Stricter drug enforcement policies created the heroin epidemic.
In its 2015 National Drug Threat Assessment Summary, the United States Department of Justice Drug Enforcement Administration reported that drug poisoning deaths (overdoses) involving opioid analgesic (codeine, fentanyl, Hydrocodone, Demerol, Dilaudid, Vicodin, OxyContin and methadone) rose from 14,408 in 2007 to 16,235 in 2013. On August 22, 2014, the Drug Enforcement Administration published the Final Rule moving hydrocodone combination products (e.g. hydrocodone-acetaminophen), widely popular opioid analgesic among college students, from Schedule III to the more restrictive Schedule II class of drugs. Pain management clinics and doctors, a key source for the acquisition of opioid analgesic medication among users, tightened restrictions to address the rising threat. (21.2% of users obtained opioid pills from a single doctor, whereas 53% received the pills from a friend or relative; however, 83.6% of the friends or relatives acquired the pills from a single doctor.)
Meanwhile, during the same time period, overdose deaths from heroin rose dramatically from 2,402 to 8,257. The Dallas Field Division of the Drug Enforcement Administration, and 65% of field divisions around the United States, reported that heroin was more available in the first half of 2014 than it was during the second half of 2013 and that demand for heroin had increased, while the availability of opioid medications such as Hydrocodone, Vicodin, codeine, OxyContin, and methadone remained “stable.” Local police departments noted an increase in the amount of heroin seized, with heroin seizures in the United States increasing 81% from 2010 to 2014. The average size of a heroin seizure increased from less than one kilogram, to nearly two kilograms.
The national trend is mirrored at the city level as well: for example, the Denton Police Department, for example, seized about 4 grams of heroin from January 1, 2015 to January 1, 2016; during the first six months of 2016, the Denton Police Department has seized 35.682 grams of heroin. The Dallas Field Office of the DEA reported less than 10 heroin seizures in 2011; in 2013, the Dallas Field Office reported more than 100 heroin seizures.
It is abundantly clear that heroin is more abundant today than it was prior to the restrictions placed on opioid prescription pain killers. The explanation for this shift—the relative stability of opioid pain killers, and dramatic increase in the availability of heroin—is easily explained. As the Drug Enforcement Administration suggests, many opioid pain killer abusers, when unable to afford pills, began using heroin, a significantly cheaper alternative. Per the 2015 National Drug Threat Assessment, more than 90% of prescription opioid abusers who began using heroin did so because it was more accessible than prescription opioid medication, and because it was significantly less expensive.
Why is heroin less expensive and easier to obtain? Precisely because of the August 2014 scheduling increase, and increased restrictions on doctors and pain management clinics that followed the rise of opioid prescription abuse in the latter half of the first decade of the 21st century. It’s not unlike squeezing one of the end a balloon and causing the other to swell. What makes sense in addressing the heroin epidemic is not greater restriction, more police, and stricter drug enforcement policies: it’s providing substance abuse treatment to address the root of the problem.