Drug Update:  Heroin – The Scourge Continues

By Joseph E. Troiani, Ph.D.

March 11, 2001

According to drug experts, public health officials, and law enforcement authorities, we are in the midst of a major heroin epidemic that is rivaling the epidemics of the late 1950’s and 1960’s.  Younger people are now using this more potent and potentially more dangerous brand of narcotic.  Government officials are expressing concern that this epidemic will overwhelm our health care system and lead to an increase in the crime problem associated with heroin use.  The increase in heroin use today is the result of the following: there has been a dramatic increase in the worldwide production and refinement of opium.  In addition to it coming from southeast and southwest Asia where it has historically come from, we are now seeing a dramatic increase coming from the former Republics of the Soviet Union, since its breakup starting in 1989.

More heroin is entering the United States despite the efforts of supply reduction.  It is estimated that more then 400 tons of heroin is illegally imported annually into the U.S.  This cycle of rising production and importation has led to greater availability, increased purity and prices falling to new record lows.  With increased production, we have seen for the first time in years, growing use of this drug.  In addition, heroin with higher purities can be smoked or snorted, avoiding the use of needles.

This new and improved heroin has developed an appeal among middle-class suburban

kids, especially those identified with alternative or counter cultures, such as the punk rock, hippie, or what has emerged as the “heroin chic”.   It also has been glamorized in films and by the fashion industry where it has had a most pervasive effect on impressionable juvenile viewers thus resulting in the current sharp rise in usage among teens and young adults.  This has been made popular by such movies as “Pulp Fiction” and “Trainspotting”. In 1997 President Clinton strongly condemned the fashion industry for capitalizing on the “Heroin Chic”, the style of fashion advertising, shows, and photography that appears to glamorize the “strung out look” of the heroin addict. The fashion industry was purposely portraying heroin use as glamorous in order to sell particular lines of clothing to young people. One fashion photographer who was well known for his photographs of seeming strung-out heroin-addicted models recently died of heroin overdose. You could add to the list all those in the music industry who have died of heroin use including River Phoenix, Sid Vicious of the Sex Pistols, Jonathan Melvoin of Smashing Pumpkins, and Kurt Cobain of Nirvana just to mention a few. This is very different from the historic memory of previous generations of heroin addicts who were looked down upon as down-and-out street junkies.

 The appeal of heroin goes beyond the chic of the experience.  Just look at the description of using this drug as explained by one person, “Heroin is really good in the short term.  It’s the ultimate live-for-the moment drug.  It makes all of life’s problems seem strangely irrelevant.  But that’s the problem.  Once you discover how good life is with heroin, you never want to go back to a life without it.  If heroin had no drawbacks, it would be

wonderful.  But it substitutes for everything that we consider important to having lived a worthwhile and interesting life. It is like a living suicide”.  A recent story by an Associate Press writer tells of a sixteen year old girl in juvenile lockup waiting trial as an adult on charges that could land her a life prison sentence.  This suburban Detroit teen had been charged with armed robbery and is suspected in several others allegedly to support her $200-a-day heroin habit.  She was a high school honor student and gymnast who had started using heroin at the age of 14.

The average price of heroin has dropped by nearly two-thirds, while purity has gone up from 15% to well over 50%.   This increased purity of heroin makes snorting a realistic alternative to injecting and is creating a new generation of heroin sniffers, snorters, and intranasal users, rather then the intravenous user. Also research suggests that persons who smoke or inhale heroin may do so because the pharmacological effects of this higher purity heroin are similar to those achieved by injecting the drug.  Using it this way makes it easier for people to start using it in the first place, especially those who might have been deterred by the prospect of injecting themselves with needles and the fear of HIV infection. There is also research which suggests that long term users of cocaine and/or crack will cross over to heroin use to relieve themselves of the long term debilitating chronic effects of these drugs with a more mellow feeling narcotic high. It has been recently reported that the same dealers are selling heroin and cocaine/crack.  This is unusual because separate distributors have dealt traditionally heroin and cocaine.

Government data has reflected this trend of the increased popularity of heroin.

There were estimated 122,000 new heroin users in 1994 that increased to 141,000 new users in 1995.  During that same time period heroin-related emergency room episodes increased by 32 percent. Most frequently recorded reasons for an emergency room visit among heroin-related episodes during that time frame were chronic effects, seeking detoxification and overdose. 

Barry R. McCaffrey, Director, Office of National Drug Control Policy in his January 1999 report on “Reducing Drug Abuse in America” list heroin as an emerging illegal drug threat.  Their studies of the problem reveal that there are an estimated 810,000 chronic users of heroin.  Also heroin initiation rates (new users) have continued to risen dramatically since 1992 with the most dramatic increase occurring in 1996.  It points out that “the growing use of heroin by young people is an alarming recent trend”.  Rates of heroin use among teenagers rose in eight, tenth, and twelfth grades in the 1990s resulting in the mean average age of initiation declining from 26.2 years in 1988 to 18.1 in 1996.

Dr Troiani has been working in the field for 30 years.  He is a consultant and trainer for Terence Gorski’s CENAPS Corporation with whom he has developed a training seminar “DRUG UPDATE 2001”.  His other responsibility includes the Directorship of Mental Health and Addiction Programs for the Health Department, and is the Coordinator of Addiction Studies at the Adler School of Professional Psychology located in Chicago.