Diacetylmorphine, also known as heroin, and commonly called dope, smack, dragon, or simply H on the streets, is an opiate-based recreational drug known for inducing powerful highs and for its dangerously addictive qualities. The most widely used methods of taking heroin include injection, smoking, or snorting. Heroin can also be taken orally in a pill form. Globally, an estimated 9.2 million people use heroin (from drugfreeworld.org).
As of 2004, 87% of the world’s supply of opium, used in making heroin, came from Afghanistan. While Afghanistan remains the leading supplier, more recently Mexico and Colombia have produced an increasingly larger share of the world’s opium (from Wikipedia.org).
Recent Heroin Epidemic in the United States
The following clip from NBC news provides an informative overview of the recent heroin epidemic in the United States:
In the throes of an increasingly disturbing heroin epidemic, many neighborhoods, counties, and states across the United States are desperate for a solution to the mounting crisis. Nationally, heroin use has “nearly doubled since 2007 to 620,000, according to government statistics” (Carey, 2014). Heroin deaths increased 45% between 2006 and 2010 (Gray, 2014).
The purity of the heroin varies from package to package, and some distributors are enhancing its potency—and lethality—by lacing it with the powerful narcotic fentanyl. These variables contribute to the number of fatalities, because users are often unaware of just how deadly a particular dose of heroin can be.
New England has been particularly hard hit. New Hampshire had 67 heroin related deaths in 2013, up from 16 deaths in 2008. By comparison, in 1993, New Hampshire did not have a single heroin-related death (“New Hampshire in the grips of ‘Heroin Epidemic’” from Boston.com). Reporting on heroin use among young adults in New York, Cara Buckley writes, “In 2000, 59 people ages 19 to 25 entered Nassau’s detoxification and rehabilitation centers for heroin abuse, according to Arlene Sanchez, the county’s commissioner of mental health, chemical dependency and developmental disabilities services. In 2008, 458 did” (Buckley 2009). Heroin related deaths in New York increased by 84% between 2010 and 2012 (Hoffman, 2014).
Vermont Governor Peter Shumlin, sensing the urgency and magnitude of the problem, devoted his entire State of the State address to the mounting opiate addiction crisis (Seelye 2014). Many other state and regional leaders are sounding the alarm: Heroin is a devastating problem, and it’s ruining our communities.
Contributing Factors to the Heroin Epidemic
A significant factor in the recent epidemic is the rise in use of opiate-based prescription painkillers. Prior to the late 1990s, these powerful painkillers were reserved for only extreme circumstances of pain. By the mid 2000s, however, opiate-based prescription painkillers such as Vicodin, OxyContin, and Percocet, were prescribed much more frequently and became much more widely available.
While the painkillers are often highly effective treatments for pain, studies show links between the use of opiate-based painkillers and heroin use. A recent study reports that “some 6.8 million Americans abuse prescription pills” and “that people aged 12-49 who had abused prescription painkillers were 19 times more likely than those who hadn’t to try heroin in the previous year” (Gray, 2014).
Another contributing factor is heroin’s relatively low cost. Painkillers are extremely expensive, and many people turn to heroin as a cheaper and more potent alternative. Purchased on the street, a painkiller such as Vicodin can cost up to $40 per pill. By comparison, the amount of heroin that can be purchased for just $5 is enough to induce a six to eight-hour high (Buckley, 2009). Addiction specialist Dr. Jason Jerry says, “People eventually say, ‘Why am I paying $1 per milligram for oxy when for a tenth of the price I can get an equivalent dose of heroin?’” (Quoted in Carey, 2014). Captain Scott Tucker of the Rutland Police Department in Vermont puts it this way: “If the market is flooded with low-priced, high-grade heroin, a significant population is addicted… That’s the free market” (Seelye, 2013).
Possible Solutions and Methods of Treatment
To quell the epidemic, some have suggested the need for more outpatient treatment centers. Resistance to this proposal has surfaced from those who do not want the stigma of having a heroin treatment center near their home. But those in favor argue that making an effort to reduce the stigma and offering treatment will not only help those addicted to heroin but save thousands of dollars. Steven Kassels, writing in the Boston Globe, asserts, “We are wasting tax dollars: it costs up to $50,000 or more per year to incarcerate and approximately $5,000 per year for outpatient treatment” (Kassels, 2014).
Other controversial methods of treatment include prescribing Methadone or Buprenorphine, both weaker opiates used to wean people off of heroin. But both of these drugs come with their own health risks and possibility of addiction. For more on the controversy surrounding the use of Methadone and Buprenorphine, see “Addiction Treatment with a Dark Side” (Sontag, 2014).
Naloxone, a medicine that can be used to counteract the effects of an opiate overdose, is gaining wider acceptance, and heroin users are increasingly encouraged to have it on hand as a precautionary measure. Naloxone remains controversial, however, and opponents argue that having an overdose antidote available would only encourage drug use. Proponents argue that it would decrease the number of heroin related fatalities. They are working with state legislatures to pass laws which would make it easier for doctors and addiction treatment clinics to prescribe and distribute Naloxone. For more on Naloxone, see “How to Stop Heroin Deaths” (Hoffman, 2014).
Questions for Reflection and Discussion
Do you know anyone who has used heroin?
What is your reaction to hearing the news related to this recent heroin crisis?
Where and how should the issue of heroin addiction be discussed?
Heroin addiction is growing at an alarming rate in the United States.
There seems to be a link between the use of opiate-based prescription painkillers and the use of heroin.
Many treatment methods for heroin addiction are controversial. The effectiveness and long-term implications of addiction treatment methods are currently being debated at the local and state levels.