Heroin Epidemic: America in Crisis

Heroin use in the U.S. resurfaced in major way in 2014, reaching epidemic levels and leading to broad news coverage throughout the country. As the heroin crisis continued through 2015, the growing awareness of the epidemic resulted in the development of new policies and initiatives that aim to combat the rise in heroin use across the nation. Perception of the crisis has been shaped by ongoing changes in official response to the staggering growth of heroin use. The following list highlights some 2015’s most noteworthy reports on this topic, as they decode the ways the public’s reaction to heroin use involves race, socioeconomic status, and shifting government and legal policies. 

1. In Heroin Crisis, White Families Seek Gentler War on Drugs, The New York Times

In a comprehensive article, Katharine Seelye addresses the overarching changes in the way heroin use has been framed in the media, and in particular, how shifts in user populations alter our response to the crisis. Seelye explained to us her motivation for writing the article: “One of the most pronounced yet unreported trends has been the rise of heroin use among white people in the suburbs and rural areas, putting a distinctly different cast on the problem from the days when heroin was perceived as a problem among urban blacks.” Discussing how this impacted public response to the heroin crisis, she noted, “Users are now viewed with compassion and heroin addiction as a disease, with authorities recognizing that the War on Drugs has failed and that incarceration for users has served little purpose.” Combining video clips, personal stories, and great data, Seelye’s story is a dynamic and detailed look at trends in response.

2. How Doctors Helped Drive the Addiction Crisis, The New York Times

Richard Friedman focuses on the increasing death rate of middle-aged white Americans, noting that a large part of it stems from heroin, cocaine, and opioid use, in conjunction with the increase in opioid treatments for chronic issues. Friedman critiques recent FDA actions as inadequate and calls for a “sea change within the medical profession.”

3. Why Are Middle-Aged White People’s Death Rates Rising? A Researcher Explains, Slate

Christina Cauterucci reports on a study that documents the death rate for middle-aged white Americans due to heroin overdoses is not only increasing, but also is higher than in most other countries. In this interview with the researchers, Cauterucci focuses on some of the more disturbing trends, such as regional data and the impacts of opioid restriction.

4. The Heroin Epidemic, in 9 Graphs, U.S. News & World Report

The unique angle of this article is its singular focus on heroin through data. The graphics help convey hard truths, and clarify the factual and data driven nature of the content. As the article’s writer Lindsey Cook told us, “The heroin crisis is a good representative of many of the larger problems the U.S. faces as a country, which makes it an interesting lens to explore larger issues.”

5. Mismanaging the Heroin Crisis, Hudson Institute

Authors David Murray and John P. Walters focus on the increase in usage, arguing that politicians and the media “vastly oversold” the story. They also discuss the prolific supply of heroin, the FDA’s slow intervention and questionable practices, and the DEA’s war on drugs as aspects of the health crisis being mishandled. Murray explained to us that his motivation was “driven by a certain frustration” in drug policy. He concluded, “If we fail to apprehend and then respond to the specifically heroin-supply dimension of the problem (which presents a different set of challenges from the very real but largely distinct opiate prescription misuse dimension), we will have wasted precious time and resources and will end up not genuinely leveraging the epidemiology of the threat.”

6. A Hydra-Headed Scourge, The Economist

Calling the heroin epidemic a “doctor-caused epidemic” Tom Frieden of the CDC points to the link between prescription opioid painkillers and the current heroin epidemic. In discussing the Midwest’s Rust Belt, this article highlights local impact and global implications, including the lack of experience and resources needed to cope with the epidemic.

7. How Painkillers Are Turning Young Athletes Into Heroin Addicts, Sports Illustrated

High school athletes feel pressure to play through pain. Some progress from prescribed painkillers to illicitly attained medications, and eventually to heroin as it is less expensive and in large supply. Jon Wertheim explained to us how Sports Illustrated came to cover this story, “Candidly, a source at the DEA suggested we look into the high incidence of young athletes being prescribed pain medication. Once we poked around a bit there, it was clear that — with alarming frequency — those addicted to opioids to treat injuries than became addicted to heroin,” he said.

9. It’s Not an Opiate Crisis, It’s a Heroin Crisis, The Boston Globe

Evan Horowitz captures significant data to demonstrate the exceptionality of the current heroin challenge. He uses data to address the ways in which opioids and heroin should be considered separate issues in order for the public health crisis to be resolved, which makes this piece noteworthy.

9. First in Heroin, First in the Nation to Vote, The Daily Beast

Because New Hampshire is the first state to hold a presidential primary, it is where the candidates are challenged to prove their bona fides. With very high addiction rates, New Hampshire is capitalizing on their primary to bring this critical issue to the forefront of national attention.

10. Overdoses Complicate Picture of Heroin Crisis, The Darien Times

Natalie Axton covers a town meeting focusing on heroin in suburban Darien, Conn., which brought together law enforcement, medical personnel, and families, all frustrated with how information silos prevent acknowledging the reality of drug issues. Residents and police alike complained about the lack of information due to health care privacy. Axton told us that Darien Police Sergeant Jeremiah Marron, “Literally admonished the audience, claiming people in Darien hide their family problems with addiction because they are afraid of social stigmatization.”

11. The Heroin Crisis and the Links to Sex Trafficking, Vermont Public Radio

This radio podcast reports on a new campaign against drug and sex trafficking in Vermont. Examining the sociological impact of this crisis, the guests discuss the issues of treatment, education, and law enforcement. Several experts share candid revelations and conclude that it is easier for teens in Vermont to get heroin than it is for them to get beer.

12. When Reframing the Heroin Epidemic as a Public Health Crisis, Who Gets Left Behind?, Daily Kos

Alleging that the War on Drugs was a policy that created a revised Jim Crow war on people of color and people of poverty, Vann Newkirk II’s article claims the current shift in public policy is a result of a privileged victim population. Responding to an inquiry for this list, he stated, “I chose to discuss this crisis from the health disparities framework because it’s often ignored in mainstream analyses … In asking who benefits and who pays for public health issues we can begin to really bring justice into focus and make sure that the national policy discussion targets everyone fairly.”

13. ‘Gentler War on Drugs’ for Whites is a ‘Smack’ in Black America’s face, The Root

Comparing the Three Strikes Law and the War on Drugs with the current state of drug policy, Kirsten West Savali criticizes the “Just Say No” aspects still inherent in racist policy implementation, laying bare the links between poverty, treatment, and sentencing.

14. Heroin, USA: How the Middle Class Got Addicted, The Toronto Star

This article approaches the emotional side of families whose loved ones have overdosed from heroin, and highlights the socio-economic divide in heroin addicts. Featuring mini profiles, this article presents a gallery of the many faces of the current crisis. It also highlights the inadequacies of treatment facilities and coverage, and the political sea change that seeks to provide support in campaign promises for financing.

15. The Heroin Crisis: A Special Report, Newburyport News

Covering the heroin epidemic and regional responses, this three-day, multiple story series focuses on Gloucester’s (Mass.) new addict program which offers dignity and support to those looking for assistance. This program promotes open dialogue, streamlined collaboration, and easier access to detox programs, including financial and family support. John Rosenthal, who volunteers to support this program, was interviewed for the series and said, “The idea of police recognizing that addiction is a disease, not a crime — that’s changing the conversation.”

16. When Heroin Hits the White Suburbs, The Marshall Project

Andrew Cohen considers the current increase in heroin use and considers the medical and policy responses. According to Cohen, these are more public-safety-oriented than previous responses that took a criminal-justice response and filled jails with minorities. He alleges that racism is a key factor. Alex West responded to the piece and suggests class is as much a factor as race may be.

It seems unlikely that the heroin epidemic will diminish in the near future, therefore primary care providers are positioned to help prevent new victims and recognize patients who may be suffering from addiction. Within approximately the last year, shifts in policy and law have helped raise awareness on the profile of those most affected by this epidemic. These articles can help initiate discussions and raise further awareness, but ultimately we depend upon our health care providers to act as the first line of defense.