Heroin Use Stats in America May Be Higher Than Reported

By Paul Gaita 08/25/17

A new analysis of heroin use data suggests that the statistics may not include certain sections of the population. 

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Analysis in the Washington Post suggests that recent statistics may not accurately reflect the true number of individuals with heroin dependency and overdose deaths in the United States.

The story examines figures from the National Survey on Drug Use and Health (NSDUH), an annual survey that details patterns of alcohol, tobacco and illegal substance use and mental health among U.S. citizens 12 years and older.

According to the NSDUH, 591,000 Americans have heroin use disorder. But the Post opines that the numbers may, in fact, be flawed, based on the exclusion of certain sections of the population and information about drug use withheld by survey participants.

The analysis' author suggests that the true number of Americans with heroin use disorder may in fact be twice, or even three times, the amount estimated by the NSDUH.

According to the Post story, written by Stanford University professor of psychiatry Keith Humphreys, the key problems with NSDUH's data involve individuals who are not included in the survey—namely, members of the U.S. prison population and homeless individuals.

The Post piece suggests that both groups have very high rates of drug use, and statistics appear to underscore this idea in regard to U.S. prisoners: a 2015 feature by Politico cites 300,000 of America's 2.2 million adult inmates as having a history of heroin dependency, while 2013 research conducted among the homeless population in Boston, Massachusetts, found that overdoses from drugs—predominately heroin and prescription painkillers—were the leading cause of death for homeless adults in that city.

By not including these two groups, the Post article suggests that a significant section of the U.S. population has not been included in the NSDUH survey.

The analysis also notes that the NSDUH relies on individuals self-reporting their own drug use, and suggests that fear and discomfort about revealing heroin use to a government-related survey may hamper honest admissions from survey participants. Other factors that could negatively impact the NSDUH survey, according to the analysis, include incomplete death certificate data from county coroners, which the Post says are among the main sources for overdose mortality statistics.

The feature cites a 2017 report that proposes that a number of death certificates that list drug overdose as the primary cause of death do not specify which substances were involved; when corrected, the study author suggests that the death rate for heroin overdose in the U.S. could be more than 20% above government figures.

By compiling more accurate data on heroin from a wider range of demographics than those included in the NSDUH report, the Post feature suggests that government agencies may be able to provide greater and more accurate policies—and in turn, treatment—to assist Americans grappling with heroin dependency today.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites.