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Substance Abuse and Addiction Health Center

Heroin Holding More and More People Under Its Spell

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"I have the sense that we've maintained a high level, in New York state, ranging form 600 to 1,000, a year in the New York City area, and what's interesting is no mayor has ever stood up and screamed his head off about this," Backes says.

The Drug Abuse Warning Network (DAWN) has compiled some data from 25 U.S. cities, according to Backes, who says, "there's definitely been an increase nationwide in overdose deaths. In 1998, from that report, there was over 6,500 overdoses in the top 25 cities followed, and as I said, it's an underestimation of those 25 cities."

Backes put the numbers in perspective by comparing them to alcohol-related auto fatalities in the U.S. "There's 16,000 a year alcohol-related auto fatalities, so comparatively, we're talking about a huge public health problem related to drugs that's not being addressed. So if it rounds up to maybe 10,000 in the U.S., we're talking comparatively, a massive problem of which there's been very little attention [paid]."

Of course, it just makes sense that if that many people are overdosing, many more are using the drug who aren't. Oxman says it's estimated there are about 10,000 active heroin users in the community around Portland. Backes says a "standing estimate" for injection drug use in New York state over the last 10 years has run up to 250,000 and there's large injecting populations in Baltimore, Philadelphia, Newark, and Boston, to name a few.

And these people come from all walks of life; they're not all street urchins and criminals. "There's the popular image of the heroin user as being very down and out, a homeless criminal type ... what we're talking about is people who use heroin and represent a very wide cross section of the community. These folks are not monsters, they're human beings and they're struggling with a horrible addiction that they can't drop," Oxman says.

No longer is it necessary to be a full-time criminal to afford heroin, although many users can obviously fall into crime as their habit progresses. Many people work minimum wage jobs and maintain a heroin habit, Oxman says.

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