Trends and correlates of perceived access to heroin among young adults in the United States, 2002–2016

Background: We are at a unique moment in United States (US) history as heroin overdose rates are higher than at any time in recent memory. Based on prior research and the developmental risks faced by young adults (ages 18–25), we examine the trends and correlates of perceived access to heroin among this group over a 15-year period. Methods: We analyzed national trend data from the National Survey on Drug Use and Health (2002–2016) on young adults’ (N = 247,679; ages 18–25) perceived access to heroin. We conducted logistic regression analyses with survey year specified as an independent variable and heroin access specified as the dependent variable while controlling for sociodemographic factors. Results: A majority of respondents reported that it would be difficult or impossible to obtain heroin, if desired. Young adult reports that it would be “probably impossible” to access heroin increased significantly from 31% in 2002 to 41% in 2016. The upward trend in the perceived lack of access was most robust among African Americans and Hispanics as well as those reporting no past-year substance use or drug/criminal justice system involvement. Conclusions: In the midst of a very serious opioid epidemic, the present study found that most young adults in the US consider that it would be “probably impossible” to obtain heroin. This trend was observed across young adulthood and across gender, racial/ethnic, and family income differences. However, we found that these trends are largely driven by those at relatively low risk of drug misuse and deviant behaviors generally.