‘The spread of heroin to a new market of relatively affluent, suburban whites has allowed the drug to make a comeback, after decades of decline.’ — The Economist
‘So we are at a strange new place. We enjoy blissfully low crime rates, yet every year the drug-overdose toll grows. People from the most privileged groups in one of the wealthiest countries in the world have been getting hooked and dying in almost epidemic numbers from substances meant to numb pain. Street crime is no longer the clearest barometer of our drug problem; corpses are.’ — The New York Times
‘It may sound sick and twisted, but if you tell a drug addict there is dope so good that it’s going to kill you, it doesn’t make them not want to try it. It makes them want to try it even more.’ — recovering addict Michael Pack
Nearly every day, there’s a new headline about heroin and the scourge it has become in communities around the nation. Our newspapers have closely covered the epidemic, and will continue to do so; as recently as Friday, Dayton Police Chief Richard Biehl told us that his officers had administered Narcan, the treatment used to reverse a heroin overdose, 24 times in the last month alone. A quick search of the web shows that similar stories and statistics are playing out in cities all over the United States. Today, we offer a few selected voices and views from publications around the country to offer some new views and illuminating details on this continuing story.
The drug is old, but the face of the addict has changed
From The Economist
The face of heroin use in America has changed utterly. Forty or 50 years ago, heroin addicts were overwhelmingly male, disproportionately black, and very young (the average age of first use was 16). Most came from poor inner-city neighbourhoods. These days, more than half of users are women, and 90 percent are white. The drug has crept into the suburbs and the middle classes. And although users are still mainly young, the age of initiation has risen: most first-timers are in their mid-20s, according to a study led by Theodore Cicero of Washington University in St Louis.
The spread of heroin to a new market of relatively affluent, suburban whites has allowed the drug to make a comeback, after decades of decline. Over the past six years, the number of annual users has almost doubled from 370,000 in 2007 to 680,000 in 2013. Heroin is still rare compared with most other drugs: cannabis, America’s favourite (still mostly illegal) high, has nearly 50 times as many users, for instance. But heroin’s resurgence means that, by some measures, it is more popular than crack cocaine, the bogeyman of the 1980s and 1990s. Its increased popularity in America contrasts strongly with Europe, where the number of users has fallen by a third in the past decade. What explains America’s relapse?
… The 1990s saw a big increase in prescriptions of opioids for chronic pain. In some states the number of opioid prescriptions written each year now exceeds the number of people. That oversupply feeds the black market: last year 11 million Americans used illicitly acquired prescription painkillers, more than the number who used cocaine, ecstasy, methamphetamine and LSD combined. People who would never dream of injecting heroin seem to assume that opioids in packets are safe.
… Just as the demand side of America’s heroin market was heating up, so too was supply. Though Afghanistan accounts for 80 percent of global opium production, America gets most of its heroin from Mexico. Historically that has checked consumption, since Mexico has long been a relatively small producer of opium poppies.
In the past few years the Mexicans have upped their game. One of the many unintended consequences of Mexico’s war on organised crime in urban hotspots, such as Ciudad Juárez, was that the army was diverted from poppy eradication in the countryside. Farmers in the Sierra Madre made the most of this: by 2009 cultivation was ten times higher than in 2000. Although production has fallen back in the past few years, Mexico is now the world’s third-biggest producer of opium, after Afghanistan and Myanmar.
Policy changes in America have given Mexico’s narco-farmers further incentives to focus on opium. Until not so long ago, Mexican traffickers made a lot of their money from cannabis. But these days most of the cannabis in America is home-grown. Nearly half the states have legalised medical marijuana, and four have voted to legalise it outright. Exporting pot to the United States is now like taking tequila to Mexico. Facing a glut in the cannabis market, Mexican farmers have turned to poppies.
America’s police have seen the impact.
Blame much of the problem on the ‘raging pain pill epidemic’
From the Associated Press
The increase in heroin use nationwide over the past few years has its roots in the raging pain pill epidemic. When states clamped down on “pill mill” clinics and prescription drugs became harder to get, many addicts turned to heroin because it’s cheaper and easier to find. …
“It may sound sick and twisted, but if you tell a drug addict there is dope so good that it’s going to kill you, it doesn’t make them not want to try it. It makes them want to try it even more,” says Michael Pack, a 39-year-old recovering addict in central Ohio who has helped dozens of users get into detox, sometimes driving them to other cities where there is space in treatment programs.
The Centers for Disease Control and Prevention reported in March that heroin overdose deaths in the United States quadrupled from 2000 to 2013, with most of the increase coming after 2010. In Ohio, heroin overdose deaths rose from 697 in 2012 to 983 in 2013, the last year for which statistics were available.
Many more likely would be dying if not for naloxone, better known by its brand name Narcan, which was administered 15,493 times by emergency medical crews in Ohio last year, according to the state health department. Ohio is among a handful of states taking steps to make the lifesaving drug available to virtually anyone willing to be trained to use it.
Even the new crop of presidential candidates are talking about heroin
From the Washington Post
When aspiring presidential candidates step into Mayor Ted Gatsas’s office Manchester, N.H., he doesn’t let them leave without telling them about what he calls one of the most pressing, dire issues his city faces: heroin.
“Every candidate that comes in here, what I say to them is, ‘It’s not only an issue here in Manchester, New Hampshire. It’s a national issue,’ ” said Gatsas (R). “If we don’t get our arms around it, it’s going to take over our country.”
The nation is in the throes of an epidemic of prescription-drug and heroin abuse — a wave that’s leaving its mark on the 2016 presidential campaign, too.
Hillary Rodham Clinton has told supporters that drug abuse and mental health will be key issues in her Democratic presidential campaign, and she launched a policy-focused outreach effort on the issue. New Jersey Gov. Chris Christie (R) recently participated in a round-table discussion at a drug treatment facility here. Republican Carly Fiorina has spoken movingly about losing a stepdaughter to addiction. Sen. Rand Paul (R-Ky.) has made reforming drug laws and the criminal-justice system a centerpiece of his presidential campaign. And former Florida Governor Jeb Bush (R) said he learned about New Hampshire’s heroin problem while touring as a potential presidential candidate.
Drug addiction and treatment are no longer problems acknowledged only with infrequent stump lines. They are driving a sustained conversation on the presidential campaign trail.
And that conversation revolves around ending — not stepping up — the war on drugs. It centers on the language of addiction and treatment, on the sharing of deeply personal experiences and on calls from candidates for the criminal-justice system to be restructured to make the government’s response to illegal use less punitive.
… According to the Centers for Disease Control and Prevention, the number of deaths nationwide involving heroin increased from 3,041 in 2008 to 8,260 in 2013, the most recent year for which statistics are available. In 2013, 16,235 people died from overdosing on prescription opiates; in 2008, 14,800 people died. Drug overdoses were the nation’s leading cause of injury death in 2013, according to the CDC. Among people 25 to 64, overdoses caused more deaths than traffic accidents.
In New Hampshire, the state’s medical examiner has called heroin abuse “the Ebola of Northern New England.” New Hampshire recorded 325 drug overdose deaths last year; about 90 percent of them involved opiates, according to the medical examiner’s office. The state also has seen a rapid increase in the number of deaths from the painkiller fentanyl, which is often mixed with heroin.
… For all the talk, there’s little yet in the way of policy plans. The first votes of the 2016 campaign are still months away, and so far, no candidate has come up with concrete proposals on how he or she would handle the epidemic from the Oval Office.
‘And yet this is also our quietest drug plague.’
From the New York Times
Fatal heroin overdoses in America have almost tripled in three years. More than 8,250 people a year now die from heroin. At the same time, roughly double that number are dying from prescription opioid painkillers, which are molecularly similar. Heroin has become the fallback dope when an addict can’t afford, or find, pills. Total overdose deaths, most often from pills and heroin, now surpass traffic fatalities.
If these deaths are the measure, we are arguably in the middle of our worst drug plague ever, apart from cigarettes and alcohol.
And yet this is also our quietest drug plague. Strikingly little public violence accompanies it. This has muted public outrage. Meanwhile, the victims — mostly white, well-off and often young — are mourned in silence, because their parents are loath to talk publicly about how a cheerleader daughter hooked for dope, or their once-star athlete son overdosed in a fast-food restaurant bathroom.
The problem “is worse than it’s ever been, and young people are dying,” an addiction doctor in Columbus, Ohio — one of our many new heroin hot spots — wrote me last month. “This past Friday I saw 23 patients, all heroin addicts recently diagnosed.”
So we are at a strange new place. We enjoy blissfully low crime rates, yet every year the drug-overdose toll grows. People from the most privileged groups in one of the wealthiest countries in the world have been getting hooked and dying in almost epidemic numbers from substances meant to numb pain. Street crime is no longer the clearest barometer of our drug problem; corpses are.
Most of our heroin now comes not from Asia, but from Latin America, particularly Mexico, where poppies grow well in the mountains along the Pacific Coast. Mexican traffickers have focused on a rudimentary, less-processed form of heroin that can be smoked or injected. It is called black tar, which accurately describes its appearance. Cheaper to produce and ship than the stuff of decades past from Asia, heroin has fallen in price, and so more people have become addicted.
… Some places have gained ground on the epidemic. Portsmouth, Ohio, was among the first to see a generation addicted, and pill mills — pain clinics where doctors prescribed pills for cash and without a proper diagnosis — were virtually invented there. Portsmouth, like a junkie who has hit rock bottom, has found within it a spirit of self-reliance that has helped kindle a culture of recovery. The town shuttered the pill mills. Narcotics Anonymous meetings are now everywhere; recovering addicts are studying to be counselors. And after years of watching jobs go abroad, in 2009 townspeople stepped in to save one of Portsmouth’s last factories — a shoelace manufacturer, which now exports shoelaces to China, Mexico and Taiwan.
Like Portsmouth, we need to take accountability for our own wellness. There is a time and a place for pain pills, of course. But we need to question the drugs marketed to us, depend less on pills as solutions and stop demanding that doctors magically fix us.
It will then matter less what new product a drug company — or the drug underworld — devises.
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