The number of drug-related deaths continues to rise in the United States, with heroin-related cases increasing considerably (from 5,925 deaths in 2012 to 8,257 in 2013) to reach their highest levels in the past decade according to the UNODC. Prescription painkiller overdoses also continue to rise, particularly among women. Over the period 2004-2011, emergency room cases related to heroin and other opioid use rose by 183 per cent.
Increased demand for, and use of, heroin is being driven by both increasing availability of heroin in the U.S. market and by some controlled prescription drug (CPD) abusers using heroin. CPD abusers who begin using heroin do so chiefly because of price differences, but also because of availability, and the reformulation of OxyContin®, a commonly abused prescription opioid.
Many cities are reporting the increase in heroin overdose deaths is more common in the suburban areas and outlying counties surrounding the cities. Possible reasons for these increases in overdose deaths include an overall increase in heroin users; high purity batches of heroin sold in certain markets, causing users to accidentally overdose ( Like in the methamphetamine market, when economic times are tough, purity goes up and price comes down); an increase in new heroin initiates, many of whom are young and inexperienced; abusers of prescription opioids (drugs with known compositions and concentrations) initiating use of heroin, an illicitly-manufactured drug with varying purities, dosage amounts, and adulterants; and the use of highly toxic heroin adulterants such as fentanyl in certain markets. Further, heroin addicts who have stopped using heroin for a period of time (due to rehabilitation programs, incarceration, etc.) and subsequently return to using heroin are particularly susceptible to overdose, because their tolerance for the drug has decreased.