Statistics on Drug Use in America
There are many elements to substance abuse in the United States, and the numbers tell some of those stories. Facts and figures on how entire communities, neighborhoods, and cities have been ravaged by men and women becoming addicted to dangerous chemical substances are the tip of the iceberg, but the statistics on drug use in America shed light on how widespread the problem is.
States of Abuse
In 2013, the Substance Abuse and Mental Health Services (SAMHSA) released a report of the areas in America that were most severely hit by drug use between 2010 and 2011. With 626,000 people, Vermont is the second least populated state in America, but it was the most mentioned state in the SAMHSA report: 95,765 of its residents (15.29 percent) used illegal drugs within the month prior to being surveyed. On the other end of the spectrum was Utah, where only 4.29 percent of its 2.76 million people admitted to taking drugs in the month before the survey.
The purchase and use of marijuana for recreational purposes in Vermont are illegal, but 13.12 percent of the state’s residents told SAMHSA that they smoked it. Perhaps unsurprisingly, teenagers accounted for the highest demographic of consumption at 14.04 percent.
The population of Washington, DC is even less than that of Vermont, but 3.04 percent of the residents in the district reported using cocaine between 2010 and 2011. Commenting on the SAMHSA findings, Business Insider writes that, according to the US Drug Enforcement Agency, crack cocaine is the biggest drug-related public health concern for the district. A documentary produced by WAMU 88.5 radio talks of how crack – “the drug that consumed the nation’s capital” – used to be sold openly. With addiction came the crime, making DC the “nation’s murder capital.” SAMHSA’s polling revealed that DCs 2nd Ward possessed the highest rate of cocaine use across any area in the country.
In 2014, the National Survey on Drug Use and Health reported that 1.5 million Americans aged 12 and up had used cocaine in the past month. For adults between the ages of 18 and 25, 1.4 percent of respondents used cocaine in the month before the survey, which was the highest rate of active cocaine use among those age demographics.
Statistics on Narcotics
SAMHSA saved its gravest statistics on drug use for the scourge of opioid abuse that has made headlines across the country. In Oregon, 6.37 percent of the state’s 3.83 million people (244,039 people) told SAMHSA that they took restricted painkillers for off-label (recreational) purposes. They either faked symptoms, forged prescriptions, borrowed (or stole) pills from friends or family members, or illegally bought pills from people they knew or online.
Overdosing on prescription painkillers is behind more American deaths than heroin and cocaine combined. In 2013, medications like oxycodone and hydrocodone were responsible for 16,235 people dying; in that same year, cocaine was implicated in the deaths of 4,944 people and heroin in the deaths of 8,257 people. Marijuana and prescription drugs are the most consumed drugs in America, accounting for more consumption that heroin, methamphetamines, MDMA, and cocaine put together. Even as heroin deaths surge, says the Huffington Post, “the deadliest drugs still come in pill bottles.”
More people have died from overdosing on prescription painkillers than have been killed in car crashes. This “deadly epidemic” has been the status quo since 2008, according to the Centers for Disease Control. Opiates like oxycodone (branded OxyContin) and hydrocodone (branded Vicodin) are behind the deaths of an average of 40 Americans every day, or 15,000 people every year. Despite the daunting numbers and health risks, the pharmaceutical industry and household name-recognition of many of these drugs as a go-to for pain or discomfort have led to them saturating the painkiller market. In 2010, says the CDC, doctors and pharmacies had prescribed enough of these medications to theoretically give everyone in the United States (309.3 million people that year) enough drugs to last them for a month.
The Prescription Problem
The deadly epidemic that the CDC spoke of has two sides: the prescription opioids that are widely given to patients (or bought and sold illegally), and the heroin that lurks in the background. Healthline explains how both heroin and opioid-based painkillers, such as morphine, codeine, hydrocodone, oxycodone, and dozens of others, are chemically isolated from the opium poppy. Once consumed by a user, they work in much the same way: attaching themselves to the opioid receptors in the brain so that any transmission of pain or discomfort is dulled (or even entirely blocked), leaving instead a pleasant, euphoric feeling.
For people in legitimate physical distress, the sensation might be their only source of relief; but the drugs are so powerful that even a person in perfectly normal health will experience the narcotic bliss of being on those medications. Over time, the allure becomes an addiction, and the only priority is to chase those feelings again. At that point, heroin becomes a cheaper, more widespread, and more effective alternative.
A doctor at the National Institute on Drug Abuse (NIDA) tells Healthline that at least 80 percent of heroin addicts today got their first taste of opioids from legally prescribed medication. It’s a marked difference from a generation ago when heroin was in a class of its own. What’s changed is how, during the 1990s, drug companies aggressively marketed opioid painkillers as a cure-all for any ailment. Doctors and consumers alike were bombarded by advertisements and marketing pitches for OxyContin, the brand-name variation of oxycodone produced by Purdue Pharma, which raked in hundreds of millions of dollars a year in sales on that drug alone.
In 1991, there were 76 million opioid prescriptions written across America, says Healthline. By 2011, the number had increased to 219 million. With so many powerful drugs being prescribed so quickly, a generation of Americans (all from different demographics, ethnicities, age groups, and genders) got hooked on their meds. Over 60 percent of the drug overdoses in 2014 were a result of opioid abuse.
The Transition to Heroin
The flood of opioid-based prescription medication has changed the landscape of drug abuse in America. While marijuana use is a risk factor for heroin addiction (People who consume cannabis are three times more likely to get addicted to heroin than those who don’t use drugs.), and cocaine users have a 15-fold risk, an addiction to prescription opioids raises the risk of a heroin problem by 40 percent, according to the CDC.
“They start off with pills,” said the doctor from the National Institute on Drug Abuse, “and then there’s a transition to heroin.”
More than 669,000 people across the US told the National Survey on Drug Use and Health that they took heroin in 2012. The director of NIDA attributes the figure to the saturation of prescription medication that has given hundreds of thousands of people their first taste of the same chemical compounds that are found in heroin. This represents the biggest public health and safety issue facing Americans today, says NIDA.
Even as other drug use falls, writes Forbes magazine, heroin abuse is on the rise. The problem is felt very severely felt in Vermont. Already noted by the Substance Abuse and Mental Health Services Administration for its high rates of drug abuse, the catastrophic spike in heroin-related fatalities – which rose by 250 percent from 2000 to 2014 – led to Governor Peter Shumlin using the entirety of his 2014 address to the Vermont legislature to talk about the “full-blown heroin crisis” in his state. Between 2000 and 2012, Vermont hospitals saw more than 770 patients who needed treatment for opioid overdoses; 80 percent of the state’s prison population were charged for crimes stemming from drug possession and distribution; and every week, more than $2 million in heroin and illegally sold prescription pills are smuggled through Vermont.
Massive Increase in Heroin Addiction Treatment
“No other drug,” writes Yahoo! News in 2015, “has risen in popularity more [than heroin].” While Vermont’s struggle with the hike in heroin use has made headlines, it is the state of Kentucky that, according to HealthGrove, is the state with the biggest heroin problem. In 2002, there were only 65 reported admissions to rehabilitation centers for heroin use. Just a decade later, the number had increased to 1,282, a mind-boggling increase of 1,872.3 percent.
A sample of the other states with the most dramatically spiraling rates of heroin abuse include:
- Oregon: 4,421 heroin rehab admissions in 2002; 39,051 admissions in 2012; 783.3 percent increase
- Missouri: 249 admissions in 2002; 4,065 admissions in 2012; 1,532.5 percent increase
- Alaska: 11 admissions in 2002; 197 admissions in 2012; 1,690.9 percent increase
Alaska’s population was a mere 731,081 in 2012, giving it “one of the biggest drug problems in America,” in the words of National Geographic.
Despite being the largest state in America by area, it is the third least populous state and the least densely populated state in the country. The situation is reversed on the other side of North America, where New Jersey – the fourth smallest state, the 11th most populous, and the most densely populated – is having its own heroin nightmare.
New Jersey’s New Problem
In the Garden State, more people have succumbed to heroin overdoses than have died as a result of HIV/AIDS, suicide, or even vehicular accidents. North Jersey News describes the problem as “the deadly secret” of the suburbs. The geographical area hints at how the opioid epidemic has changed the statistics of drug use in America. While heroin was historically and typically seen as a drug consumed by low-income, disenfranchised people, New Jersey’s 2008 per capita gross state product ranked second across the United States and above the national per capita gross domestic product ($54,699 to $46,588). At $51,358, the state’s per capita income was the highest in the country.
With New Jersey doing so well for itself, why is it one of the centers for the opioid crisis striking at the heart of America? In the words of the chairman of the New Hampshire Governor’s Commission on Alcohol and Drug Abuse talking about the situation in his own state, every community, demographic, and ethnic group have been hit by the plague of drug overdose deaths.
In New Jersey, the problem is such that 49 percent of the state’s residents need treatment for heroin or prescription painkiller abuse. That amounts to 128,000 people, a number so large that putting all those people together would make up New Jersey’s fourth biggest city. The population of that hypothetical city (dubbed “Herointown” by NJ.com) receive a steady stream of prescription medications from their local doctor (who may or may not be receiving bonuses from one of the many pharmaceutical corporations based in the state), the neighborhood pharmacy, or a friend or family member who’s willing to share. These people aren’t heroin addicts, but lawyers, teachers, engineers, and promising sports prospects who pick up an injury and are put on a regimen of OxyContin or Vicodin – some of the most abused and habit-forming drugs in the country.
The result is that the rate New Jersey’s heroin overdose deaths is three times higher than the national average: 741 fatalities tied to overdoses in 2013 equates to 8.3 deaths per 100,000 in the state; the national amount for 2013 is 2.6 per 100,000. All it took was 10 years, said the director of the Centers for Disease Control, and the landscape of addiction changed irrevocably. Analysis of the situation in New Jersey shows that heroin overdoses have resulted in the death of more people every year “than the flu and pneumonia combined,” according to the state’s Department of Health.
The CDC figures are only updated to 2013, but local investigations have found that the problem persisted; 781 people died because of overdosing on heroin in the state in 2014, making the fourth consecutive year that the number has increased unabated. Since 2010, New Jersey has experienced an increase of deaths blamed on heroin of over 155 percent. The counties of Middlesex, Monmouth, Bergen, and Passaic suffered the brunt of the wave; each one lost more of its residents to heroin than it had in the previous year (the increase was at least 25 percent). Hundreds more people died after overdosing on prescription drugs, a sign that efforts to restrict the trend of overprescribing have yet to turn the tide in the crisis.
America’s Heroin Capital
But while New Jersey’s struggle with heroin is a recent development, Baltimore’s problem goes back a very long way. With approximately 60,000 heroin addicts calling the city home, it has become “the heroin capital” of the United States; the statistics account for 10 percent of Baltimore’s 645,000 people. In 2002, the Drug Enforcement Administration reported that the higher number of heroin addicts and the highest rates of crime caused by heroin (usually property crime in an attempt to get money to buy more heroin) are found in Baltimore. The finding wasn’t a new one: as far back as 1983, the journal of Drug and Alcohol Dependence published an article on “the day-to-day criminality of heroin addicts in Baltimore.” Researchers wrote that “the start of addiction was associated with a high level of criminality,” with individuals committing crimes related to the procurement of heroin an average of 255 days a year.
As recently as December 2015, the White House and the Baltimore mayor’s office calculated that at least $165 million is spent on heroin every year.
One Year, 300 Heroin Deaths
In 2013, Baltimore hospitals recorded over 300 deaths as a result of people overdosing on heroin. The city’s strategic location on the East Coast makes it a haven for smugglers and kingpins, who capitalize on the generations of crime, corruption, racial tension, and antipathy toward law enforcement and local government. This makes the Helen Delich Bentley Port of Baltimore one of the key landing zones for heroin (and other contraband) that is shipped up from the loosely monitored Caribbean islands; this, in turn, means that the heroin that is spread and sold across Baltimore is chemically purer than the product that is eventually trucked and trafficked to other destinations. The problem is similar in New Jersey, where the Port Newark-Elizabeth Marine Terminal – the largest shipping port on the East Coast – has been used to facilitate the movement of drugs.
As an example of the magnitude of the problem, in the same year that more than 300 Baltimore residents overdosed on cocaine, US Customs and Border Protection agents seized 128 pounds of cocaine inbound from Panama. The value of the haul was $4 million.
Justice, West Virginia
The extent to which the opioid epidemic has shifted statistics on drug use in America is best shown in the damage done to some of the areas and people in America’s heartland. In the small towns that dot the landscape far removed from the bustling streets or neatly mowed lawns of cities and suburbs, illegally trafficked prescription painkillers are given a new name: hillbilly heroin, so called because of the clientele who get hooked on the drugs. They are usually low-income, poorly educated, and working in strenuous and dangerous jobs, like mining, farming, construction, and timber-work. They live far from the eye of robust law enforcement, and news stories of the dangers of prescription medication abuse filter slowly.
This is the situation in states like West Virginia, specifically the tiny town of Justice, where The Guardian writes that 40 percent of the adults have developed an addiction to opioids. The population of Justice – named after an early postmaster – is only 412. The nearby town of Gilbert is having a very similar problem. Not only are prescription tablets passed around and consumed at leisure, families on welfare trying to make money any way they can are turning to selling the tablets. That such an act is a felony makes no difference to people who are desperate for money and desperate to get high again. When the money doesn’t come, they resort to shoplifting and theft. “We’re a real small town,” the Gilbert police chief told The Guardian, “and our thefts tripled in the last summer.” Police believe that 80 percent of the crime committed in the small towns of the hilly counties of the Virginias and Kentucky are OxyContin-related.
In the early 2000s, writes Mother Jones, only 5 percent of the people seeking substance abuse treatment in West Virginia were struggling with opioid abuse; then, the poison of choice was alcohol. But through a combination of aggressive pharmaceutical business, corrupt doctors, and a sense of despair and desperation that began to fester in small, forgotten towns, where half the population depend on relief checks (usually based on compensation for workplace injuries or low income), rural America has a new vice. It was just 5 percent a decade ago, but in 2012, 26 percent of West Virginians checking in for treatment did so because they were hooked on OxyContin or Vicodin.
In 2001, there were 91 recorded overdose deaths in West Virginia; seven years later, the number was 390.
The Crisis in California
For all intents and purposes, California is on the other side of the world from West Virginia, but the medical community and law enforcement fear that the heroin problems of the Appalachian region are heading toward the Golden State. It is the worst healthcare crisis in the history of the state, says Bakersfield.com; California hospitals treat one overdose as a result of heroin or prescription painkillers every 45 minutes. Overdoses killed 4,521 Californians in 2014, more than any other state in America for that year. Between 2011 and 2012, Kern County hospitalized 1,112 of its residents because of opioid overdoses and buried 131.
The less populated areas of the state have not been spared the misery of addiction. Shasta County has a population of 177,223 (out of the state’s 39.14 million), but over 1,100 of its people overdosed on heroin between 2006 and 2013. Per 10,000 people, eight of Shasta County’s residents overdosed, which is three times the state average. Other California counties with overdose rates higher than California’s average include Sacramento, Placer, and El Dorado.
California is home to San Francisco, the second most densely populated major city in America. San Francisco was mentioned in a 2009 Forbes article as one of “the drug capitals of America,” along with New Orleans and Baltimore.
The Forbes article also made special mention of a small city in New Mexico called Española.
When Española was accounted for in the 2010 census, it only had a population of 10,495, but other government measures have consistently found Española to top the rankings for the cities that experience the most drug overdoses. The national average of drug-related deaths per 100,000 citizens is 7.3; in Española, it is 42.5. The New York Times reports that the city is torn between a desire to eliminate drug use and simultaneously encourage drug users to go to the authorities for help. Caught in that deadlock, “there has been no evidence yet of a decline in addictions,” furthermore due to there being a dearth of treatment facilities in the area.
In Española, heroin addiction goes back a long way. Soldiers returning from the Vietnam War brought their substances (and dependencies) with them, and, like with the tightly knit communities of the heartland, family drug use bred a new generation of addicts. Add the proximity to the Mexican border into the equation and the prescription opioid epidemic infecting small, remote places where education is low and public health information is hard to come by, and Española adds its name to the woeful list of statistics on drug use in America.
Meth in Missoula
To assume that race and ethnicity play roles in determining the nature of the statistics would be erroneous. Española is 85 percent Hispanic; Missoula, Montana, on the other hand, is only 2.9 percent Hispanic, but a 2009 Substance Abuse and Mental Health Administration survey found that Missoula had the highest rate of illegal drug use in the United States: From 2004 to 2006, 13.8 percent of households reported consumption of illegal drugs. A hometown detective was at a loss to explain to the Missoulian why his fellow citizens would turn to meth in such large numbers. In 2012, the number of crimes and charges related to methamphetamine jumped by 30 percent, and it has kept growing.
That sense of frustration and despair is echoed by every member of the law enforcement and medical communities across the country. Whether as a result of the prescription opioid crisis, smarter smuggling operations, or cybercrime, drug use in America has not yet slowed down. Fighting against the trend are drugs like Narcan, the nasal spray that can reverse overdoses, and new policing initiatives that offer drug users treatment and rehabilitation instead of prison time. The desperate hope is that such measures will make the statistics on American drug consumption look very different before an entire generation is lost.