Heroin was once the scourge of the urban poor, but today the typical user is a young, white suburbanite, a study finds. And the path to addiction usually starts with prescription painkillers.

A survey of 9,000 patients at treatment centers around the country found that 90 percent of heroin users were white men and women. Most were relatively young — their average age was 23. And three-quarters said they first started not with heroin but with prescription opioids like OxyContin.

In contrast, when heroin first became popular in the ’60s and ’70s, most users were young minority men who lived in cities. “Heroin is not an inner-city problem anymore,” says Dr. Theodore Cicero, a psychiatrist at Washington University School of Medicine in St. Louis who led the study.

The results of the study, which were published Wednesday in the journal JAMA Psychiatry, square with earlier findings that heroin abuse is both growing and spreading beyond urban centers.

In 2007, over 2,000 people died of heroin overdoses, according to the Centers for Disease Control and Prevention. And 200,000 went to ERs after overdosing in 2008.

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