- Heroin also poses special problems because of the transmission of HIV and other diseases that can occur from sharing needles or other injection equipment.
- Heroin can be injected into a vein ("mainlining"), injected into a muscle, smoked in a water pipe or standard pipe, mixed in a marijuana joint or regular cigarette, inhaled as smoke through a straw, known as "chasing the dragon," snorted as powder via the nose.
- Over 80% of heroin users inject with a partner, yet 80% of overdose victims found by paramedics are found alone.
- The variability in quality of street heroin can range from 0-90%, which greatly increases the risk of accidental overdose and death.
A generation ago, the heroin available in the U.S. was barely 5% pure and use of it was by only a relatively small percentage of young people because it had to be injected with a needle. Now, it appears heroin use is back with a vengeance and it is addicting large groups of new users.
The Office of National Drug Control Policy issued a report (April 1992, No. 5, pp. 1-6) claiming "a massive increase in heroin use and addiction is not likely." One reason for this was, "...the apparent absence of new initiates (i.e., those who use heroin had little or no prior drug-using experience)." However, based upon recent news reports and other sources, the ONDCP report appears to have been premature, to say the least.
Just this past February, Attorney General Janet Reno admitted heroin is more plentiful, purer, and less expensive than it was just a few years ago. "If we do not counteract the heroin threat now," she said, "we risk repeating the terrible consequences of the 1980s' cocaine and crack epidemic." Authorities estimate that heroin use has increased 20% and worldwide production has grown sharply, even as other illegal substance abuse is declining.
Reports of problems have sprung-up nation wide. In California, heroin sold in the San Joaquin Valley is cheap, potent, and plentiful - business is booming in area emergency rooms as two or three overdose cases appear each day. In Colorado, Boulder County officials may establish a methadone clinic for the first time in 16 years to deal with increasing heroin use. On the East Coast, heroin is reported to be 40 to 70 percent pure and around $10 for a small packet. The number of heroin-related hospital emergencies has more than doubled in New York City and surrounding areas.
Many drug abusers mistakenly believe inhaling heroin, rather than injecting it, reduces the risks of addiction or overdose. Injection continues to be the predominant method of heroin use among addicted users seeking treatment; however, researchers have observed a shift in heroin use patterns, from injection to sniffing and smoking. In fact, sniffing/snorting heroin is now a widely reported means of taking heroin among users admitted for drug treatment in Newark, Chicago, New York, and Detroit.
In some areas, "shabanging" - picking up cooked heroin with a syringe and squirting it up the nose - has increased in popularity. Street heroin carries prophetic names: "DOA," "Body Bag," "Instant Death," and "Silence of the Lamb." Rather than scaring off young initiates, the implied danger seems to actually increase the drug's allure.
Heroin Use Continues Climb In Northwest States
Heroin overdoses are up nationwide, but not as dramatically as in Oregon and Washington, the Centers for Disease Control and Prevention reports. In Seattle and surrounding King County, there are 15,000 to 20,000 individuals who use heroin, with overdose deaths increasing 134% in 10 years. In 1990, there were 37 heroin overdose deaths, 110 in 1999.
King County expands its methadone treatment program but still has a waiting list of 600. In Portland and surrounding Multnomah County, nearly as many men age 25-54 die from heroin use as from cancer or heart disease. In 1993, there were 46 heroin overdose deaths, 111 in 1999. Both regions are ports and on the Interstate 5 corridor from Mexico to Canada, thus making the areas tempting targets for smugglers with potent black tar heroin from Mexico and South America, police say.