The Heroin Upsurge (

By MARK A. R. KLEIMAN | May 28, 2014

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Every illicit drug has its own myths that public information campaigns need to fight. “Marijuana isn’t addictive.” “Cocaine is a rich person’s party drug.”

Until recently, heroin’s reputation was so awful that there wasn’t anything worth fighting. Heroin has always been “the hardest drug,” with a social stigma even among problem users of other drugs. In fact, heroin was often the ultimate fear factor in anti-drug propaganda; every recreational drug has at some point been alleged to “lead to heroin use.”

Things have changed. Even though heroin is still very rare compared with cocaine or methamphetamine, its use has increased. That’s probably the result of the prescription-opiate problem (mostly hydrocodone [Vicodin] and oxycodone [Percodan, Percocet, and Oxycontin]) that exploded between 1994 and 2002 and has not dropped off much since. About as many people start dabbling in prescription opiate abuse each year as take up marijuana, and a small but significant number of them will eventually turn to heroin. Easier access to potent prescription opiates has allowed people to develop a heroin-strength habit before they even try the drug.

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