The untimely death at the weekend of actor Philip Seymour Hoffman has drawn attention to the unprecedented rise in the use of heroin across the United States.
The governor of Vermont devoted his entire “state of the state” address last month to what is fast becoming a public health crisis.
Peter Shumlin called for it to be treated as a chronic disease: “The time has come for us to stop quietly averting our eyes from the growing heroin addiction in our front yards,” Governor Shumlin said, “while we fear and fight treatment facilities in our backyards.”
Use of the drug, says the New York Times, has soared across New England, with its relatively affluent communities and easy access to drug dealing centres like Philadelphia, Boston and New York. Local officials say that $2m worth of heroin and other opiates is being trafficked into Vermont every week.
And what is happening there is being mirrored across the nation. Figures show that heroin use has more than doubled over the last five years, while it has increased among first time users by 60 per cent over the last decade, according to the US Substance Abuse and Mental Services.
Read more: tributes paid to Hollywood's Philip Seymour Hoffman
Users are typically young and middle class. At just $9 a dose, heroin is often cheaper than any alternative hits – and it is getting easier to access. But there is more to the recent spike than this.
State authorities around the country have been cracking down on abuse of prescription drugs, especially painkillers. The illegal facilities – known as “pill mills” – have been shut down. Drugs companies have made their products harder to crush down so they can be snorted.
So those who had become reliant on painkiller abuse – already saddled with an opiate habit – have been looking for their fix elsewhere. And, it seems, they are turning to heroin instead, often fatally, like the 22 who died recently in Pittsburg after taking a lethal mix of heroin and a potent cancer drug.
At a time when other forms of substance abuse are falling, heroin has now become the new battlefront. And it is the young, the educated and the suburban middle class that are seeking their fix.