Heroin use and overdose deaths are rising fast in the United States, particularly among whites and women, US health authorities said Tuesday.
More than 8,200 people died from a heroin-involved overdose in 2013, nearly twice the number of deaths seen just two years earlier, according to the Vital Signs report issued by the US Centers for Disease Control and Prevention (CDC).
Heroin use has doubled among women since 2002, reaching 1.6 women per 1,000 people by 2013.
Heroin use rose 50 percent among men in the same period, to a rate of 3.6 users per 1,000 nationwide in 2013.
About 500,000 people are currently addicted to heroin in the United States, CDC chief Tom Frieden told reporters.
"Heroin use is increasing rapidly across nearly all demographic groups, and with that increase, we are seeing a dramatic rise in deaths," he said.
"Around one in 50 people who are addicted to heroin may die of it in each year of their addiction," Frieden added.
"That is a remarkably high proportion, and a reflection of how dangerous it is to have a heroin addiction, to have heroin supply from sources where purity may change rapidly, and to be using it by an intravenous route."
The CDC report was based on an analysis of data from the 2002-2013 National Survey on Drug Use and Health, comparing trends among demographic and substance-using groups.
Two key reasons for the mounting toll from heroin include an increasing number of people addicted to prescription painkillers, which contain the same active ingredients as heroin, and the low cost of readily-available the street drug, said Frieden.
Heroin-related overdose deaths nearly quadrupled over the decade studied.
Companion drugs "Alarmingly, nearly all people who used heroin also used at least one other drug on the past year and most used at least three other drugs," Frieden added.
The most common companion substances for heroin were alcohol, cocaine and marijuana.
Sixty percent of heroin-related overdose deaths involved at least one other drug.
Frieden also addressed what he described as misperception by some that addicts are moving on to heroin as a replacement for prescription painkillers.
"In general, what we are finding is the higher the rate of prescription opioid use, the higher the rate of heroin use."
Since the drugs work in much the same way, those who are addicted to prescription painkillers are "primed" for heroin addiction.
Abuse or dependence on opioid painkillers was the strongest risk factor for heroin use or dependence.
The low cost of heroin is also a draw for addicts. The drug costs five times less than prescription painkillers.