title: Purchase and use patterns of heroin users at an inner-city emergency department.
abstract: BACKGROUND
  Many consider heroin abuse a problem of the inner city, but suburban patients may also be at risk.
  
  
  OBJECTIVE
  To characterize the demographics and purchase/use patterns of heroin users in an inner-city emergency department (ED).
  
  
  METHODS
  The study was conducted in one of the most impoverished and crime-ridden cities in the United States. Demographics and substance use habits of ED patients were prospectively collected. Patients who were<18 years of age, cognitively impaired, or did not speak English were excluded. Participants were further categorized as homeless, inner-city, and suburban residents.
  
  
  RESULTS
  Of 3947 participants, 608 (15%) used an illicit substance in the past year, with marijuana (9%) and cocaine (6%) the most commonly used. Heroin ranked third, used by 180 (5%) participants, with 61% male, 31% black, and 20% Hispanic. There were 64 homeless, 60 suburban, and 56 inner-city heroin users. The most common route of use was injection (68%), with the highest rate in the homeless (84%). The majority of homeless and inner-city users bought (73%, both groups) and used (homeless 74%, inner city 88%) in the inner city. Of suburban users, 58% purchased and 61% used heroin in the inner city. Prescription narcotic use was more common in homeless (20%) and suburban (23%) heroin users than in inner-city users (9%) (p<0.001).
  
  
  CONCLUSIONS
  Heroin is the third most commonly used illicit substance by ED patients, and a significant amount of inner-city purchase and use activity is conducted by suburban heroin users.
authors.affiliation: Department of Emergency Medicine, University of Medicine & Dentistry of New Jersey-Robert Wood Johnson Medical School and Cooper University Hospital, Camden, New Jersey 08103, USA.
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Baumann
authors.forename: Anthony
authors.initials: A
authors.lastname: Mazzarelli
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Brunner
authors.forename: Michael E
authors.initials: ME
authors.lastname: Chansky
authors.forename: Nicole
authors.initials: N
authors.lastname: Thompson
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Boudreaux
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology* / Q000209:etiology*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D055553:Prescription Drugs; D015995:Prevalence; D011446:Prospective Studies; D013383:Suburban Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D055553:Prescription Drugs