Issue Overview: Heroin Addiction

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Issue Overview: Heroin Addiction By Lauren Etter, Bloomberg, adapted by Newsela staff on 12.16.16 Word Count 789 Level 1160L TOP: A heroin user prepares to inject himself on March 23, 2016, in New London, Connecticut. U.S. communities are struggling with the unprecedented heroin and opioid pain pill epidemic. BOTTOM: This advertisement from a 1900 magazine shows two drugs developed by Bayer, heroin and aspirin. Bayer introduced heroin in 1898 as a cough suppressant. Aspirin was produced in the same Bayer laboratory. This article is available at 5 reading levels at https://newsela.com. 1

Everything about heroin addiction in America is changing. The United States is not the only country to see an increase in the use of heroin, as stronger, cheaper heroin from Afghanistan has been spreading around the globe. However, the profile of the typical American heroin user has shifted as the powerful drug has spread from poor cities into wealthy suburbs. This change has reignited a debate over the country's ongoing war on drugs. This article is available at 5 reading levels at https://newsela.com. 2

Difficult questions have been raised by the new wave of heroin addiction. For one, many are asking why it took an increase in the number of white overdose victims to switch attention from law enforcement to treatment. For many years, heroin use has been seen as a crime that should be severely punished. Now, it is increasingly being viewed as a disease. The behavior of doctors and drug companies has also been called into question. On the one hand, both have a desire to treat pain effectively. On the other hand, there is growing evidence that prescription opioid painkillers like OxyContin and Vicodin have become gateway drugs for heroin. Four of five new U.S. heroin users report having previously misused prescription pain relievers. The Situation Nearly 500,000 Americans are now estimated to be using heroin, up from 161,000 in 2007. Heroin overdoses more than tripled in four years. Deaths from all opioids are now approaching the number of deaths from car crashes. In 2015, nearly every state introduced laws related to opioid abuse. They include measures targeting doctors and pharmacists who prescribe or dispense too many of the pills. Many states are also offering criminal immunity to patients seeking treatment for an overdose. This means addicts do not risk being sent to jail if they seek treatment to cure their addiction. President Barack Obama ordered states to cover drug treatment and proposed $1.1 billion in new spending to reduce heroin deaths. Congress passed a bill to provide grants to states for treatment, but without funding. In September, a stop-gap spending bill passed that included $37 million to fight opioid addiction. This article is available at 5 reading levels at https://newsela.com. 3

Heroin, morphine, opium and other opioids are derived from the poppy plant. In 2014, poppy cultivation reached its highest global level since the 1930s. Heroin addiction in Afghanistan the world s largest opium producer has soared. The drug's use also has risen in China and Africa. Between 2012 and 2014, opium poppy cultivation in Mexico increased by an estimated 60 percent. In that same time period, the amount of heroin seized at the U.S.-Mexico border more than tripled. The Background Heroin, first produced in 1898 by Bayer, the German drug company, was marketed as a nonaddictive substitute for morphine. By the early 1900s, however, widespread heroin use led states like New York to open addiction centers in hospitals. Heroin s latest wave arose from changes in prescription opioid use. Opioid painkillers rose in popularity in the 1990s, partly in response to what was seen as widespread undertreatment of long-term pain. In 1996, Purdue Pharma introduced OxyContin as an alternative to stronger opioids, which were reserved mainly for the dying. Its annual sales surged to $1 billion. In 2007, Purdue paid $600 million in fines and its executives pleaded guilty to federal criminal charges for misbranding the product as less addictive than other painkillers. In 2010, it released a reformulated version that was harder to crush for snorting. A May 2015 study found that while the new version reduced illegal use of the painkiller, it led more people to take up heroin, the price of which was dropping. This article is available at 5 reading levels at https://newsela.com. 4

Nearly 90 percent of new heroin users in the U.S. are now white, compared with an equal mix of whites and non-whites before 1980. Fentanyl, a powerful chemical opioid commonly mixed with heroin, is accounting for an increasing share of overdoses. The death of the popular musician Prince this past April was caused by the drug. The Argument Heroin and opioid addiction became issues during the U.S. presidential election in 2016. Republican candidate Donald Trump now the president-elect focused on cutting off the supply from Mexico. In contrast, Democratic candidate Hillary Clinton proposed greater access to treatment. Officials from hard-hit states have criticized federal regulators for not doing more to restrict opioid prescriptions. However, many patients suffering from long-term pain worry that increased restriction will lead to needless suffering. Government health organizations are encouraging doctors to give the strongest painkillers only to patients who do not respond to milder drugs. Meanwhile, some officials have turned to unusual approaches. Seattle will soon be opening sites where heroin addicts will be able to use the drug under medical supervision. New York is considering a similar plan. This approach is currently being tried with some success in Vancouver, Canada. This article is available at 5 reading levels at https://newsela.com. 5