Drug analogs are chemical compounds that are similar to other drugs in their effects but differ slightly in their chemical structure. Some analogs are produced by pharmaceutical companies for legitimate medical reasons. Other analogs, sometimes referred to as "designer" drugs, can be produced in illegal laboratories and are often more dangerous and potent than the original drug. Two of the most commonly known opioid analogs are fentanyl and meperidine (marketed under the brand name Demerol, for example).

Fentanyl was introduced in 1968 by a Belgian pharmaceutical company as a synthetic narcotic to be used as an analgesic in surgical procedures because of its minimal effects on the heart. Fentanyl is particularly dangerous because it is 50 times more potent than heroin and can rapidly stop respiration. This is not a problem during surgical procedures because machines are used to help patients breathe. On the street, however, users have been found dead with the needle used to inject the drug still in his or her arm.

NIDA's 2005 Monitoring the Future study** showed that 1.5% of 10th and 12th graders had used heroin at least once. (Source: NIDA Infofacts: High School and Youth Trends.) According to the 2005 MTF, rates of heroin use were stable among all three grades measured.

Heroin indicators, as measured by the Community Epidemiology Work Group (CEWG), remained high in Baltimore, Newark, Boston, Chicago, New York City, Philadelphia, San Francisco, Seattle, and Washington, DC. Baltimore and Newark ranked highest of all CEWG areas in the percentage of heroin items analyzed by forensic labs in 2004; heroin was identified in 34 percent of items analyzed in Newark, and in 26 percent of items analyzed in Baltimore. Eighty-two percent of drug treatment admissions (excluding alcohol) in 2004 were attributable to primary heroin abuse in Newark, followed by 74 percent in the Boston area, and 60 percent in Baltimore.

The 2004 NSDUH reports a significant decrease in lifetime heroin use among Americans age 12 or older, most notable in those 26 or older. An increase in past-month use of heroin was reported, however, among persons age 21 to 25.

Medical Complications and Treatment

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