On June 3rd, 2016, an autopsy confirmed musician Prince died from an overdose of Fentanyl, a powerful opioid.
Far fewer Americans heard about 9-year-old Audrey Stepp, profiled two days later by NBC for learning how to administer Naloxone to her 26-year-old brother, Sammy, who suffers from heroin addiction. Fewer still may have heard of Jonathan Marshall, a Rochester youth who has been in and out of jail for seven years because of heroin addiction.
Audrey, Sammy, and Jonathan cast light onto the tragedy of the needle and the damage done. Stories of addiction further elucidate the rapid and unstable rise in heroin and opioid addiction in the U.S., now reaching peak levels.
Nationally, victims are getting younger and younger. In Massachusetts, the majority of prescription opioids and heroin victims are between the ages of 25 to 34. Historically, overdose victims were between the ages of 45 to 54.
How the heroin epidemic started
In the 1800s, morphine was used to treat opium addiction, but morphine addiction became so widespread that another treatment was developed near the turn of the 20th century: heroin.
Heroin is made from the milky, sap-like resin of poppy plants, opium. Opium is refined into morphine, and morphine is refined into heroin. Heroin and prescription opioids like hydrocodone (e.g., Vicodin) and oxycodone (e.g., OxyContin) work the same way: by reducing the intensity of pain signals reaching the brain and affecting emotional responses.
Heroin is highly addictive, and usually injected, which puts users at risk for HIV transmission. By the late 1900s, the mortality rate for heroin addicts was 2,000% higher than normal. In 2011, 4.2 million Americans aged 12 and older had used heroin at least once. Over 23% of all heroin users become addicted.
Today, the U.S. is facing a new heroin epidemic. Heroin overdoses have reached unprecedented levels. The overdose rate is 100% higher than the national average and deaths from prescription opioids (like OxyContin) aren’t far behind. Between 2013 and 2014, prescription opioid overdoses increased by 90%: In many cases, heroin and opioid fatalities involve both drugs.
How has the U.S. responded to the heroin epidemic?
Fortunately, the Obama administration has begun combating the growing heroin epidemic facing millennials. President Obama recently announced at the National Rx Drug Abuse and Heroin Summit that the government intends to expand access to treatment, prevent overdose deaths, and implement better prevention measures. These measures include:
- Increasing the patient limit for qualified physicians who prescribe buprenorphine to treat opioid addiction from 100 to 275 patients each
- Advancing access to mental health and substance abuse treatment services by expanding healthcare coverage basics
- Implementing a “syringe service” program to provide addicts with safe syringes that reduce the spread of HIV and viral hepatitis
Additionally, local police precincts across the country have begun changing tactics in the face of the growing crisis. In 2015, Gloucester Police Chief Leonard Campanello started a nonprofit program to encourage heroin addicts to come to the police for help with drug addiction.
So far, Chief Campanello’s Department has referred over 400 people to treatment centers. Cities around the U.S., including Albany, New York and Santa Fe, New Mexico, have also adopted the program at their police departments. By diverting nonviolent offenders away from jail and into rehabilitation programs, police departments hope to turn a new leaf in a now gentler war on drugs.
Traditionally, methadone and buprenorphine have been used to help recovering heroin users with withdrawal. Patients have to visit methadone clinics once or twice a day for their doses. Buprenorphine, on the other hand, can be taken at home,
More recently, SALOME (Study to Assess Longer-term Opioid Medication Effectiveness) research has resulted in a new heroin treatment, and the results are very promising.
Injectable hydromorphone, a licensed pain medication, is as effective as diacetylmorphine. It has a very high success rate: nearly all study participants reported fewer days of “street” use at six months, and 80% remained in treatment after six months. Hydromorphone is administered in a clinical setting in the unlikely event of an overdose. Out of 88,451 injections, 14 overdoses and 11 seizures were successfully managed in the clinic.
Medications for heroin and prescription opioid addiction
While more clinical trials will be needed before the long-term effectiveness of injectable hydromorphone can be corroborated, over-the-counter methadone and buprenorphine remain very viable treatment options for heroin or prescription opioid addiction.
The prices of prescription and over-the-counter medication vary by pharmacy and by location. Prescriptions like methadone and buprenorphine can cost a patient between $10.99 and $37.22 a month. If not covered or only partially covered by insurance, there are free tools that can help.