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State of Alaska

Health Indicator Report of Drug Use - Heroin - Adults (18+) (NSDUH)

Heroin is a highly addictive opioid drug derived from morphine, and its use is a growing problem both in Alaska and nationwide.^2,3^ Consistent with national trends, the number of heroin overdose deaths in Alaska has increased steadily every year since 2010.^3^ The problem of heroin use is closely tied to that of prescription opioid abuse, as research has suggested that misuse of prescription pain medication may act as a gateway to heroin use; in fact, a study conducted by the Center for Behavioral Health Statistics and Quality (CBHSQ) at SAMHSA found that nearly 80% of heroin users had abused prescription opioids prior to turning to heroin.^4^ Heroin users generally inject, snort, or smoke the drug, and some combine heroin with crack cocaine to form a "speedball." ^2^ Short term effects of the drug include an initial feeling of euphoria accompanied by heaviness in the limbs and clouded mental functioning.^2^ Long term effects of heroin use may include collapsed veins, pneumonia and other lung complications, and liver or kidney disease.^2^ In addition to the lives lost to overdose deaths, heroin addiction creates high health care costs due to substance abuse treatment and the long-term health problems associated with drug use, increased crime, and decreased stability in families and communities.^3^ [[br]][[br]] ---- {{class.SmallerFont 1. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. [http://www.samhsa.gov/data/]. Accessed February 14, 2017. 2. National Institute on Drug Abuse (NIDA). Drug facts: Heroin. [https://www.drugabuse.gov/publications/drugfacts/heroin#references]. Published January 2017. Accessed May 17, 2017. 3. State of Alaska, Division of Public Health. The economic costs of drug abuse in Alaska, 2016 update. [http://dhss.alaska.gov/dph/Director/Documents/heroin-opioids/Economic-Costs-of-Drug-Abuse-Final-4.24.17.pdf]. Accessed May 17, 2017. 4. Muhuri PK, Gfroerer JC, Davies MC. Associations of nonmedical pain reliever use and initiation of heroin use in the United States. Center for Behavioral Health and Statistics (CBHSQ) Data Review. [http://archive.samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.pdf]. Published in 2013. Accessed May 17, 2016. }}

Notes

Data are from the [http://pdas.samhsa.gov/saes/state Interactive NSDUH State Estimates] for 2013-2014 through 2014-2015 and the [https://www.samhsa.gov/data/sites/default/files/NSDUHsaeExcelTabs2016/NSDUHsaeExcelTabs2016.xlsx NSDUHsaeEscelTabs2016.xlsx] for the 2015-2016 period.

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Interpretation Issues

The National Survey on Drug Use and Health (NSDUH) is a nationally standardized survey that has been performed since 1971. The NSDUH is completed annually using a sample from the U.S. civilian, non-institutionalized population 12 years of age and older. In 1999, the sample design expanded to include all 50 states and the District of Columbia. In 2002, the name of the survey was changed from the National Household Survey on Drug Abuse (NHSDA) to the NSDUH. Information on background and methodology of the NSDUH, managed by the Substance Abuse and Mental Health Services Administration (SAMHSA), can be found at: [https://nsduhweb.rti.org/respweb/project_description.html]. Recent data are predominantly from the 2-year averages of NSDUH surveys from Population Data - NSDUH at: [https://www.samhsa.gov/data/population-data-nsduh/reports?tab=33]. Historic data with maps and data downloads are available from the small area estimates website for state and national NSDUH surveys at: [http://pdas.samhsa.gov/saes/state]. NSDUH obtains information on the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, and methamphetamine, as well as prescription pain relievers, tranquilizers, stimulants, and sedatives. The NSDUH questionnaire underwent a partial redesign in 2015, in which methodological changes were made to the measurement of 7 of the 10 illicit drug categories--hallucinogens, inhalants, methamphetamine, and prescription pain relievers, tranquilizers, stimulants, and sedatives. For example, questions regarding the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives that previously asked about lifetime misuse were restructured to ask about past year misuse. As a result, 2015 and later estimates for these measures and overall summary measures (such as any illicit drug use) are not comparable to prior years.^1^

Definition

Percentage of adults (18+, 18-25, 26+ years of age) who reported having used heroin in the past year on the [https://nsduhweb.rti.org/respweb/homepage.cfm National Survey on Drug Use and Health (NSDUH)].

Numerator

Weighted number of adults (18+, 18-25, 26+ years of age) who reported having used heroin in the past year on the NSDUH.

Denominator

Weighted number of adults (18+, 18-25, 26+ years of age) with complete and valid responses on the NSDUH to the question on having used heroin in the past year.

Healthy People Objective: Reduce past-month use of illicit substances

U.S. Target: Not applicable, see subobjectives in this category

How Are We Doing?

There was no significant difference in the percentage of adults in Alaska who reported heroin use in the past year from 2013-2014 to 2015-2016. Additionally, during this period there was no significant difference in heroin use among the three age groupings (18+, 18-25, and 26+ years of age).

How Do We Compare With the U.S.?

Overall heroin use in the past year was significantly higher in Alaska than the national comparisons for the 18+ and 26+ age groups. During 2015-2016, 0.82% of Alaskan adults over 18 years of age reported past year heroin use, more than double the national percentage of 0.36%.

What Is Being Done?

In February 2017, Governor Bill Walker declared a public health crisis in response to the dramatic increase in heroin and opioid abuse in Alaska.^5^ The disaster declaration established a statewide Overdose Response Program and allows for the distribution of Naloxone, a lifesaving drug that can reverse overdoses caused by opioids, including heroin.^5^ The disaster declaration was accompanied by the signing of Administrative Order 283, which instructs all state departments to apply for federal funding for drug abuse prevention and treatment options, the elimination of illegally imported drugs into the state, assistance with a prescription drug monitoring program, and the development of resources to provide medical treatment to drug users.^5^ These will help to combat the problem of heroin and opioid abuse in Alaska through a three pronged approach: 1) Prevent dependence on opioid drugs, 2) Reduce addiction by recognition and treatment, and 3) Reverse the life-threatening effects of overdose.^3^ [[br]][[br]] ---- {{class .SmallerFont 3. State of Alaska, Division of Public Health. The economic costs of drug abuse in Alaska, 2016 update. [http://dhss.alaska.gov/dph/Director/Documents/heroin-opioids/Economic-Costs-of-Drug-Abuse-Final-4.24.17.pdf]. Accessed May 17, 2017. 5. State of Alaska, Office of the Governor. Safer Alaska: Building stronger communities. [https://gov.alaska.gov/administration-focus/safer-alaska/]. Published May 16, 2017. Accessed May 17, 2017. }}

Evidence-based Practices

SAMHSA maintains a website that collects the latest in substance abuse prevention evidence based practices. The link to the information can be found here: [http://www.samhsa.gov/ebp-web-guide/substance-abuse-prevention].

Available Services

If you are using injection drugs, use a clean needle. Injection drug use is responsible for approximately 10% of HIV cases annually, and use of injected drugs also increases your risk of other diseases like Hepatitis C.^3^ The only way to be truly safe is to always use new needles, directly out of the package from a trusted source. The following links show where you can exchange used needles for new ones in Alaska. http://www.alaskanaids.org/index.php/prevention/syringe-exchange https://www.interioraids.org/ If you are seeking treatment for substance abuse, contact a medical provider or locate a treatment center nearest you at https://findtreatment.samhsa.gov/ To learn more about Naloxone, including how it can reverse the effects of opioids and where it is being distributed, visit http://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/narcan.aspx For more information on how to get help, visit http://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/help.aspx [[br]][[br]] ---- {{class .SmallerFont 3. State of Alaska, Division of Public Health. Heroin and Opioids in the Last Frontier. Available at http://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/default.aspx, Accessed May 17, 2017. }}

Health Program Information

A more detailed account of the health impacts of heroin use in Alaska is available at: [http://epibulletins.dhss.alaska.gov/Document/Display?DocumentId=12] The State of Alaska Epidemiologic Profile on Substance Use, Abuse and Dependency is available at: [http://dhss.alaska.gov/dph/Epi/injury/Documents/sa/SubstanceAbuseEpiProfile_2013.pdf]. This profile provides a more detailed report on the state of substance use and abuse in Alaska. The State of Alaska also provides websites on opioid use through Health and Social Services. Please use the following links to access more information about the misuse of opioids: [http://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/default.aspx].
Page Content Updated On 05/11/2018, Published on 05/11/2018
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 18 September 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Fri, 11 May 2018 12:34:53 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 18 September 2018 5:47:14 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Fri, 11 May 2018 12:34:53 AKDT