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July 20, 2001 Heroin—Changes In How It Is Used |
In Brief |
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| The National Household Survey on Drug Abuse found that the age-specific rate of first heroin use among 12 to 17 year olds increased from less than 1 per 1,000 person-years during most of the 1980s to almost 2 per 1,000 person-years from 1996 to 1998.1 A large proportion of these new users smoked, sniffed, or snorted the drug. Data on substance abuse treatment admissions from the Treatment Episode Data Set (TEDS), 1993 to 1998, provide a way to monitor changes in the way drugs were used by the population. These data support the conclusion that inhaling heroin was a new and growing problem among young adults in the mid- to late 1990s. Further, these data suggest that users may have progressed from inhalation to injection as the addiction took hold. |
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Heroin Treatment Admissions In the 1990s, there were about 1.6 million annual admissions for substance abuse treatment in publicly funded facilities. Of these, the proportion who sought treatment for heroin addiction increased from 12 percent in 1993 to 14 percent in 1998. Historically, people treated for heroin addiction have injected the drug; in 1998, 66 percent of the people treated for heroin addiction were injectors (Table 1). However, this estimate reflects a decline from 74 percent in 1993. On the other hand, inhalation of heroin increased: in 1998, 29 percent of people treated for heroin addiction inhaled the drug, an increase from 23 percent in 1993. Age at Admission People who inhaled heroin and sought treatment tended to be younger than those who reported injecting heroin at the time of admission. However, the difference in age between these two groups decreased (Figure 1). In 1993, 47 percent of admissions for heroin inhalation were under 30 years of age. Only 23 percent of those injecting heroin at the time of admission were under 30. By 1998, however, 27 percent of those reporting heroin injection were under 30, compared with 35 percent of those admitted for inhaling heroin. One explanation is that those who began by inhaling the drug eventually went on to inject it. |
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Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).
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Duration of Use before Seeking Treatment Those who inhaled heroin sought treatment sooner than heroin injectors (Figure 2). The median duration of use before seeking treatment was about 6.5 years for inhalers and about 11 years for injectors. There are two possible reasons for the difference. First, heroin inhalation was relatively new compared to injection; people had less opportunity to inhale heroin than to inject it. Second, people may have progressed from inhalation to injection before first seeking treatment. First Treatment Episode As a new drug or route of administration is introduced, it attracts a new user group, people who have not been in treatment before. A high proportion of treatment admissions for the new drug will be entering treatment for the first time. As time goes on, however, admissions will include proportionally more long-term users (who have been in treatment before) and fewer new users. The proportion of heroin injectors entering treatment for the first time
was steady from 1993 to 1998, at 18 to 19 percent (Figure 3). But there was a decline in
the proportion of inhalers entering treatment for the first time. This pattern suggests
that heroin inhalation was relatively new. |
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Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).
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Methadone Treatment Heroin inhalers were less likely than heroin injectors to receive methadone treatment (Figure 4). The use of methadone as part of treatment generally declined for both heroin injectors and inhalers from 1993 to 1997. In 1996 and 1997, only one in four heroin inhalers was placed in methadone treatment, compared with about half of heroin injectors. In 1998, however, about one in three heroin inhalers was placed in methadone treatment. |
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The Drug and Alcohol Services Information System (DASIS) is an
integrated data system maintained by the Office of Applied Studies, Substance Abuse and
Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment
Episode Data Set (TEDS), a national-level dataset comprising State administrative data
from treatment facilities receiving public funds. The TEDS system includes records for
some 1.6 million substance abuse treatment admissions annually. TEDS records represent
admissions rather than individuals, as a person may be admitted to treatment more than
once. The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina. Information and data for this issue are based on data reported to TEDS through April 16, 2001. Access the latest TEDS reports at: Access the latest TEDS public use files at: |
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| Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).
End Notes 1The numerator of each rate is the number of persons in the age group who first used the drug in the year, while the denominator is the person time exposure measured in thousands of years. Substance Abuse and Mental Health Services Administration (2000). Summary of findings from the 1999 National Household Survey on Drug Abuse (DHHS Publication No. SMA 00-3466, NHSDA Series H-12). Rockville, MD: Author. |
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The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report may be downloaded from Other reports from the Office of Applied Studies are also available on-line at the OAS home page: http://www.oas.samhsa.gov. |
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This page was last updated on December 31, 2008. |