The Number of Heroin Users in America Grew Five Times in a Decade

White men are not faring well in America's drug crisis.

Last week we wrote about how rampant opioid addiction is lowering the lifespan of poor, white men in rural America. This week a new study from Columbia University Mailman School of Public Health looked at the rising number of heroin users in the country, and most of them, again, are middle-aged white men without a college education.

According to the JAMA Psychiatry study, heroin use increased around five-fold, from .33 percent of the population between between 2001 and 2002, to 1.60 percent of the population between 2012 and 2013. Within that uptick, heroin use was higher among white Americans than non-white Americans, 1.9 versus 1.1 percent, respectively. The people most vulnerable to heroin use and heroin disorders were single white men in their thirties and forties who had either no degree or just a high school degree.

There are several reasons white men could be increasingly turning to heroin. For one, the middle class is shrinking, and white Americans, men and single people have made fewer economic gains than in previous decades, according to Pew Research Center. This dismal economic state has also fueled a mental health problem, and men are less likely to seek social support or medical care, instead turning to drugs to self-medicate, said Silvia Martens, author of the study and an epidemiologist at Columbia University.

"We know people use these drugs for psychiatric orders," she said.

It's important to note that the increase in heroin use is happening alongside the opioid epidemic, and the two are interconnected. Martens told me that some opioid users turn to heroin when their supply of prescription drugs run out—more than half of the the study participants reported this transition. And the way we regulate painkillers can make it worse.

"If [the laws are] too lax, it's easy to go doctor shopping for opioids, if they're too tight, people end up transitioning to heroin," Martens said. Doctors play a large role in the opioid epidemic, and therefore the increase in heroin use. For one, doctors are more likely to prescribe painkillers to white people, since there is still a stigma that minority patients will abuse drugs. This has actually made it easier for white Americans to get addicted to opioids simply because of access.

But doctors are also the gatekeepers—meant to curb addiction and recognize drug abuse. Educating doctors, Martens said, might be one of the simplest ways to make sure Americans don't have access to addictive drugs in the first place.