Pubdate: Tue, 04 Feb 2014
Source: Wall Street Journal (US)
Copyright: 2014 Dow Jones & Company, Inc.
Contact:  http://www.wsj.com/
Details: http://www.mapinc.org/media/487
Author: Arian Campo-Flores And Zusha Elinson

HEROIN USE, AND DEATHS, RISE

The death of Philip Seymour Hoffman From an Apparent Heroin Overdose 
Underscores the Drug's Resurgence

The death of actor Philip Seymour Hoffman from an apparent heroin
overdose underscores the drug's resurgence in recent years, fueled by
a growing supply from Latin America and a crackdown on prescription
narcotics that has pushed addicts to seek old-fashioned
alternatives.

The number of heroin users in the U.S. jumped almost 80% to an
estimated 669,000 in 2012 from 373,000 in 2007, according to surveys
by the Substance Abuse and Mental Health Services Administration, part
of the Department of Health and Human Services. Annual overdose deaths
attributed to heroin hit 3,094 in 2010, the most recent data
available, up 55% from 2000, said the Centers for Disease Control and
Prevention.

Unlike the heroin scourge of the late 1960s to early 1980s, which was
concentrated in urban centers, today's epidemic is ravaging suburbs
and rural areas as well. At a National Institute on Drug Abuse meeting
last month, 17 of 20 researchers from across the country reported that
heroin was their top emerging issue, said James Hall, an
epidemiologist at Nova Southeastern University's Center for Applied
Research on Substance Use and Health Disparities in Miami.

"Heroin doesn't have any sort of geographic or demographic
boundaries," said Rusty Payne, a spokesman for the Drug Enforcement
Administration in Washington. "It touches pretty much every segment of
society." A major factor driving the heroin comeback are prescription
pain-pill addicts who have switched to heroin as the pills became "too
expensive or less accessible," said Gil Kerlikowske, the White House
drug czar. Heroin is cheaper yet part of the same family of drugs as
oxycodone and other opioids, whose illegal use has been subject to a
crackdown by law enforcement.

About 80% of people trying heroin for the first time previously used
prescription pain drugs, according to a report last year by the
Substance Abuse and Mental Health Services Administration. New users
typically start off smoking or snorting the powder, then sometimes
move on to injecting it, which causes the quickest and most intense
high.

Another factor is that heroin manufacturers in Mexico have boosted
production in recent years, drug officials say. Traffickers
increasingly are distributing Mexican heroin not just in the western
U.S., where it has long prevailed, but in the East, which had been
dominated by Colombian supply. Heroin seizures along the border
between the U.S. and Mexico rose 232% from 2008 to 2012, to 1,855
kilograms, according to DEA data. Batches also generally have become
more potent, in part because of more sophisticated production methods,
officials said.

While heroin is diluted with other substances as it makes its way to
the street, retail buyers often get a purer product than in decades
past, said James Hunt, special agent in charge of the DEA's New York
division. While a dose of heroin in the 1980s might have been 5% pure,
it is not uncommon to find a street bag today that is 50% pure, making
it potentially more lethal, he said. Moreover, heroin is sometimes
combined with other dangerous drugs, including the synthetic opiate
fentanyl. That combination has been blamed for a spate of deaths in
recent months along the East Coast, including 37 in Maryland and 22 in
Pennsylvania.

Users "think they're getting regular street heroin," said Thomas Carr,
director of the Washington-Baltimore High Intensity Drug Trafficking
Area. "Instead, they're getting something that could kill a horse." In
the case of Mr. Hoffman, toxicology tests are pending. Police found
several envelopes in his New York City apartment that contained what
is believed to be heroin.

The heroin supply in New York has surged since 2009, said Bridget
Brennan, special narcotics prosecutor for the city. "We started to see
production mills that were capable of producing hundreds of thousands"
of bags a day, she said. The current epidemic rivals that of the 1970s
in scope, Ms. Brennan said. But "the change is the new user," she
said. "That new user tends to be younger and more affluent."
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