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National Drug Intelligence Center
Heroin in the Northeast: A Regional Drug Threat Assessment
Treatment data indicate that heroin is abused at high and increasing levels in the Northeast, particularly in New York, New Jersey, and Massachusetts. According to the Treatment Episode Data Set (TEDs), there were 148,972 heroin-related treatment admissions to publicly funded facilities in the Northeast in 1999 and that number increased to 177,610 in 2001, the most recent year for which data from all states constituting the region are available. Further, there were more heroin-related treatment admissions than admissions for any other illicit drug each year during that period. Most individuals admitted for heroin abuse in the region were Caucasian, and a significant portion were male. The predominant age categories varied among the states. For example, individuals admitted for heroin abuse in Vermont and some other New England states typically ranged from 18 to 30 years of age, while those in Washington, D.C., typically ranged from 36 to 50 years of age. Those in other states usually fell somewhere in between. At least 66 percent of all heroin-related treatment admissions in the region each year were recorded in New York, New Jersey, and Massachusetts.
Emergency department (ED) and mortality data affirm the significant threat posed by heroin to the Northeast. The total number of heroin-related ED mentions in the seven northeastern cities1 that participate in the Drug Abuse Warning Network (DAWN) increased from 30,275 in 1999 to 31,968 in 2000 before decreasing slightly to 31,058 in 2001. The number of ED mentions was higher than for any other illicit drug (except cocaine) each year during that period. Further, the rates of heroin-related ED mentions per 100,000 population in each of these seven metropolitan areas were higher than the rates nationwide every year from 1999 through 2001. The rates in Baltimore and Newark were significantly higher than in any other metropolitan area in the Northeast and at least four times higher than the rates nationwide. The rates in Washington, D.C., were lower than in any other area in the Northeast every year during that period. In addition, DAWN mortality data indicate that there were 1,346 heroin/morphine-related deaths in the Northeast2 in 2001, the most recent year for which data are available. There were more heroin/morphine-related deaths in Philadelphia (391) than in any other metropolitan area in the Northeast that year; however, Baltimore (349), Boston (195), Newark (177), and Long Island (96) also had significant numbers of heroin/morphine-related deaths.
The level of heroin abuse has increased among some prescription drug abusers in the Northeast. Law enforcement and treatment reporting in several areas indicates that diverted pharmaceuticals, such as OxyContin and other synthetic opiates, are less available and more expensive, causing some users to switch to heroin. In Calais, Maine, for example, law enforcement and legislative efforts were effective in decreasing the availability of diverted pharmaceuticals, particularly opiates. As a result, many users switched to heroin, which produces similar physiological effects, often at a significantly reduced price. This switch to heroin is alarming because prescription drug purities, which are federally regulated, are much more consistent than are those for heroin. As a result, these new heroin abusers may suffer serious health consequences (including death) because the purity level of the heroin they purchase may be several times greater than that of the prescription drugs they are accustomed to abusing.
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