Heroin: New markets for an old scourge

Heroin marketing
Heroin traffickers may be exploiting this lack of education. Drug interdiction officials have found that, in their bid to reach U.S. middle-class customers, traffickers have taken a page from a marketing handbook, all but adapting the language of informericals to target the middle class: It's Improved! Cleaner! No Messy Needles! No Fear of Getting HIV/AIDS!

According to a March 2004 report by the International Narcotics Control Board, the U.N.'s Vienna-based drug monitoring agency, heroin smuggled into the United States increasingly is being packaged for inhalation instead of injection, “making it more acceptable to many middle-class Americans.”

“This shows how the illicit market operates in a very smart way by selling a drug to a new class of users by telling them, 'Use it in a different way and you won't become addicted,' ” said Rainer Wolfgang, a member of the U.N. board.

Authorities say many users prefer inhaling heroin because they don't have to worry about contracting blood-borne diseases like hepatitis and AIDS through needles, and because it spares them the physical discomfort of injection.

For IV users, risk vs. reward
But addicts usually ending up injecting the drug, Kane-Willis said. “There's kind of a cost-benefit analysis to it,” she said. “They have to think of the cheapest modality there is, and that's injection. It's economically more efficient.”

Heroin users who smoke the drug face a relatively new and dangerous risk. A 2003 study by the University of British Columbia found that heroin smokers have a higher risk of contracting toxic leukoencephalopathy, a sometimes fatal disorder that affects smokers more than other users of the drug, impairing motor and speech functions of the brain.

INTERACTIVE A look at how heroin, cocaine and other drugs affect the body

Another option: liquefied heroin in an inconspicuous squeeze bottle, much like a container for any over-the-counter nasal spray.

“Trafficking groups who want to continue to make money are constantly looking for new illicit marketing strategies to increase their profits . . . this is one of their cleverest tricks yet,”  Herbert Schaepe, secretariat of the U.N. agency, said in a March 2004 interview with The Observer (U.K.).

However the drug is administered, use of heroin has led to new and sometimes controversial approaches to controlling its worst effects. In February, hard-core heroin users began participating in a test program in Vancouver, British Columbia.

Researchers in the North American Opiate Maintenance Project study (NAOMI), with approval of Canadian health officials, are providing addicts with free heroin, in an attempt to find whether steadily decreasing doses of heroin is more effective than methadone use in weaning addicts off heroin.

Differing analyses
U.S. agencies that monitor drug use have been curiously at odds in their assessments of whether heroin is a growing problem.

FBI statistics reveal a decline in arrests for heroin use through 2002, even as the number of hard-core users in the U.S. has hovered between 750,000 and 1 million.

“Heroin use in the United States and the number of new initiates have been relatively flat,” said Dave Murray, an analyst with the U.S. Office of National Drug Control Policy in Washington. “I don't think there's much that's new. We have a reasonably good picture of heroin use in the U.S. as relatively unchanged in the last decade.”

But Murray's assessment runs counter to analyses from other U.S. agencies.

The 2002 survey by the Substance Abuse and Mental Health Services Administration found that the rate of heroin use among youths ages 12 to 17 and adults 18 to 25 increased between 1995 and 2002.

While the annual number of new heroin users between 1988 and 1994 ranged between 28,000 and 80,000, the number of new users climbed between 1995 and 2001 to a number “consistently greater than 100,000,” the study said.

Moreover, Murray's own office found that by June 2003, the number of hard-core heroin users in the United States had reached somewhere between 750,000 and 1 million — a sharp increase from the 630,000 users in 1992, according to the U.S. Drug Enforcement Administration (DEA).

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