Majority of Heroin Users Begin with Rx Opioids

HealthDay News — The demographics of heroin users have shifted substantially in the past 50 years, according to a study published in JAMA Psychiatry.

Participants who began using heroin in the 1960s were predominantly young men (82.8%; mean age, 16.5 years). Heroin was their first opioid of abuse (80%). In contrast, more recent users were older (mean age, 22.9 years) men and women living in less urban areas (75.2%) and were introduced to opioids through prescription drugs (75%), the researchers found.

In those initiating use prior to the 1980s, whites and nonwhites were equally represented. However, nearly 90% of respondents who began use in the last decade were white. Heroin was selected because of its high and because it was more readily accessible and much less expensive than prescription opioids.

“Our data show that the demographic composition of heroin users entering treatment has shifted over the last 50 years,” Theodore J. Cicero, PhD, from Washington University in St. Louis, and colleagues reported.

The findings come from an ongoing study utilizing structured, self-administered surveys. The researchers gathered retrospective data on past drug use among 2,797 patients entering substance abuse treatment programs across the United States who were diagnosed with heroin use/dependence.

Data were also reviewed from unstructured qualitative interviews from a subset of 54 patients who completed the structured interview.


  1. Cicero TJ et al. JAMA Psychiatry. 2014; doi:10.1001/jamapsychiatry.2014.366.