Why Is Heroin Making a Comeback?

Drug Seizures, Reported Overdoses Increase Dramatically

Cooking Heroin
Heroin Is Making a Comeback. &copy Getty Images

There is little doubt that heroin use is making a comeback in the United States given the increase in the amount of seizures of the illegal drug at U.S. borders and the rapid increase in overdose deaths reported throughout the country.

The difference now is heroin use is not limited to the dark corners and back alleys of urban America, it's finding its way into rural back roads, suburban streets and high-end apartments in New York City, cutting across all demographic groups.

The Reach of Heroin

Almost daily, news articles from law enforcement and health officials across the nation report sharp local increases in heroin overdose deaths. In Vermont, Gov. Pete Shumlin devoted his entire 2014 annual address to the legislature to what he called the heroin crisis in the state.

The current prevalence and reach of heroin use in society was highlighted with the news reports of the death of Academy Award-winning actor Philip Seymour Hoffman, who was found dead with a needle in his arm and 70 bags of heroin in his $10,000-a-month New York apartment.

Heroin Use Increases Sharply

According to the latest data from the Substance Abuse and Mental Health Services Administration, heroin use rose sharply for people ages 12 to 49 between 2007 and 2011:

  • Past-month heroin users rose from 373,000 to 620,000
  • Those addicted to heroin increased from 179,000 to 369,000
  • First-time heroin users jumped from 106,000 to 178,000

    Heroin Overdose Deaths Increasing

    The U.S. Drug Enforcement Administration developed its 2013 National Drug Threat Assessment Summary using data from 1,307 state and local law enforcement agencies. According to the DEA's report, deaths attributed to heroin overdose rose from 1,879 in 2004 to 3,038 in 2010.

    Officials in the Minneapolis, Minnesota area reported that heroin overdose deaths tripled in just one year from 2010 to 2011. Heroin-involved intoxication deaths in Pennsylvania almost doubled in the same one-year period.

    The DEA attributes the increase in heroin overdose deaths to three factors:

    Availability of High-Purity Heroin

    Law Enforcement officials in every area where an increase of heroin overdose deaths have been seen, also reported an increase of high-purity heroin available at the street level.

    Based on an increase in the amount of heroin seized at the nation's Southwest Border, DEA officials believe the increase in higher purity heroin into the U.S. is coming from Mexican-produced and South American-produced heroin from traffickers expanding into areas of the country used to a less-pure form of the drug.

    Southwest Border seizures of heroin increased 232% from 2008 to 2012, according to the DEA.

    Prescription Drug Abusers Switching to Heroin

    The crackdown by federal and state authorities on the prescription drug abuse epidemic had some unintended consequences.

    The focus on shutting down "pill mills" and "doctor shopping" made prescription drugs like OxyContin more difficult to get and more expensive.

    Consequently, many former pain pill abusers turned to heroin instead because it was readily available and less expensive. People who previously used prescription pain pills non-medically were 19 times more likely to initiate heroin use than non prescription abusers, according to a SAMHSA report.

    In fact, SAMHSA's 2013 report showed that almost four out of five (79.5%) of new heroin users previously abused prescription pain relievers. Law enforcement and treatment officials likewise report that a majority of heroin users they encounter previously abused prescription opioids.

    Today's Heroin Users Are Younger

    Another reason DEA officials think that heroin overdose deaths are increasing is because more people are using the drug and doing so at a younger age. Research indicates that the average age of first use of heroin is dropping significantly.

    In 2011, the average age at first use was 22.1 years and in 2010 it was 21.4 years. Both of those numbers are significantly lower that the 2009 estimate of 25.5 years for average age of first use of heroin.

    What Is the Danger?

    There are two main dangers in using heroin: it is highly addictive and it has a high risk of accidental overdose. Unlike prescription drugs, heroin purity and dosage amounts can vary widely. Basically, the heroin user never really knows what level of dosage they may be taking.

    If someone is used to using a form of heroin that has been heavily "cut" or "stepped on" by mixing it with other ingredients and they suddenly find themselves with a batch of pure heroin, the consequences can be fatal.

    Combined With Other Drugs

    Sometimes heroin dealers mix the drug with other substances. For example, a batch of heroin sold in bags marked "Theraflu," "Bad Ice," or "Income Tax" was mixed with the potent painkiller fentanyl and was blamed for 22 overdose deaths in the Pittsburgh area, proving again that heroin users never know what they are getting.

    Also, heroin is the most commonly found illicit substance involved in accidental alcohol and/or drug intoxication deaths. Drinking alcohol with any opioid is highly dangerous because both are central nervous system depressants that can combine to stop the user's breathing.

    If new heroin users are younger today, an increase in overdose deaths could be attributed, in part, to the fact that many young people are also binge drinkers. The combination can be a deadly one.


    Substance Abuse and Mental Health Services Administration. "Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States." August 2013.

    Substance Abuse and Mental Health Services Administration. "Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings and Detailed Tables." 2 October 2013.

    U.S. Drug Enforcement Administration. "National Drug Threat Assessment Summary - 2013." November 2013.

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