Heroin is a highly addictive opioid derived from morphine that can be injected, inhaled or smoked.
The findings from the National Center for Heath Statistics (NCHS) report state that the age-adjusted rate of deaths involving heroin increased from 0.7 deaths per 100,000 to 2.7 per 100,000 during this period, with the majority of this rise occurring after 2010.
"This report provides the latest national statistics on drug overdose deaths involving heroin, highlighting the substantial increase in death rates and the populations most at risk," the authors state.
Drug poisoning (overdosing) is the number one cause of injury-related death in the US. In 2013, a total of 43,982 deaths across the country were attributed to drug poisoning.
According to the National Institute on Drug Abuse (NIDA), in 2011, around 4.2 million Americans aged 12 and above (1.6% of the population) had used heroin at least once in their lives. Experts believe that almost a quarter (23%) of individuals that use heroin go on to develop a dependency on the drug.
Many heroin overdoses are characterized by a suppression of breathing that reduces the amount of oxygen that can reach the brain (hypoxia), potentially leading to dangerous symptoms such as coma and brain damage.
While in recent years the amount of drug-poisoning deaths involving opioid analgesics has leveled, deaths involving heroin have experienced a sharp spike, with death rates reportedly tripling since 2010.
During the period investigated, the researchers found an average increase in heroin-related drug-poisoning deaths of 6% per year from 2000 through to 2010. From 2010 through 2013, the average increase was a staggering 37% per year.
The new report from the CDC provides demographic insight into heroin use by identifying which populations heroin-related drug-poisoning is most prevalent in. "Identifying populations at high risk of heroin-related drug-poisoning death can help target prevention strategies," write the authors.
Heroin-related drug-poisoning deaths were far more prevalent among men than women, with 1,732 women reported having died from heroin use in 2013, compared with a total of 6,525 men - nearly four times as many.
As death rates increased between 2010 and 2013, this ratio remained consistent. The rate for men increased from 1.6 to 4.2 per 100,000 while the rate for women increased from 0.4 to 1.2 per 100,000. The researchers also found that the rate of heroin-related drug-poisoning deaths was consistently highest among adults aged 25-44.
A number of demographic shifts were observed, however, from 2000 through 2013. In 2000, the highest rate for heroin-related drug-poisoning deaths for racial and ethnic groups was among non-Hispanic black people aged 45-64. By 2013, these deaths were most prevalent among non-Hispanic white people aged 18-44.
There was also a regional shift in where drug-poisoning deaths involving heroin were most prevalent. While increases were observed in all regions of the US, the biggest increase was found in the Midwest region, where death rates grew to almost 11 times the number - from 0.4 to 4.3 per 100,000 - between 2000 and 2013. In 2000, the Northeast and West regions had the highest rates.
The authors of the report - Holly Hedegaard and Li-Hui Chen from the NCHS Office of Analysis and Epidemiology, and Margaret Warner from the NCHS Division of Vital Statistics - acknowledge a number of factors that may have influenced the findings of the report.
Different regions in the US may use different toxicological tests to determine the types of drugs responsible for drug-poisoning deaths. Due to the way that the body breaks down heroin into morphine within the body, it can be difficult to distinguish between a heroin-related death and a morphine-related death, which may have led to the misclassification of some fatalities.
The authors report that data on the types of drugs involved in 22% of drug-poisoning deaths in 2013 were not recorded. Finally, drug-poisoning deaths can involve multiple drugs, with previous research demonstrating that around 16% of heroin-related drug-poisoning deaths also involve the use of opioid analgesics.
Although heroin-related drug-poisoning deaths have increased sharply in recent years, the overall rate is still considerably lower than that for opioid analgesics. In addition, NIDA suggest that the abuse of prescription opioids such as Oxycontin and Vicodin could be the first step toward heroin abuse for many people.
Last year, Medical News Today reported on a study that found deaths from prescribed painkillers outnumber deaths from heroin and cocaine combined.