Heroin is popular again, though not for reasons you expect. Gone are the days of desperate junkies in poverty settings. Now it is primarily cheap young urban professionals.

Few studies on the demographics of present day heroin users have compared them to heroin users 40 to 50 years ago. In the 1960s, heroin junkies were primarily young men from minority groups living in urban areas. Theodore J. Cicero, Ph.D., of Washington University, St. Louis, and colleagues analyzed data on nearly 2,800 patients from an ongoing study that used self-reported surveys from patients with a heroin use/dependence diagnosis entering treatment centers and also from patients who completed a more detailed interview (n=54).  

Respondents who began using heroin in the 1960s were predominantly young men (average age 16.5 years) whose first opioid abuse was heroin (80 percent). Recent users were older (average age almost 23 years) men and women in less urban areas (75.2 percent) who were introduced to opioids through prescription drugs (75 percent). 

Nearly 90 percent of the respondents who began using heroin in the last decade were white. Heroin was often used as the drug of choice because it was cheaper than prescription drugs and more readily accessible.

Bottom Line: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin.

"Our surveys have shown a marked shift in the demographics of heroin users seeking treatment over the past several decades," the authors write.