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When you think of Vermont, images of maple syrup, snow, and beautiful scenery may pop into your mind; however, many residents and lawmakers of Vermont may see a far different image. At the start of 2014, Vermont Governor Peter Shumlin devoted his State of the State address to the “full-blown heroin crisis” that has hit and ravaged Vermont.

It isn’t just Vermont that is plagued with this epidemic; much of the U.S. has noticed an increase in heroin use and deaths resulting from it. The CDC reports that every day in the United States, 105 people die as a result of drug overdoses involving heroin or pharmaceutical opioids.

Heroin is no longer a drug found just in urban areas; if you scratch beneath the surface of suburban America you will find that heroin has become increasing popular among the middle to upper class. This surge in heroin usage and increase in opioid-related overdoses has prompted people to wonder how heroin has consumed many people’s lives and if we can stop it.

The culprit for the spike in heroin use stems from America’s addiction to prescription painkillers. During the 1980s and 1990s, the Food and Drug Administration approved several prescription painkillers: Vicodin in 1984, OxyContin in 1995 and Percocet in 1999. These painkillers, which are opioids similar to heroin, were heavily advertised and in turn heavily prescribed. The opioids found in prescription painkillers produce a high and cause the brain to want more, causing cycle leading to drug addiction.

Because it seemed easier for doctors to simply write a prescription for a painkiller rather than confront the patients underlying issue, painkiller abuse and misuse became an epidemic in the U.S. NPR highlighted a report from the CDC which found that the amount of prescription painkillers sold to pharmacies, hospitals and doctors’ offices across the U.S. quadrupled between 1999 and 2010.

Prescription painkillers were more accessible to those with access to healthcare, which were typically people in middle to upper class areas. This is likely why we are seeing an increase in heroin use among this demographic. In an interview with NPR, Dr. Andrew Kolodny, the president of Physicians for Responsible Opioid Prescribing, said that “Areas with the highest rates of opioid or heroin addiction are often wealthier areas, where people have more access to medical care. With medical care comes access to doctors — doctors who could write prescriptions.”

In 2012, doctors cut back on prescribing painkillers and the street prices of these prescription painkillers rose; as a result, people who were now addicted to them turned to a cheaper and more convenient alternative –heroin. This idea is demonstrated through statics from The U.S. Substance Abuse and Mental Health Services Administration’s 2012 National Survey on Drug Use and Health. This report indicated a drop in non-medical prescription opiate abuse overlapping with an increase in heroin abuse. The increase is predominately economic. With an increase in heroin importation by Latin American cartels a dose of heroin costs about $9, while a single 80 mg OxyContin pill costs $60 to $100 on the streets.

Dr. Kolondy also said that most of people who use heroin today, “will tell you that their opioid addiction began with exposure to painkiller” and that “The main reason they switched to heroin is because heroin is either easier to access or less expensive than buying painkillers on the black market.” According to the SAMHSA survey, heroin abuse among first-time users has increased by nearly 60 percent in the last decade, from about 90,000 to 156,000 new users a year.

In 2013, the FDA proposed tighter regulations on painkillers that would go into effect sometime in 2014. These new regulations would include: a written prescription from a doctor, refills would be prohibited, and patients would be required to check in with their doctor to get another prescription. These regulations would make it increasing harder for people to get painkillers; however, what does this mean for those who are addicted? Will heroin dealers see an expanded market of people seeking to satisfy their opioid addiction or will these regulations halt the growth of first-time heroin users?


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