Despite being one of the most addictive and dangerous illicit drugs, heroin is being used by increasing numbers of people, especially among youth. Heroin use has even spread to American suburbs, a departure from the past when it was largely confined to urban areas. Effectively combating the heroin epidemic will require a new strategy and change of focus, from emphasis on incarceration to emphasis on education, rehabilitation and economic well-being.
The Rise of Heroin As a Recreational Drug
Heroin’s rise as a recreational drug coincided with the return of soldiers who fought in Vietnam and began using it during the war. During this time, massive amounts of heroin were shipped into the United States from Southeast Asia to satisfy the growing demand. In particular, urban areas rife with poverty were hard-hit during the 1970s and 1980s. Because the heroin trade was and is very lucrative, rival gangs fought for turf in urban areas to ply the trade, contributing to the violent crime waves in major cities in previous decades.
More recently, heroin has grown in popularity due to the rise and decline in the recreational use of pharmaceutical opiates. As regulations on pharmaceutical opiates have significantly reduced their supply and thus increased their price, recreational users of opiates have shifted to heroin, a cheaper yet very potent alternative. According to the National Institute on Drug Abuse, those meeting criteria set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for heroin dependence more than doubled from 214,000 in 2002 to 467,000 in 2012 in the United States.
Today, a significant amount of heroin, particularly the very pure heroin, enters the United States from Latin America. Because it is easier to snort pure heroin, the rise in purity of the drug has coincided with the increased use of it, especially in the suburbs. Those who are disinclined to use the drug intravenously are more likely to snort it as part of their drug experimentation.
What Can Be Done to Stop the Heroin Epidemic?
Effectively combating the heroin epidemic will require a shift from imprisoning substance abusers to rehabilitating them. Imprisoning users not only is very costly, but the prison environment itself is also often a place where drug use is rampant. Once substance abusers are released back into society, without serious efforts to rehabilitate them during their sentence, they are likely to revert back to substance abuse. For this reason, rehabilitation or counseling is important to get at the root of heroin use and to prevent rates of recidivism among heroin users. In conjunction with rehabilitation, which generally involves individual or group therapy, medications such as methadone, buprenorphine and naltrexone have been an effective tool in treating heroin addiction, by reducing cravings or the pleasurable effects of heroin among users.
Providing more economic opportunities for youths is also critical to address the heroin epidemic. Those at the fringes of society with no hope of advancing socioeconomically are more prone to use drugs to cope with their predicament. As alternatives to drug-peddling are created in economically depressed areas, more youths will likely model positive behaviors that do not contribute to the cycle of social decay in choosing their trade. Alleviating poverty and bringing hope can thus reduce both the supply and demand of the drug and become part of the solution to stopping the heroin epidemic.
The most effective way to combat the heroin epidemic is to provide high quality treatment programs such as inpatient rehabilitation. These programs provide a safe, residential environment far from the triggers that contribute to the heroin abuse. It also provides patients the education, skills training and support needed to help them maintain a drug-free existence for the long-term.