Heroin use has increased rapidly over the past 13 years, with huge increases in groups such as women who usually don't abuse the deadly drug.
Use among women has doubled from 2002 to 2013 and more than doubled among non-Hispanic whites, according to a report from the Centers for Disease Control and Prevention. Both of those groups have had traditionally lower rates of heroin use.
The CDC found that deaths are on the rise, too. From 2002 to 2013, the rate of overdose deaths nearly quadrupled, and in 2013 alone there were more than 8,000 deaths.
The agency analyzed data from the National Survey on Drug Use and Health.
The biggest reason for Americans flocking to the deadly drug is through addiction to prescription painkillers, the CDC reported in a call with reporters. People who abuse painkillers are 40 times more likely to abuse heroin, the report found.
The chemical makeup is essentially the same between prescription painkillers and heroin. Since heroin is much cheaper than painkillers on the street, that is fueling the increase, according to the CDC.
In addition, about 96 percent of people who reported heroin use also reported using at least one other drug in the past year, with more than half (61 percent) using at least three other drugs, the agency said.
"The use of multiple substances increases the risk of overdose," said CDC Director Tom Frieden.
Abusers mostly took alcohol, cocaine or marijuana in addition to heroin.
The agency said states play an important role in addressing opioid and heroin abuse, saying that officials should use any prescription monitoring databases for any trends and expand use of the overdose treatment naloxone.
Physicians also should look at their prescribing practices to see if they are unnecessarily prescribing opioids to patients, the agency said.