The recent death of Philip Seymour Hoffman has highlighted the resurgence of heroin use and overdoses in the US. Heroin use doubled between 2007 and 2012. Between 2006 and 2010, there was also a 45% increase in lethal overdoses, up to more than 3,000 deaths per year. The death toll continues to grow, and includes more than 80 deaths over the past few weeks as a result of heroin laced with fentanyl.

The rise in heroin use may be linked with the prevalent use of oxycontin and other opiate-based prescription drugs. The crackdown on illicit use of prescription opiates makes them more expensive, and more users have turned to heroin.

• Pradip K. Muhuri, Joseph C. Gfroerer, and M. Christine Davies. 2013. “Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States.” Center for Behavioral Health Statistics and Quality. Rockville, MD: Substance Abuse and Mental Health Services Administration.
• April Young and Jennifer Havens. 2012. “Transition from first illicit drug use to first injection drug use among rural Appalachian drug users: a cross-sectional comparison and retrospective survival analysis.” Addiction 107(3): 587-596.

Anti-drug campaigns and moral panics in the media may actually have the unintended effect of promoting, not reducing, substance abuse. In fact, a minority of interviewed users reported seeking out the stronger batches of heroin reported in the media.

• Craig Reinarman and Harry Levine. 1997. “The Crack Attack: Politics and Media in the Crack Scare.” In Crack in America. Berkeley, CA: University of California Press.
• Thomas Kerr, Will Small, Elaine Hyshka, Lisa Maher, and Kate Shannon. 2013. “’It’s more about the heroin’: injection drug users’ response to an overdose warning campaign in a Canadian setting.” Addiction 108(7): 1270-1276.
• Peter Miller. 2007. “Media reports of heroin overdose spates: Public health messages, moral panics or risk advertisements?” Critical Public Health 17(2): 113-121.

Solutions to these problems often focus more on treatment and harm-reduction than tough enforcement of drug laws.

• Teresa Gowan, Sarah Whetstone, and Tanja Andic. 2012. “Addiction, agency, and the politics of self-control: Doing harm reduction in a heroin users’ group.” Social Science & Medicine. 74(8): 1251-1260.

For more on harm-reduction approaches, see this recent Public Criminology post.

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