Study On Suburban Heroin Use Dispels Myths About Protective And Risk Factors

"I was not a big risk taker as a kid. [My parents] can't picture me using heroin. My mom was putting ribbons in my hair in fifth grade, and curling my hair," a 27-year-old woman identified only as C, a former cheerleader from a well-educated, high income family in the western suburbs said. "And then there was a day that it clicked, when we were using, and got sick when we didn't use...we didn't know we were sick from the heroin. But then we talked to my boyfriend's friend and he told us 'you guys are addicted.' I figured it would happen to 'those people' and not me."

The Robert Crown Center for Health Education released the results Tuesday of a 10-month study on suburban heroin use that paints a frightening picture of the prevalence of heroin abuse in affluent communities surrounding Chicago, where stories like C's are becoming increasingly common.

Their findings were the result of an unprecedented series of case studies examining 15 suburban heroin users, eight females and seven males, ages 22 to 31. The extensive interviews, led by researchers from the Illinois Consortium on Drug Policy (ICDP), were anonymous, conducted with disposable cell phones and unnamed Gmail accounts.

The study was looking for patterns in the paths that led suburban heroin users to dependency, as well as differences in the using experience for suburban residents. Previous data was largely focused on urban populations.

Heroin use among young, white suburban users has been rising drastically in the last decade. While hospital discharges for heroin among Chicago residents aged 20 to 24 declined 67 percent between 1998 and 2007, heroin discharges in that same age range increased more than 200 percent in the collar counties.

"Three years ago, when I lost my son, I was very alone," said Former Police Captain John Roberts, a panelist at a recent community forum on suburban heroin use and co-founder of the Heroin Epidemic Relief Organization (HERO). "Now I'm in good company. Yes, I did spend 30 years as a police officer in the city of Chicago. When I moved to the western suburbs, I didn't expect to find heroin in my backyard. Not only in my backyard, but in a lot of my neighbors' backyards. It's a terrible, terrible threat."

The study found that young suburban users demonstrate distinctive, divergent use patterns--in some cases, more extreme than their urban counterparts. The ICDP reports that 74 percent of 18 to 24 year old suburban users in publicly-funded treatment were injection users.

The case studies identified three repeated, predictable paths that are consistently leading suburban youth to heroin dependency: cocaine users who rely on heroin to soften the effects of cocaine but eventually become dependent, poly drug-users who fall victim to heroin's disproportionately high addiction rate compared to other commonly-abused drugs, and prescription pain pill users, abusive or otherwise, who eventually replace opioid pills with heroin.

The third camp is particularly troubling, said Kathie Kane Willis, Director of the ICDP, because pain pill addiction can happen very easily to people without a history of drug abuse. She says 70 percent of people who initiate to heroin use start with legal pain medications.

An alarming pattern appeared in the case study findings that Kane Willis says indicates a deficiency in drug education in Illinois. Several of the subjects surveyed expressed a reduction in their aversion to heroin use when they realized it was chemically similar to medications legally prescribed by doctors.

"I remember thinking that I was scared to try it because it was heroin, but then I remember thinking that it was the same as oxys so it was OK...I loved oxy and I had been told that heroin was similar," a participant identified in the study as M told researchers.

Patterns in the case studies identified two paths to community-wide heroin use: individuals already on the path to abuse leave their non-using peer groups to seek out social circles where heroin use is prevalent and accepted, or, more menacingly, heroin comes into a group and spreads.

Many participants said the drug education they were provided in school wasn't enough, something the ICDP hopes the study's findings can help correct.

"We had D.A.R.E. [Drug Abuse Resistance Eduation]. And a poster that showed the different drugs. But there were no drugs in junior high. At all," one participant told researchers. "In the high school there was no drug education, but there were drugs in high school."

Another problem that researchers suspect contributes to the suburban epidemic stems from young people's relationships with their parents--many of whom don't know how to broach the topic with their kids.

"When my dad found my pot bowl [pipe], he said 'this is for crack' and I laughed," female participant C, 27, said. "They sent me to my room and that was parents missed an opportunity then."

The study also found that widely-accepted risk and protective factors often lull suburban parents into a false sense of security, where individualized experiences prove that subtle nuances within those umbrella categories matter.

"Two-parent households are a protective factor, but not when the parents are involved in an abusive relationship with each other, or not when they are abusing their child," Kane Willis said during the community forum. "Sports and engagement are a protective factor, but not so much when the outside activities include cheerleading and using drugs, or playing sports and using drugs, or having a job and using drugs. It's complicated."

The study was funded by the Robert Crown Center for Health Education's Reed Hruby Heroin Prevention Project, a program funded largely by Burr Ridge residents Roger and Nadeane Hruby, whose grandson Reed died of a heroin overdose in 2008. Its findings will be used to guide education and prevention programs in suburban Illinois communities, where, as the study demonstrates, such initiatives are desperately needed.

"I hope all of you come away from tonight asking, 'Could this happen to my family?" Roberts said. "It could. Be very concerned."