Young people are finding it cheaper and easier to get heroin than prescription opiates these days. Both kinds of drugs offer a similar high, and a similar addiction danger, said Caleb Banta-Green, author of the report and a researcher at the University of Washington's Alcohol and Drug Abuse Institute.
The data from Washington mirrors a national trend, but the most up-to-date national research is a few years behind Washington, according to Tom McLellan, CEO of the nonprofit Treatment Research Institute and President Barack Obama's former deputy drug czar.
A National Institutes of Health study cites national numbers from 2009 that show a national rise in opiate addiction and overdoses. The authors of that study, which was published in February 2013 in the Public Library of Science journal, predicted heroin use would likely increase as a result.
"The state of Washington has by far the best and the most comprehensive and the most up-to-date statistics, way better than the national government," McLellan said.
Banta-Green found the largest increases in heroin use and abuse in Washington state were outside of metropolitan areas, where drug treatment and awareness are lowest.
Overdose deaths from heroin or related prescription drugs more than doubled in Cowlitz, Snohomish, Grays Harbor, Chelan, Lewis, Mason, Thurston, Benton and Kitsap counties between 2000 and 2011.
"It's a big change," Banta-Green said, adding, however, that he's not surprised by the data.
He attributed part of the increase to new state rules that make it harder to get pharmaceutical opiates because of better prescription tracking.
Washington is ahead of the nation in that trend, Banta-Green said. He expects other states also may see an increase in heroin use after they tighten their prescription rules.
"This is a state manifestation of the broader national picture," McLellan agreed.
Since 1997, doctors and pharmacists have done a better job nationally of treating pain, but the unfortunate side effect of that medical improvement was the more prescription pain medication was getting in the wrong hands because of theft or resale, he explained.
The diversion of drugs has led to an increase in overdoses, especially among young people, and has also led to more interest in heroin, McLellan said.
Washington is also setting an example for the nation with new pharmacy rules that allow pharmacists to distribute overdose response kits, including a medical antidote to heroin, naloxone, without a prescription from a doctor. So far, only one pharmacy in Washington is participating in the program, but Banta-Green expects that will change.
"What we are seeing and the pharmacy work is leading the country, for good and bad," he said.
Banta-Green used three sources of data for his study: police drug evidence testing, treatment statistics and county death certificates. Here's what he found:
-- The number of pieces of police evidence that tested positive for heroin totaled 842 in 2007 and increased statewide to 2,251 in 2012.
-- Drug treatment admissions for heroin increased statewide from 2,647 in 2002 to 7,500 in 2012. The majority of 18- to-29-year-olds seeking drug treatment for the first time in 2012 were being treated for heroin use.
-- The number of accidental deaths statewide involving heroin and prescribed opiates doubled from an average of 310 a year between 2000 and 2002 and 607 a year from 2009 to 2011. In King County, almost three-quarters of drug-caused deaths involved heroin or a prescription opiate between 1997 and 2012.
Banta-Green believes the pharmacy program and a relatively new 911 overdose Good Samaritan law, along with increased awareness, could turn at least the overdose statistics around.
Washington passed the Samaritan law three years ago to encourage people to seek professional help when someone is overdosing. The law gives the person calling for medical help immunity from prosecution for drug possession charges.
Report on opiates: http://bit.ly/1a4rr0w
Stop Overdose: http://www.stopoverdose.org
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