trends were mixed. A troubling development is the continued reporting of teen heroin use and heroin addiction in many cities, including Atlanta (mostly white youth who snort), Baltimore, Boston (mostly young adults who inject and some high school students who snort), Chicago, Denver (youth who primarily snort or smoke), Detroit (suburban youth), Newark, Seattle (young injectors), and Washington, DC. In Boston, Chicago, Denver, Miami, and Washington, DC, snorting heroin seems to be increasing and is often the initial route of administration for many young, new users; conversely, injecting is on an upward trend in Baltimore (among suburban youth), Boston (among youth), Minneapolis/St. Paul, Newark, New York City, and Seattle (among younger users), and many CEWG ethnographers note that heroin snorters often progress to injecting. Heroin addiction trends show a great need for real addiction treatment NOW.

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