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 When “Glee” TV star Cory Monteith died last year at age 31 after a heroin overdose, the tragedy was underscored by an element of disbelief. 
 
 He was young, affluent and white — the exact opposite of the stereotype of an inner-city user. Drug abuse experts had to expend considerable effort to explain that, in fact, Monteith was the new face of heroin. 
 
 “He is what a heroin user looks like,” Caleb Banta-Green, a University of Washington research scientist who specializes in drug abuse, emphasized at the time. 
 
 Philip Seymour Hoffman's overdose death brought another wave of shock. 
 
 Now comes a new analysis, published in the journal JAMA Psychiatry, which confirms that there’s been a dramatic shift in the demographics of heroin use in the United States. 
 
 In the 1960s, the typical user was an inner-city teenager, likely as not a minority, whose habit started with heroin. Fifty years later, new heroin users in America are more likely to be white suburban men and women in their 20s who get hooked on prescription opiates and then turn to heroin because it’s cheaper and easier to get. 
 
 “Our typical image of a heroin user is a ‘dirty junkie,’” said lead study author Theodore J. Cicero, a professor of psychiatry at Washington University School of Medicine in St. Louis. “This is not the current heroin user.” 
 
 “This has become a mainstream problem. This is now affecting white children living in the suburbs." 
 
 Cicero and his colleagues analyzed data from an ongoing study that included nearly 2,800 heroin addicts entering substance abuse treatment in centers across the U.S. In addition, they conducted intensive interviews with 54 addicts about their experiences and motivations related to using heroin. 
 
 In the 1960s, nearly 83 percent of users were boys and men, with a median age of 16.5, who lived in urban areas and started using heroin as their first opiate, the study found. 
 
 Before the 1980s, whites and other races were equally represented. But in the last decade, nearly 90 percent of new heroin users were white. New users now are typically older, with a mean age of 23, and they start their addiction with prescription narcotics like Oxycontin, only to progress to heroin. 
 
 “This has become a mainstream problem,” Cicero said. “This is now affecting white children living in the suburbs." 
 
 That’s clear to Dr. Jason Jerry, a professor of psychiatry and psychology at the Cleveland Clinic, who treats heroin patients. He wasn’t involved in the new study, but he said it accurately underscores the shift he’s seen. “The crackdown in prescription narcotics has pushed more people over to heroin,” he said. 
 
 To be sure, prescription opiates cause 16,600 deaths a year, according to federal figures. That compares to about 3,000 deaths a year from heroin. But as U.S. Attorney General Eric Holder noted in March, heroin overdose deaths climbed by 45 percent between 2006 and 2010, flagging what he called “an urgent and growing public health crisis.” 
 
 “The typical path to heroin nowadays starts with prescription narcotics.” 
 
 Cynics might suggest that surging heroin use and rising numbers of overdoses have only drawn such high-profile attention because it's becoming a middle-class issue, Cicero noted. "When it was an inner-city problem among minorities, it wasn't a problem," he said. 
 
 The new study should serve as a caution to those who still view heroin use — and opiate addiction — through the lens of old stereotypes. For instance, parents of teenagers should monitor prescription painkillers carefully and keep them away from kids because such early use can easily escalate, the experts said. 
 
 “The typical path to heroin nowadays starts with prescription narcotics,” Jerry said. ||||| The image of the heroin user is changing, according to researchers who say the great majority are now white men and women who mostly live outside the cities. 
 
 Their study, published in JAMA Psychiatry, tracked data from almost 2,800 heroin users and found that first-time users are now generally older than those who began taking the drug in the 1960s. About 90 percent are white, according to the study, and 75 percent now live in non-urban areas. 
 
 The research also confirmed a link between the rise of opioid abuse and the growing use of heroin that had been noted in earlier studies. Heroin use has jumped 80 percent to 669,000 users from 2007 to 2012, according to the National Survey on Drug Use and Health, after being relatively stable since 2000. 
 
 Heroin “is not confined to inner-city areas,” said Theodore Cicero, the lead author and vice chairman for research at Washington University School of Medicine in St. Louis, Missouri. “It’s now a main stream problem.” 
 
 The uptick in usage is attributed to users waning off of prescription opioids and turning to heroin because it’s cheaper and more readily accessible than prescription drugs, the researchers said in their report. 
 
 After widespread prescription drug abuse in the 1990’s, prices for prescription drugs have surged. Companies have also made the pills more difficult to manipulate, leading users to choose heroin as an alternative even though it carries a lot of risk, Cicero said in a telephone interview. 
 
 Deadly Overdoses 
 
 “It doesn’t have the safety of a prescription drug,” Cicero said. Because heroin is often cut with other chemicals, and injected through non-sterile solutions, users are prone to infections that can be fatal as well as deadly overdoses. 
 
 “There’s a lot of interest in how whites are getting so many opioids,” said Meghan Ralston, harm reduction manager for the Drug Policy Alliance. “That reflects what research shows -- that blacks and minorities are not even prescribed opioids at the same rates.” 
 
 The study found most people who began using the drug in the last decade were 23-years-old on average. That compares with the 1960’s, the researchers wrote, when users were 16-years-old on average. 
 
 The majority of heroin users surveyed in the study, 94 percent, said that if there were given the choice, they would prefer prescription pills to heroin. 
 
 Cicero said it’s likely that most people are using the drug as self-medication to treat depressive tendencies. Knowing this, better mental health and depression treatments in schools and communities could curb rates of heroin use. 
 
 He is now studying whether there’s a correlation between depression and drug abuse, Cicero said. 
 
 Vermont Addicts 
 
 Vermont is one state among several in the U.S. seeing a surge in heroin addiction in rural areas, with a 260% increase in people receiving treatment since 2000, according to the governor’s office. The number of deaths from heroin overdose almost doubled in 2013 from a year earlier. 
 
 Surging addiction is in part due to a “depressed economy, loss of hope, and challenges with just getting by day-to-day,” said Harry Chen, Commissioner of the Vermont Department of Health. He said it has hurt the “Vermont way of life” through its impact on families, communities, and health-care spending. 
 
 “We’re trying to approach it comprehensively,” Chen said in a telephone interview. 
 
 Drug enforcement officials have in the past been prone to attack the problem only from the supply side, the study author, Cicero, said. 
 
 “Comprehensive policy would address both a demand and a supply side,” he said. “We need some emphasis on why are people using these drugs, and why they find them attractive.” 
 
 To contact the reporter on this story: Sonali Basak in New York at sbasak7@bloomberg.net 
 
 To contact the editors responsible for this story: Reg Gale at rgale5@bloomberg.net Angela Zimm ||||| PORTSMOUTH, Ohio — Prescription pain pill addiction was originally seen as a man’s problem, a national epidemic that began among workers doing backbreaking labor in the coal mines and factories of Appalachia. But a new analysis of federal data has found that deaths in recent years have been rising far faster among women, quintupling since 1999. 
 
 More women now die of overdoses from pain pills like OxyContin than from cervical cancer or homicide. And though more men are dying, women are catching up, according to the analysis by the Centers for Disease Control and Prevention. And the problem is hitting white women harder than black women, and older women harder than younger ones. 
 
 In this Ohio River town on the edge of Appalachia, women blamed the changing nature of American society. The rise of the single-parent household has thrust immense responsibility on women, who are not only mothers, but also, in many cases, primary breadwinners. Some who described feeling overwhelmed by their responsibilities said they craved the numbness that drugs bring. Others said highs made them feel pretty, strong and productive, a welcome respite from the chaos of their lives. 
 
 “I thought I was supermom,” said Crystal D. Steele, 42, a recovering addict who said she began to take medicine for back pain she developed working at Kentucky Fried Chicken. “I took one kid to football, the other to baseball. I went to work. I washed the car. I cleaned the house. I didn’t even know I had a problem.” 
 
 Ms. Steele, now a patient at the Counseling Center, a rehabilitation center here, remembers getting calls about deaths of high school classmates while working at an answering service for a local funeral home. She counted about 50 women she had known who had drug-related deaths. She believes that had it not been for a 40-day stint in jail for stealing pain pills, she would have been among them. 
 
 “I felt like I sold my soul somewhere along the way,” said Ms. Steele, whose father was an alcoholic and abusive. “I didn’t feel like I deserved to be given a second chance. I thought my kids would be better off without me.” 
 
 For years, drug overdose deaths in the United States were seen as mostly an urban problem that hit blacks hardest. But opioid abuse, which exploded in the 1990s and 2000s and included drugs like OxyContin, Vicodin and Percocet, has been worst among whites, often in rural places. The C.D.C. analysis found that the overdose death rate for blacks in 2010, the most recent year for which there was final data, was less than half the rate for whites. Asians and Hispanics had the lowest rates. 
 
 According to the report, 6,631 women died of opioid overdoses in 2010, compared with 10,020 men. 
 
 While younger women in their 20s and 30s tend to have the highest rates of opioid abuse, the overdose death rate was highest among women ages 45 to 54, a finding that surprised clinicians. The range indicates that at least some portion of the drugs may have been prescribed appropriately for pain, Dr. Nora Volkow, director of the National Institute on Drug Abuse, said in an interview. If death rates were driven purely by abuse, then one would expect the death rates to be highest among younger women who are the biggest abusers. 
 
 Deaths among women have been rising for some time, but Dr. Thomas R. Frieden, the C.D.C. director, said the problem had gone virtually unrecognized. The study offered several theories for the increase. Women are more likely than men to be prescribed pain drugs, to use them chronically, and to get prescriptions for higher doses. 
 
 The study’s authors hypothesized that it might be because the most common forms of chronic pain, like fibromyalgia, are more common in women. A woman typically also has less body mass than a man, making it easier to overdose. 
 
 Women are also more likely to be given prescriptions of psychotherapeutic drugs, like antidepressants and antianxiety medications, Dr. Volkow said. That is significant because people who overdose are much more likely to have been taking a combination of those drugs and pain medication. 
 
 Broader social trends, like unemployment, an increase in single-parent families, and their associated stressors, might have also contributed to the increase in abuse, but they are slow moving and unlikely to be a direct explanation, Dr. Volkow said.
– Not too long ago, the profile of the typical heroin user was pretty straightforward: an inner-city male about age 16. No more, says a new study in JAMA Psychiatry. Thanks in part to the surging use of prescription painkillers such as OxyContin and Vicodin, today's typical first-time heroin user is more likely to be a white 20-something, either male or female, from the suburbs or a more rural area, reports Bloomberg. The link to the prescription drugs? People get hooked on them but can't afford to sustain the habit and so turn to cheaper, easier-to-get heroin. “The price on the street for prescription painkillers, like OxyContin, got very expensive,” says the study's author in Forbes. “It has sold for up to a dollar per milligram, so an 80 milligram tablet would cost $80. Meanwhile, they can get heroin for $10.” The result is that 90% of new heroin users in the last decade were white, with the average age of first use at 23. Three-quarters of them got started on prescription meds. The shift to heroin has become even more pronounced as the makers of the prescription drugs take steps to curb abuse, such as making their pills harder to crush. “The crackdown in prescription narcotics has pushed more people over to heroin,” an expert at the Cleveland Clinic not involved with the study tells NBC News. (Click to read how how NYPD officers are going to start carrying a heroin antidote.)