Drug Policy

How the Government Promotes Heroin Use


The Dayton Daily News, summarizing a new report from the Ohio Substance Abuse Monitoring Network, says narcotic painkillers are a gateway to heroin:

Heroin use has increased in the past six months in Dayton and statewide. The report attributes the spike in part to the wide availability of opioid prescriptions, which often lead to addiction and then heroin use when pills become too expensive….

Robert Masone, a pain specialist and president of the Ohio Society of Interventional Pain Physicians, said because two or three OxyContin 80 milligram pills can cost up to $200, many addicts are forced to seek other alternatives when money is scarce.

"When they can get that money, that's what they prefer. When they can't there's always a heroin pusher out there offering them a single dose of heroin," Masone said.

The state's spin on this finding is that overprescription of opioids leads to heroin use. But there is another implication as well: To the extent that the government is successful at preventing "diversion," making painkillers harder to come by and more expensive, it encourages current users to switch to an illegal drug that is more dangerous because dose and quality are unpredictable in a black market. The Dayton Daily News gives an example:

Ross [a methadone clinic counselor] attributed the low price [of heroin] to the fact that there is very little pure heroin in many of the batches found in Dayton. "They are cutting with anything," she said, citing one recent case where a woman was hospitalized after injecting heroin cut with drywall powder. 

In addition to enforcement aimed at discouraging opioid prescriptions, the paper says, the reformulation of OxyContin, which now yields a gel when crushed instead of a powder, may have encouraged a shift toward heroin. Since efforts to stop nonmedical use of prescription painkillers seem to be making drug use more dangerous in Ohio, what does the state government plan to do? Crack down some more, of course:

House Bill 93, which would require those prescribing opioids to be board certified in pain medicine, fine physicians who don't comply with the licensure, and would delineate how often doctors should check OARRS is up for a committee vote this week in the Senate.

Aside from whatever impact this restriction might have on the black market, it is bound to hurt patients suffering from severe pain, who will find it more difficult to get relief because far fewer doctors will be allowed to provide it. The Obama administration's plan to curtail nonmedical use of opioids, which I criticized in a column last month, poses a similar danger.

In a 2003 Reason article, I noted that heroin's hazards are largely (though not entirely) due to prohibition.

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  1. Hey, this is brought to us by the people who specifically wanted acetaminophen mixed with hydrocodone and oxycodone to make large doses hepatotoxic. As far as they are concerned, this is a feature, not a bug.

  2. Hey Reason, Ron Paul =/= “The Government”.

  3. “Heroin use has increased in the past six months in Dayton and statewide.”

    I find this highly suspect.

  4. The entire country (except for me and thee) has gone fucking bugshit crazy.

    That is all.

  5. “In April, Gov. Kasich announced that $36 million in federal and local funds would be used to fight prescription drug abuse. Montgomery County will receive $2.73 million from the Department of Education’s Rehabilitative Services Administration to use for drug abuse counseling, mental health treatment and vocational job training programs.”

    Ah, the real reason that the study indicates an increase in heroin use. That fiscal conservative Kasich is on to something. It’s call the government tit. It’s a jobs program. I wonder how much federal money Kasich is going after to build more jail space and hire more cops.

  6. Heroin, to restore vigor and bouyancy.

  7. I wonder how many mandates are in the $36 million fed money. I can see this legislation being required by the acceptance of the federal money. Those tricky bastards.

  8. Come to Florida for your pills. We like the tourist dollars.

  9. Listened to “Bauer and Rose” briefly on The Sirius Radio on the way back to Cleveland last night. The subject of R’s ‘debate’ and teh heroin came up.

    One of them (I don’t know which is who) said that if heroinn were legalized, “corporate interests” would get kids hooked on heroin instead of drug dealers. And we’ll have a bajillion more kids hooked on heroin and meth if they’re legalized. And “why can’t I drive 100mph if I won’t hurt anyone. Isn’t that the same as arguing I should be able to do heroin since it doesn’t hurt anyone else. But people are OK that we establish speed limits” ARRRRRRRGH NOOOOO!!!

    Since I was driving a company car, I changed the station rather than smash the FUCKING radio. It was an exceptionally illogical and frustrating discussion to listen to.

    1. In response, you should have driven company car in excess of 100MPH…on heroin preferably.

  10. Former New England Patriot running back Mack Herron, 62, was arrested for heroin possession. For a brief moment in time, he was the best all purpose back in the NFL-i.e., the first half of the 1974 season.

  11. A close friend of mine is prescribed morphine for some serious chronic pain issues; she’s taken it for years, so naturally she requires a fairly hefty daily dose. Her long-time doctor moved recently, and her new doc, apparently spooked by the well-publicized pain med prescription “partnership” between the local hospital and police, will not prescribe the amount she needs. So now, guess what? The last week of every month she buys and uses heroin. Bet nobody could’ve seen that one coming, could they?

    1. That is awful. Ugh. Drs so scared they won’t prescribe the right/needed pain meds.

      I’ll say it again – I hope every one of these politicos pursuing the Rush Limbaughs of the world and their doctors re: “Overprescriptions”, esp of pain meds, suffers a crushed spinal disk. And is denied ANY pain treatment.

      And we’ll set the loaded .45 next to them and see how long before they use it.

    2. Yea government regulations that try and proscribe how a doctor should help their patients! Why the fuck should bureaucratic suits who know nothing of medicine make pre-emptive medical decisions which effectively destroy doctor/patient relationships.

      This is central planning at its worst.

  12. The insanity of this new Bill is breath-taking, WTF is wrong with these Pols, and their so called Medical Professionals collaborators?

    Prohibition of drugs has never worked, and never will–not to mention that they are causing pain patients to turn to dangerous street drugs for relief rather than treating the separate issue of addiction as a medical problem that can be best controlled by opiate replacement drugs such as suboxone.

  13. When all you have is a needle, every problem looks like a vein.

  14. Holy shit, Oxy costs 200 bucks a pill? Who wouldn’t do heroin? In fact, I’ma go get some right now.

    1. Oh ok, 2 or 3 pills. So 100 bucks a pill. My comment stands.

      1. Going street price for Oxy is a buck a mg, at least where I live; you’d be mad crazy not to do heroin instead.

    2. My thought was, “Oxycontin costs $200 (or $100) a pill? Who wouldn’t do heroin demand single-payer healthcare? (and then sell his pills on the street?)”

  15. The bill’s not going to restrict narcotics prescribing to pain specialists, it’s just going to add a requirement to CME and boards that presumably all physicians will take.

    1. I belong to a chronic pain community, believe me, most doctors are already spooked about prescribing pain relief, adding another Federal Hoop for them to jump over will make it even worse for pain patients to get help. If you look at the percentage of people who became hardcore addicts over the last 100 years, the numbers have remained fairly constant, like alcoholics (a much more dangerous and prevalent legalized addiction) addiction is a human condition that cannot be legislated away, and this is despite the fact that opiates are one of the most prescribed drugs–however, most of the prescriptions are for acute conditions, and not chronic pain, chronic pain patients remain under-treated, not to mention that these Laws, and the para-military group created to monitor them (DEA), are Nanny Government at its worse.

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  17. As someone who is currently undergoing physical therapy to rehabilitate a broken leg, let me just extend a hearty “eat shit” to all the fine folks who want to make it harder for me to get adequate pain relief.

  18. This made up ‘crisis’ by the DEA has affected my 86 year old father. Dad is a WW2 vet and thanks to the thugs at the DEA his doctors are becoming more reluctant to prescribe pain meds in the doses needed for a decent quality of life. The government seems bent on reversing all of the advances in pain treatment. Personally I think when it comes to drug policy we should go back to the days before the Harrison Narcotics Act.

  19. I am a substance abuse counselor, have been for over 10 years. Addiction is genetically passed down, being prescribed opiates does not turn people into addicts that were not already predisposed to such behavior. The DEA, and politicians, are turning doctors into law enforcement and its sad. It is true many say screw it and treat themselves with Alcohol and Heroin. Freedom means free to make your own choices, for better or worse.

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