Heroin has been killing Americans for generations, but lately government officials have said that its use is increasing. Meanwhile, a larger number of Americans have become addicted to prescription painkillers, which might shoulder the blame for any increase in heroin use.

At the Drug Enforcement Administration, spokesman Lawrence Payne claimed there’s been a “spike” in the number of heroin users that’s “significant and alarming.”

Others, though, say the trouble is blown out of proportion, largely because the drug is now mostly used by white people, particularly women. “We have a syndrome in this country; when you have a young white woman at risk, it makes national headlines,” Roseanne Scotti, state director of the New Jersey Drug Policy Alliance, told the Philadelphia Inquirer.

 “There’s no doubt [heroin has] gotten more attention since it’s become an issue that’s perceived as affecting people in the suburbs,” Scotti added. “But for more than 20 years, it hasn’t been an issue. People died of overdoses all the time. It never got any news coverage, none at all.”

Statistics show that about 90% of heroin users are white men and women who first tried prescription painkillers. The total number of addicts is about half a million, with approximately 3,000 deaths from the drug in 2010. But those numbers pale in comparison to the impact of opioid painkillers, such as oxycodone.

There are more than two million Americans hooked on these legal medications, which killed 16,651 people four years ago. There could have been more, but oxycodone has become more expensive and more difficult to abuse, so some users switch to heroin.

 “Now they’re using [heroin] as a default drug,” Dr. Theodore J. Cicero, a professor of psychiatry at Washington University in St. Louis, told the Inquirer. “They’d really prefer to go back to prescription drugs, but they couldn’t afford them. They wanted to get high, but mostly they didn’t want to get sick” with withdrawal.

The root cause of some of the addiction might be overprescription of painkillers. Over the past two decades, hospitals have become too quick to dispense opioid painkillers, according to Hospital of the University of Pennsylvania director of medical toxicology Jeanmarie Perrone. “We clearly have a problem with the treatment of pain and the diagnosis of pain,” she said.

Meanwhile, politicians are less likely to act against prescription drugs than they are against heroin because prescription painkillers are produced by pharmaceutical companies that contribute to election campaigns, whereas heroin is distributed by drug cartels that generally do not engage in lobbying.

-Noel Brinkerhoff

To Learn More:

Heroin Epidemic: Is it Real? (by Sam Wood, Philadelphia Inquirer)

Smack Madness (by David Krajicek, Crime Report)

What is the Scope of Heroin Use in the United States? (National Institute of Drug Abuse)

More U.S. Deaths from Prescription Drug Abuse than from Heroin and Cocaine Combined (by Noel Brinkerhoff, AllGov)

New FDA Painkiller Labeling Rules Seen as Good PR but Bad Medicine (by Noel Brinkerhoff and Danny Biederman, AllGov)