Fewer prescription pills, more heroin

While the federal Drug Enforcement Administration (DEA) has warred against prescription drug abuse, heroin deaths have increased by 52 percent during the past four years.

The spike in overdoses came shortly after the DEA slowed the flow of illegal painkillers. As pills became less available, heroin filled the void. At roughly $10 a dose, compared to $60 a pill, addicts get a similar high at a fraction of the price.

In Vermont, where heroin usage has increased by 770 percent since 2000, Gov. Peter Shumlin dedicated his entire State of the State address to the issue, and in March 2014, the Massachusetts governor declared a public health emergency after 185 people died of overdoses in five months.

Major Clarence T. Hunter of the Henrico, Va., County Police Departmentsaid the trend from prescription pills to heroin is particularly troubling because addicts are shifting from a regulated to a non-regulated substance: “You buy it from one guy one day and another guy the next. Because it’s unregulated, you have no idea of the purity you are getting. And that is what causes the overdoses.”

The danger of the non-regulated drug was also evident in Pennsylvania in February 2014, when 22 people died from a batch of heroin laced with fentanyl. In the Northeast, dealers often label their batches, and initially they sold the fentanyl-laced heroin in bags with the labels “Theraflu” and “Bud Ice.”

After the names of the dangerous batches went public, authorities found fentanyl-laced heroin being sold as “Sky High.” The dealers rebranded the dangerous batches and continued to sell them. Federal prosecutors have pursued tougher penalties in cases like this, seeking more prison time when a dealer can be linked to an overdose.

Heroin once was primarily associated with dirty needles and back-alley junkies, but increasing purity levels have enabled users to snort the drug rather than inject it. According to DEA Special Agent Greg Cherundolo, that has encouraged use: “A lot of people say ‘I would never get to the point where I am injecting something. But if I’m snorting it, I’m OK.’”

In Kentucky, where overdose deaths have increased by 1,000 percent in two years, lawmakers are debating the best way to handle the heroin problem. Republicans want stricter sentences for low-level dealers, while Democrats want more needle exchange programs to slow the spread of diseases related to the drug. Kentucky leads the nation in Hepatitis-C cases.

The journal JAMA Psychiatry surveyed 9,000 patients in recovery centers around the United States in 2014 and revealed 90 percent of heroin users were white. Three out of four addicts were initially addicted to painkillers.