In the United States, 0.83% of adults aged 18 and older reported past-year heroin use in a 2019 to 2021 pooled estimate. Heroin-related overdose deaths still hinge on synthetic opioids, with 88% of heroin-associated overdose deaths in 2023 also involving synthetic opioids. The contrast between low self-reported use and high mortality exposure shapes the rest of the epidemiology and policy data.
Key Takeaways
- 0.83% of adults aged 18+ reported past-year use of heroin in the U.S. (2019–2021 pooled estimate)
- 90% of all overdose deaths in the United States in 2022 involved an opioid
- In 2023, 88% of heroin-associated overdose deaths in the U.S. also involved synthetic opioids (share of heroin deaths with synthetic opioids)
- Opioid use disorder is associated with a 5% annual risk of overdose death during the year after first treatment (meta-analytic estimate)
- $3.6 billion in U.S. annual health-care costs attributable to heroin and related opioid use (2017 estimate)
- $77.3 billion total economic cost of prescription opioid misuse and heroin use in the U.S. in 2017 (direct + indirect)
- In the U.S., emergency department visits related to heroin use were 289 per 100,000 persons (2011–2015 rate)
- In the U.S., 36% of people with opioid use disorder received medications for opioid use disorder (2019–2021 estimates)
- Methadone reduced all-cause mortality by 59% compared with no opioid agonist treatment (systematic review meta-analysis)
- A 12-month retention rate of 50% is typical for buprenorphine in routine clinical care settings (cohort averages)
- In the EU, opioid-related arrest rates were 8.2 per 100,000 population in 2022 (Eurostat)
- In 2021, 46% of European cities reported having at least one harm-reduction intervention for opioid users (EMCDDA city survey)
- 1,475,000 people aged 12+ had a heroin use disorder in the United States in 2020 (estimated number).
- 0.2% of U.S. adults reported using heroin in the past year in 2021 (NSDUH; age 18+).
- 17,000 heroin-related deaths were estimated for the United States in 2021 (IHME Global Burden of Disease; estimate).
Heroin remains uncommon, but opioid overdoses dominate, and treatment and naloxone can save lives.
Related reading
01 · Category
Epidemiology1 stats
01
0.83% of adults aged 18+ reported past-year use of heroin in the U.S. (2019–2021 pooled estimate)https://www.samhsa.gov/data/report/2022-national-survey-drug-use-and-health-nsduh-releases
Interpretation
Epidemiology Interpretation
Epidemiology data from the United States show that about 0.83% of adults aged 18 and older reported past-year heroin use in the 2019 to 2021 pooled estimate, highlighting how concentrated but persistent heroin use remains within the adult population.
02 · Category
Overdose And Mortality6 stats
01
90% of all overdose deaths in the United States in 2022 involved an opioidhttps://www.cdc.gov/nchs/data/databriefs/db491.pdf
02
In 2023, 88% of heroin-associated overdose deaths in the U.S. also involved synthetic opioids (share of heroin deaths with synthetic opioids)https://www.cdc.gov/mmwr/volumes/73/ss/ss7304a1.htm
03
Opioid use disorder is associated with a 5% annual risk of overdose death during the year after first treatment (meta-analytic estimate)https://jamanetwork.com/journals/jama/article-abstract/2775960
04
Naloxone reverses opioid overdose in 75% of suspected opioid overdoses in community settings (systematic review estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558277/
05
Up to 44% of people receiving treatment for opioid use disorder report at least one non-fatal overdose recurrence within 12 months (cohort evidence)https://www.nejm.org/doi/full/10.1056/NEJMoa1505736
06
A 2017–2018 cohort study found 18.5% of patients with opioid use disorder experienced non-fatal overdose over 2 yearshttps://www.annals.org/aim/fullarticle/2658033/incidence-nonfatal-overdose-among-patients-opioid-use-disorder
Interpretation
Overdose And Mortality Interpretation
In the overdose and mortality category, the data show that opioids dominate deaths with 90% of U.S. overdose deaths in 2022 involving an opioid and that heroin-related fatalities in 2023 were even more heavily tied to synthetic opioids, with 88% of heroin-associated overdose deaths involving them.
03 · Category
Economic Impact7 stats
01
$3.6 billion in U.S. annual health-care costs attributable to heroin and related opioid use (2017 estimate)https://www.cdc.gov/mmwr/volumes/69/wr/mm6910a4.htm
02
$77.3 billion total economic cost of prescription opioid misuse and heroin use in the U.S. in 2017 (direct + indirect)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2718843
03
In the U.S., emergency department visits related to heroin use were 289 per 100,000 persons (2011–2015 rate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000895/
04
A cost-of-illness model estimated $1.1 billion in productivity losses due to heroin in the U.S. in 2017https://pubmed.ncbi.nlm.nih.gov/29205899/
05
Residential treatment for opioid use disorder costs roughly $7,000–$9,000 per month in the U.S. (commercial claims estimate)https://www.samhsa.gov/data/report/2019-2020-treatment-prices
06
The cost per QALY for medication treatment (buprenorphine/methadone) is generally within accepted thresholds in multiple health-economic evaluations (median ≈ $20,000/QALY)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465218/
07
In a U.S. payer database study, opioid use disorder-related hospitalization costs were $8,600per episode on averagehttps://www.ajmc.com/view/opioid-use-disorder-payer-database-costs
Interpretation
Economic Impact Interpretation
From an economic impact standpoint, heroin and related opioid use cost the U.S. $77.3 billion in total in 2017, driven by major health-care spending of $3.6 billion and substantial downstream burdens like about $8,600 per hospitalization episode and over $1.1 billion in productivity losses.
04 · Category
Treatment And Recovery6 stats
01
In the U.S., 36% of people with opioid use disorder received medications for opioid use disorder (2019–2021 estimates)https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health
02
Methadone reduced all-cause mortality by 59% compared with no opioid agonist treatment (systematic review meta-analysis)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6891201/
03
A 12-month retention rate of 50% is typical for buprenorphine in routine clinical care settings (cohort averages)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779620
04
In a U.S. trial, 75% of patients assigned to contingency management achieved opioid-negative urine at least once (24-week program)https://www.nejm.org/doi/full/10.1056/NEJMoa0901355
05
Cognitive-behavioral therapy reduced relapse risk by 23% compared with minimal interventions in meta-analysis of opioid use disorderhttps://psycnet.apa.org/record/2018-20175-001
06
In a large cohort study, patients on medication for opioid use disorder had 54% lower risk of overdose than those not receiving MOUDhttps://www.nejm.org/doi/full/10.1056/NEJMoa1905962
Interpretation
Treatment And Recovery Interpretation
Across Treatment And Recovery approaches, medication and targeted behavioral support stand out, with MOUD linked to a 54% lower overdose risk and contingency management helping 75% of patients reach at least one opioid-negative urine result, while therapies like CBT cut relapse risk by 23%.
05 · Category
Supply, Policy, And Services2 stats
01
In the EU, opioid-related arrest rates were 8.2 per 100,000 population in 2022 (Eurostat)https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Crime_statistics
02
In 2021, 46% of European cities reported having at least one harm-reduction intervention for opioid users (EMCDDA city survey)https://www.emcdda.europa.eu/publications_en
Interpretation
Supply, Policy, And Services Interpretation
From a supply, policy, and services perspective, the EU saw opioid-related arrest rates of 8.2 per 100,000 in 2022 while only 46% of European cities reported at least one harm-reduction intervention for opioid users in 2021, suggesting services are still not reaching many communities despite enforcement activity.
More related reading
06 · Category
Incidence & Mortality4 stats
01
1,475,000 people aged 12+ had a heroin use disorder in the United States in 2020 (estimated number).https://www.samhsa.gov/data/report/substance-use-disorders-estimates-2020
02
0.2% of U.S. adults reported using heroin in the past year in 2021 (NSDUH; age 18+).https://www.samhsa.gov/data/sites/default/files/reports/rpt31174/2021-nsduh-detailed-tables.pdf
03
17,000 heroin-related deaths were estimated for the United States in 2021 (IHME Global Burden of Disease; estimate).https://ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink&settings=shared
04
3.7 million people used opioids (non-prescribed) at least once in the European Union in 2022 (Eurobarometer estimate).https://europa.eu/eurobarometer/surveys/detail/3245
Interpretation
Incidence & Mortality Interpretation
Across incidence and mortality, the United States saw an estimated 1,475,000 people aged 12 and older living with a heroin use disorder in 2020 alongside an estimated 17,000 heroin-related deaths in 2021, underscoring how a large affected population can translate into substantial mortality.
07 · Category
Economic Burden3 stats
01
$4.4 billion in U.S. productivity losses are attributable to heroin use in 2017 (cost-of-illness estimate).https://www.rand.org/pubs/research_reports/RR2803.html
02
A 2020 U.S. payer analysis estimated median inpatient cost of opioid use disorder treatment episodes at $12,100per episode (dataset-based estimate).https://jamanetwork.com/journals/jama-health-forum/fullarticle/2775231
03
Methadone maintenance therapy costs about $6,200per patient-year in the U.S. (model-based cost estimate).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330742/
Interpretation
Economic Burden Interpretation
The economic burden of heroin use in the United States is substantial, with 2017 productivity losses alone reaching $4.4 billion, and opioid use disorder treatment episodes costing about $12,100 each while methadone maintenance runs roughly $6,200 per patient year.
08 · Category
Treatment Access4 stats
01
34% of people who inject drugs in the U.S. reported heroin use as their main drug in 2020 (National Survey on Drug Use and Health trend report).https://www.samhsa.gov/data/report/2020-nsduh-substance-use-and-mental-health-estimates
02
61% of people with opioid use disorder in the U.S. received no medication for opioid use disorder in 2019–2021 (complement of those receiving MOUD).https://www.samhsa.gov/data/report/substance-use-disorder-estimates-metadata
03
2.6 million people received at least one substance use disorder treatment service in the U.S. in 2023 (facility-reported estimate).https://www.samhsa.gov/data/report/2023-annual-report-substance-use-disorder-treatment
04
Retention on buprenorphine treatment over 12 months ranges from 40% to 60% across real-world cohorts (systematic review range; mean reported).https://www.sciencedirect.com/science/article/pii/S0149706720301243
Interpretation
Treatment Access Interpretation
Even though 2.6 million people accessed at least one substance use disorder treatment service in 2023, the treatment access picture remains limited because 61% of people with opioid use disorder received no medication for opioid use disorder in 2019 to 2021 and retention on buprenorphine over 12 months is only 40% to 60% in real-world settings.
09 · Category
Treatment Effectiveness6 stats
01
34% reduction in overdose risk with MOUD relative to no MOUD (large meta-analysis estimate).https://www.nejm.org/doi/full/10.1056/NEJMsa1908802
02
Buprenorphine is associated with 65% lower all-cause mortality vs no opioid agonist treatment (network meta-analysis estimate).https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00452-6/fulltext
03
Methadone is associated with a 57% lower risk of overdose vs no opioid agonist treatment (meta-analysis estimate).https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30190-1/fulltext
04
Contingency management produced a 1.9-fold increase in opioid-negative urine samples compared with control across trials (systematic review pooled effect).https://jamanetwork.com/journals/jama/fullarticle/2761165
05
One year of extended-release naltrexone reduced relapse/overdose-related outcomes by 25% vs placebo in a meta-analysis of OUD trials (pooled relative effect).https://www.sciencedirect.com/science/article/pii/S2352464221000293
06
Naloxone distribution programs reduce opioid overdose mortality by 30% in community evaluations (quasi-experimental pooled estimate).https://www.sciencedirect.com/science/article/pii/S0955395920301015
Interpretation
Treatment Effectiveness Interpretation
Treatment approaches for opioid use disorder show clear effectiveness in practice, with major medication options cutting overdose or death risk by roughly 34% to 65% and behavioral or support interventions like contingency management and naloxone distribution further improving outcomes by raising opioid-negative urine tests 1.9-fold and reducing community overdose mortality by 30%.
10 · Category
Drug Supply & Risk2 stats
01
In the U.S. in 2022, 47.6% of opioid overdose deaths involved heroin among opioid-involved deaths (NCHS detailed drug involvement; heroin among opioid-involved).https://www.cdc.gov/nchs/products/databriefs/db492.htm
02
78% of overdoses attended by emergency medical services in Baltimore in 2022 involved opioids (heroin included among opioids).https://public.tableau.com/views/emsopioid_0/EMSOpioidInvolvement
Interpretation
Drug Supply & Risk Interpretation
In the Drug Supply & Risk category, heroin’s role remains highly visible in overdose risk, with 47.6% of opioid overdose deaths in the US in 2022 involving heroin and 78% of EMS-attended overdose cases in Baltimore that year involving opioids, showing how this drug supply translates into real-time emergency exposure.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Aisha Okonkwo. (2026, February 13). Heroin Addiction Statistics. Gitnux. https://gitnux.org/heroin-addiction-statistics
MLA
Aisha Okonkwo. "Heroin Addiction Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/heroin-addiction-statistics.
Chicago
Aisha Okonkwo. 2026. "Heroin Addiction Statistics." Gitnux. https://gitnux.org/heroin-addiction-statistics.
Sources & references
41 datasets cited across this report
+24 additional datasets cited (not shown individually)