Drug use patterns in the USA point to more rapid injecting

11 May 2017

As prescription opioid addiction continues to increase in the USA – researchers predict a rising epidemic of injecting-related diseases such as HIV and hepatitis.

An illustration of a needle

People who abuse prescription painkillers, or opioids, in the USA are more likely to transition more rapidly to injecting their drugs over people who abuse stimulants, such as cocaine and amphetamines – putting them at a greater risk of HIV and hepatitis C.

A study led by the University of Southern California, Keck School of Medicine, found that compared to older generations, younger drug users were more likely to use heroin and prescription opioids as their first drug, meaning they are more likely to take up injecting practices. 

776 people who used drugs in Los Angeles and San Francisco were include in the study, of those born in 1970’s, it took them around nine years to start injecting – of those born in the 1980’s and the 1990’s, it took just six years for them to progress to injecting.

“The prescription opioid epidemic is creating a heroin epidemic, which will create an injection drug use epidemic,” said Ricky Bluthenthal, lead author of the study. “We’ve seen the first two. Now we’re waiting to see the last emerge on the national level. I predict we’ll see an uptick in injection-related diseases over the next couple of years.”

The use of opioids and heroin is currently on the rise in the USA, with the USA Center for Diseases Control (CDC) estimating an increase of 63% in opioid use between 2002 and 2013 alone. This rise is linked to the increase in hepatitis C infections and new outbreaks of HIV.

"The more rapid transition to injection is an impact of the prescription opioid-to-heroin use phenomenon," Bluthenthal said. "Heroin is most efficiently used via injection as compared to other formerly popular drugs such as crack cocaine or even cocaine."

The researchers state that an adequate response to these changing trends is needed, to prevent future disease-related epidemics. Prevention activities need to be tailored to the specific location and culture and behaviours of the people taking drugs in specific locations.

"We need to get ahead of a possible drug injection epidemic.” Bluthenal commented: "What works for Latinos in East Los Angeles might not work for people in West Virginia. We need to come up with prevention activities responsive to specific cultures, generations and locales to combat the move to drug injection."

Photo credit:

Written by Caitlin Mahon

Content Specialist - HIV & Sexual Health