The Economist explains

Why heroin has made a comeback in America

Millions of people have been introduced to opioids via prescription painkillers, while an increase in supply from Mexico has kept prices down

By T.W.

HEROIN was a scourge of America’s cities in the 1960s and 70s. But then it seemed to go out of fashion. By the 1990s it was less widely used than crack cocaine. In Europe its use has continued to decline, with the number of addicts falling by about one-third in the past decade. In America, by contrast, it is resurgent. Last year nearly 700,000 Americans took the drug, twice as many as a decade ago. It is now more popular than crack, by some measures. What explains heroin’s return?

One cause is the growing popularity of another drug: the prescription painkiller. Opioid painkillers such as OxyContin became more widely prescribed in the 1990s and 2000s. They are effective painkillers, but they are commonly abused: about 11m Americans use them illegally every year. That has led to a crackdown on prescriptions: doctors can now check databases to make sure patients have not already been prescribed the drugs somewhere else, for instance. So they are harder to obtain. But that means that some prescription-pill addicts have turned to heroin, which sates the same craving for a lower cost. More than two-thirds of heroin addicts have previously abused prescription painkillers.

Another reason is that the supply of heroin has increased. America gets most of its heroin from Mexico. Between 2000 and 2009, the amount of land in Mexico being used to grow opium poppies (from which heroin is derived) increased tenfold. It has fallen in the past few years, but is still far higher than before. This means that more heroin is making its way to the United States, feeding the growing demand and keeping prices low. The increase in poppy cultivation in Mexico was driven partly by the diversion of Mexican soldiers from poppy eradication to urban peacekeeping, under a crackdown on organised crime launched in 2006.

Heroin traffickers are also responding to market forces in America. For one thing, Americans are consuming less cocaine than they used to. And the cannabis they buy is increasingly home-grown: nearly half the United States now allow medical marijuana, and four have voted to legalise it outright, making it difficult for Mexican exporters to find a market. Struggling to sell cocaine and cannabis, they have homed in on heroin. The rise in consumption is therefore down to the coincidence of rising supply at a time of rising demand.

Dig deeper:
An old sickness has returned to haunt a new generation (Nov 2014)
How the legal cannabis industry may change (Nov 2014)
Mapping America's marijuana muddle (Nov 2014)

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