The growing trend of younger initiates into heroin use among suburbanites captured the attention of researchers at the Robert Crown Center for Health Education in Hinsdale, Illinois. In a 10-month study, "Understanding Suburban Heroin Use," for the Reed Hruby Heroin Prevention Project, researchers found that Chicago area suburban heroin users have little knowledge of heroin and its effects when they first use it, and they often substitute heroin after becoming addicted to prescription painkillers. Study Paints a Troubling Picture of Suburban Heroin Users It's easy to think of a heroin user as some down-and-out individual who's been homeless and addicted to drugs and alcohol for years. But a new generation of heroin users is anything but that. These are young people who have likely graduated to heroin after other types of drug and\/or alcohol use. Some of the findings of the study are more than just unsettling. They point to a great need for additional education and outreach in order to curb this growing trend. \tYoung heroin users mistakenly believed that snorting or sniffing heroin would be less likely to result in addiction. Most of these users said they thought using heroin this way was less addictive or not addictive at all. \tAll of the study respondents, except for one, said they transitioned from sniffing to injecting heroin. \tNearly two-thirds of study participants said they turned to heroin after first using prescription pain medications, or as a way to come down after using cocaine. Study respondents said their initiation into heroin use came about in one of three ways: \tUsers had first taken and often became dependent upon pain pills, such as OxyContin or Vicodin, before transitioning to heroin. \tThey were cocaine users who turned to heroin to help them come down or allow them to sleep after binging on cocaine. \tHeroin use occurred after experimenting with many other drugs. Heroin use also began at a very early age for some of the study respondents. Although the average age of first use was 18, 20 percent reported using heroin for the first time at the early age of 15. One-third became addicted to heroin while in high school. Among the higher socio-economic status participants, heroin use spread quickly in the peer group with many people becoming dependent. Most interviewees reported they knew little or nothing about heroin dependence or the withdrawal syndrome associated with the drug. Many became addicted quickly after initiation, but their dependence was generally recognized by another person - someone who was also dependent. Interviewees said they thought that they had the flu or some other kind of illness, not knowing that they were undergoing withdrawal. Many indicated that if they had known about heroin's and other opioids' addictive and dependency profile, they would not have become addicted. During the interview process, 75 percent of the study respondents either told interviewers or showed signs of co-occurring mental health condition, such as bipolar disorder, anxiety, depression or attention-deficit hyperactivity disorder (ADHD). The high level of mental health disorders, researchers concluded, indicated that one reason for using or continuing to use heroin was to ease symptoms. As a result, self-medication with heroin was common among most of the responders. In addition, more than two-thirds of those surveyed exhibited sensation-seeking behavior. Heroin Users' Drug Knowledge Low Another aspect of the research was trying to determine what the young suburban heroin users knew about the drug and its risks and effects. All of the individuals participating in the study knew of heroin, but none of them were able to describe the addictive nature of the drug, how it made them physically dependent, or the withdrawal process. In addition, few could explain what happens to the body when heroin is taken. Relative to their heroin drug knowledge, the study participants said that school programs lacked heroin-specific information and that such programs only half-explained heroin's effects, if at all. They said that heroin was lumped together with other drugs, which prevented heroin from standing out as a particularly problematic drug, especially when compared with a substance like marijuana. The respondents generally had a high disapproval about heroin use, but were not as disapproving of using opiate pills. They were also not clear about the linkage between opiate pills and heroin. When asked which substances they believed caused addiction, some participants included methamphetamine, cocaine and crack. They also didn't understand the difference between dependency and addiction. Some thought that marijuana was addictive, while others clarified their responses, saying it was more of a mental than a physical addiction. Another troubling revelation was that survey participants often brought up urban myths or legends about drug use - and believed them to be true. Nearly all the participants indicated that their parents did not know how to communicate with them effectively about drugs. Parents of Young Suburban Heroin Users Also Clueless and Confused The survey also included discussions with some 105 parents. Among this group, nearly 50 percent said they did not know where to go to obtain accurate drug information to be able to help their children. This points out an obvious and compelling need for more information available to families, educators and other influencers so that they can paint a more accurate picture to youths about the risks and harm that come with heroin use. The survey of parents revealed several areas of concern: \tParents felt they didn't know which drugs their child would encounter or the biophysical consequences of the drugs they used. Some were also concerned about their own knowledge gaps due to lack of experience with personal use. \tParents were unsure what age was appropriate to begin conversations with their child about drug use, what types of information to present, and how much detail to share with children of varying ages. \tParents felt awkward discussing drugs and being honest about their own feelings about drugs and drug use, both positive and negative. Some of the parents said they felt uncomfortable talking about their own drug use in the past and about telling their children not to do what they had done, while others did not know how to handle discussing problematic drug use among family and friends. \tParents weren't sure how to get their children to regard them as knowledgeable and reputable sources of information about drugs when their offspring displayed a "know-it-all" attitude. They wanted their children to understand that they were open and communicative, rather than be looked upon as preachy, lecturing or commanding. They were also afraid that, because of their own past drug use or lack of experience, their children would disregard their warnings as either hypocritical or uninformed. The full findings of the study are available at the Robert Crown site.