If you Google the word “epidemic,” the first definition you’ll see is “a widespread occurrence of an infectious disease in a community at a particular time.” In terms of describing the New England heroin epidemic, this means a few things. First, it describes the disease of heroin addiction as something spreading out of control. Second, “infectious” implies that the disease is spreading from one person to another. Third, it describes New England as a community, albeit a very large one. Finally, it describes the New England heroin epidemic as something happening right now—which means that the search for a solution cannot wait any longer.
We don’t often think of addiction as infectious, but think of how it spreads. A person does not walk into a store and decide to buy heroin. Someone—a friend, drug dealer or perhaps even family member—must help them acquire it. Peer pressure may be involved, although this isn’t always the case. Either way, nobody becomes addicted to heroin without finding it first. As such, we cannot fight the New England heroin epidemic without first attempting to limit the availability of the drug.
This means that we aren’t just treating heroin addiction, but also trying to prevent it from occurring at all. When a flu epidemic breaks out, you don’t just treat the infected. You also try to ensure that people receive flu shots so that they don’t come down with the illness in the first place. Fighting an addiction epidemic is no different. We must understand how the disease is spreading, and then formulate a plan from there.
In order to bolster understanding of the horrible epidemic now plaguing New England, we’ll look first at how the spread began. Then, we’ll talk about what Washington is doing to quell the spread of the disease, and what we can expect in the future. We hope that this will enlighten our readers, and keep them informed about the New England heroin epidemic—before it spreads any further.
Spread of the New England Heroin Epidemic
Talk of a heroin epidemic in New England has circulated for some time. During the New Hampshire primary, Manchester reported a spike in overdose deaths. Despite reporting only 14 deaths related to heroin and fentanyl use in 2013, this number jumped to 69 in just a couple of years. Add in the number of non-fatal overdoses, and the numbers would be even higher. Manchester Police Chief Nick Willard referred to the New England heroin epidemic as “an apocalypse.” For the families whose worlds came crashing down after the loss of a loved one, this rings poignantly true.
Heroin and fentanyl abuse don’t just affect New England, but this one section of the country seems to be receiving especially heavy blows. In New Hampshire alone, at least one person died of an overdose every day in 2015. And the epidemic is already spreading. States close to New England, such as Philadelphia and Maryland, are already experiencing increased numbers of heroin overdose deaths. In Boston, there even exists a section of Massachusetts Avenue commonly referred to as Methadone Mile. Travel this section of the street, and you’ll likely see addicts shooting up in public. The only silver lining to this is that the New England heroin epidemic has begun receiving widespread public attention. But to citizens in communities such as Cambridge, which reports the highest rates of overdoses in Massachusetts, this does little to provide reassurance.
Those keeping an eye on the 2016 election have heard much of the blame placed on Mexico. This is not without reason. In 2015, the DEA stated in their National Drug Threat Assessment:
“Southeast Asia was once the dominant supplier of heroin in the United States, but Southeast Asian heroin is now rarely detected in U.S. markets. Mexico and, to a lesser extent, Colombia dominate the U.S. heroin market, because of their proximity, established transportation and distribution infrastructure, and ability to satisfy U.S. heroin demand.”
Politifact agreed with this assessment, but we can’t blame the New England heroin epidemic on Mexico just yet. After all, the report clearly outlines Mexico’s ability to meet demand. That demand must be coming from somewhere.
At this point, many shift blame over to the pharmaceutical industry. This blame takes one of two forms. Some blame doctors for overprescribing painkillers, suggesting that this leads to opioid addiction and then paves the road for heroin. Others say the problem is actually the crackdown on prescription painkillers. Those addicted to opioids are now deprived of their choice drug, forced to seek an alternative. This seems corroborated by a change in demographics. Heroin users seem to be generally wealthier than in previous years. But we must note that this theory appears to be based largely on the stereotype of heroin users as underprivileged. In truth, we don’t know precisely what’s causing the New England heroin epidemic. That’s what makes it so frightening, and that’s what makes it so difficult to fight.
How Washington is Fighting Heroin Addiction
Quite recently, the Obama administration requested $1.1 billion in additional funding to fight heroin addiction. While they proved unsuccessful in securing this particular amount, they still met some success with the Comprehensive Addiction Recovery Act (CARA). We can credit this bill largely to Senator Rob Portman (R-Ohio), the same senator who drew attention to the quantities of heroin originating from Mexico. He helped draft this bill, which passed the Senate 92-2 (or 94-1, according to some sources) back in July of 2016. As its main benefit, CARA sets aside $181 million for various efforts to treat and prevent opioid and heroin addiction.
CARA aims to accomplish a few vital tasks that might greatly impact the New England heroin epidemic. First, the bill hopes to increase the availability of Narcan for the purpose of preventing overdose deaths. Second, CARA aims to increase the availability of medication-assisted treatment. Third, the act aims to increase the availability of treatment instead of prison. Many believe the bill requires more funding in order to accomplish these goals. Fortunately, a health spending bill passed by the Senate Appropriations Committee will increase the budget by $261 million. This equates to $442 million toward the fight against opioid addiction. It’s not quite half of what the administration first requested, but it’s a decent start.
Portman cares deeply about the opioid epidemic, but he also supports holding off on increasing the budget. While further treatment and prevention programs would help quell the heroin epidemic, Portland believes that such funding for such programs should wait, pending further analysis of the federal budget. With the nation struggling to pay off its current deficit, and with many other problems facing the population at large, he may have a point. Unfortunately, this means that the New England heroin epidemic may continue largely unabated for some time. CARA will help alleviate some of the pressures on local communities to fight the scourge of drug addiction. But this bill alone cannot fully solve the crisis facing our nation’s treatment communities.
In the meantime, Washington must fight a simultaneous—and highly related—issue. While the New England heroin epidemic rages on, much of the heroin originating from Mexico and Colombia returns positive results for fentanyl. Not only does this make heroin more powerful, but it also makes it much more dangerous. In fact, DEA officials believe that fentanyl-laced heroin may be largely responsible for the recent rise in overdose deaths. This essentially makes the New England heroin epidemic a war fought on two fronts. The DEA is partnering with police in states such as Massachusetts to fight this threat, but many worry that treatment and law enforcement may not be enough. Awareness and education must factor into the cure, lest the disease continue to rage on.
Future of Addiction Prevention and Treatment
Education and awareness may sound like simple prospects, but they can prove a bit tricky in practice. As evidence, just look at Nancy Reagan’s 1986 “Just Say No” campaign, which many now consider a complete and utter failure. Awareness formed the backbone of this campaign, and many words from Reagan’s speech hold true today. For instance:
“Our job is never easy because drug criminals are ingenious. They work every day to plot a new and better way to steal our children’s lives, just as they’ve done by developing this new drug, crack. For every door that we close, they open a new door to death.”
These words, describing the crack cocaine craze of the 1980s, describe perfectly the state of the New England heroin epidemic a full thirty years later. In this case, fentanyl plays the part of the aforementioned “new door to death.” And on top of raising awareness, Reagan attempted to educate our nation’s addicted youth with one simple piece of advice:
“Say yes to your life. And when it comes to drugs and alcohol, just say no.”
Taken at face value, this advice seems easy to follow. After all, it’s much easier not to do something than to do it. And therein lies the problem. Drug users already understand that they have the option of saying no. They simply choose to say yes.
Even three years before Reagan’s speech, the Drug Abuse Resistance Education (DARE) program attempted to teach students that drug use could be life-threatening. But according to data aggregated by Scientific American, the program has produced few results as of 2009. This might have something to do with the fact that—much like “Just Say No”—DARE attempts to teach people something that they already know in theory. Instead, studies show that successful drug education revolves around two core concepts. First, successful education addresses the issues of peer pressure, especially when such programs involve elements of role play. Second, successful drug education teaches students that drug abusers are a minority. In other words, students learn that drugs are not the way to “fit in.”
In other words, successful drug education teaches potential users things that they do not already know. This might present the key to successfully spreading awareness regarding the New England heroin epidemic. DEA agents note that many heroin users already understand the risk of fentanyl-laced products. Clearly, this bit of education has yet to make a sizable dent in the drug trend. So future drug educators must focus on aspects of the New England heroin epidemic that some users might not know. For instance, did you know that simply nodding off may signal an impending heroin overdose? This won’t stop addiction, but it may save lives. And did you know that fentanyl—which has been previously weaponized—is likely to make heroin more addictive? Those who ignore the risk of fentanyl-laced product might think twice if they realize that the more dangerous brands are the ones most likely to hook them.
These are just ideas, but we need more. Until Washington secures more funding to provide better treatment, education might prove our best tool for combating the New England heroin epidemic. Until then, every death acts as a harbinger of things to come. Because the New England heroin epidemic of today may become the Midwest heroin epidemic of tomorrow, or the South Atlantic epidemic of next year. And before we know it, every state might find themselves fighting against ever-growing rates of overdose deaths. Things are already heading in that direction. We must do everything in our power to fight the spread before it overtakes us.
If you care about spreading awareness and fighting the New England heroin epidemic, please share this article with your friends and loved ones. Let them know that people are dying, and they need our help. Our government continues to struggle against a growing scourge. But if we band together as a community, embracing the name of the United States, perhaps we can fight back. At the very least, we have to try.
Awesome article, Kieran!