Low-cost killer leaves the back alleys: heroin climbs up US social scale
Low-cost killer leaves the back alleys to become the drug of choice for middle-class suburbanites
Anna Richter grew up near a golf course in Centreville, Virginia, where the average family makes more than US$100,000 per year.
She was 15 when she began popping prescription painkillers to get high. Two years later, she snorted heroin for the first time.
"I tried it and I loved it. And I could get it any time I wanted," she said. Heroin was cheaper than pills like OxyContin or Vicodin and it gave her a euphoric high. "All those self-defeating thoughts were gone," she said.
By the age of 20, she was injecting heroin daily. She dropped out of college, moved back in with her parents and stole money from them to feed her habit.
"There were a ton of overdoses in the area and I lost a lot of friends in Virginia due to this disease," she said.
But it didn't stop her. The users she knew were much like her - affluent, white and from educated families. They had endured no major struggles on which to blame their behaviour.
Heroin "has become so much more common. It is not like that dirty drug that people think of any more", Richter said.
Indeed, a new study has found heroin is increasingly the drug of choice for young people in the US suburbs, where an epidemic of prescription painkiller abuse has opened the path towards the cheaper street drug.
A study published on Wednesday, The Changing Face of Heroin in the United States, spans the past 50 years and shows how heroin has made its way from the back alleys to the backyards of middle-class America.
The data is based on nearly 2,800 patient surveys filled out between 2010 and last year at drug treatment centres.
On average, people are 23 when they start using heroin, according to the findings in JAMA Psychiatry, a journal of the American Medical Association.
More than 90 per cent of those who began using heroin in the past decade were white.
Back in the 1960s and 1970s, more than 80 per cent of heroin users were African-American males who lived in the inner cities and who began using at 16.
"In the past, heroin was a drug that introduced people to narcotics," said lead study author Theodore Cicero, a researcher at Washington University.
"But what we're seeing now is that most people using heroin begin with prescription painkillers such as OxyContin, Percocet or Vicodin, and switch to heroin only when their prescription drug habits get too expensive."
Cost is a key factor for addicts, even in wealthy areas. Painkillers are often US$1 per milligram, or US$80 for an 80mg pill, whereas a bag of heroin could sell for US$10 to US$25.
A crackdown on pill mills and doctors who overprescribe or illegally distribute prescription pain medications has reduced supplies of opioids over the past decade. Also, non-crushable forms of pills have been released to discourage people from snorting and injecting them.
But experts say these changes have only pushed more drug abusers toward heroin.
About 467,000 people reported heroin use in 2012, the Centres for Disease Control and Prevention has said. And the number of heroin users has more than doubled since 2007.
About 3,000 people die in the US of heroin overdoses each year, according to government data.
Richter's parents eventually gave her an ultimatum - get treatment or get out of the house.
She went through two weeks of painful detox, followed by six months of rehab, exploring the roots of her addiction and what caused her to seek out drugs.
"I am clean and sober for six years now," she said.
Richter said she has found a purpose in life helping others enter rehab. But she admits that she doesn't know how to prevent other affluent suburban youths from succumbing to heroin.
"I can't sit here and say there is something out there to stop these kids from doing it," she said. "But we can show them that there is a solution. There is a way out."