Feminization of Heroin

By DON ROLLINS

Trailblazing rocker Janis Joplin died 45 years ago in October. A victim of her own excesses, “Pearl” developed a death-grip addiction to (then) high-grade heroin that took her life and suspended her jagged persona in time – a marquee member of the “27 Club”, that long and growing list of artists who like Joplin died in their 27th year.

By no means the first raw female vocalist to succumb to heroin addiction, Joplin’s death by overdose nonetheless coincided with the subtle but steady uptick in the drug’s use among women that continues unto this day.

So pronounced is female heroin use in 2015 substance-abuse researchers and the treatment industry struggle to stay abreast of the spiking numbers and what they mean for recovery programming.

Example: Based on recent, independent reports submitted by the Substance Abuse Mental-Health Administration, Department of Health and Human Services and Centers on Disease, use of black tar and injected heroin among women over the past ten years has risen by 50%.

And the news is worse for women existing at or below federal poverty levels, for while these and other studies indicate heroin addiction is making inroads among middle-class women (and men) those who live in poverty are at even greater risk: 12 of the 18 women who die from opiate-related overdoses every day lived and died poor.

Further upping the ante is literature indicating an increased presence of risk factors related to female heroin experimentation and dependence: genetic predisposition; childhood trauma; mental illness; educational lags; prostitution; long-term unemployment; housing insecurity; domestic violence victimization and; smaller body mass.

Equally disconcerting is growing evidence pill-form opiates (see oxycodone and hydrocodone) serve as “gateway” drugs for heroin – a noteworthy factor given women have historically kept pace with if not outstripped men in the use of orally-administered opiates.

And as noted by USA Today medical reporter Liz Szabo in a July 7 profile, the sharp rise in heroin use among women has unleashed a host of health-related negatives, including increased HIV/AIDS diagnoses, hepatitis C and babies born addicted to the drug.

Substance abuse programs have been slow to rethink and retool their approaches to the new face of heroin dependence. Most treatment models were designed in tandem with research on male not female heroin users, leaving huge gaps in treatment strategies and services unique to recovering women.

Treatment funding sources, agency administrators and direct service providers intent on meeting the needs of heroin-dependent women do well to set aside some longstanding assumptions about how their female clients develop and recover from their addiction.

And take seriously the feminization of heroin.

Addendum: Fortunately there exist a growing number of evidence-based, women-centered programs worthy of study and emulation. For an example see Florence, Ky.’s Brighton Recovery Center for Women (brightoncenter.com).

Don Rollins is a Unitarian Universalist minister and substance abuse counselor in Jackson, Ohio. Email donaldlrollins@gmail.com.

From The Progressive Populist, November 1, 2015

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