Small Town America Hit by Heroin Epidemic

Une « Epidémie » d’héroïne frappe les Etats-Unis

New trend: the epidemic primarily affects white populations from middle and upper classes

Since 2012, an epidemic of a new kind has been raging across the United States; for the first time in the nation’s long-running “war on drugs” those primarily affected are not the poor, predominantly black urban areas, but the suburbs, small towns and rural outposts populated by white people from the middle and upper classes, more particularly in New England.

In 2012, the state of New Hampshire reported 40 heroin-related overdose deaths, as compared to 7 a decade ago; in 2014, opioid deaths in this state were up 76%, with 325 people dying from overdose. In 2013, the health authorities of Vermont reported a 40% increase in the number of people in treatment for heroin addiction, as compared to the previous year.


Nationwide, heroin-related deaths jumped 39% from 2012 to 2013, while the long term trend is equally worrying with the of heroin-related overdose deaths having nearly quadrupled in ten years, according the Centers for Disease Control and Prevention (CDC). Heroin and prescription opioids overdoses kill 44 people every day across the nation, more than road traffic accidents.


Actually, one cause for this surge in heroin use is the misuse of opioid prescription drugs – according to a recent survey, three out of four heroin abusers started out by using opioid drugs prescribed as painkillers. Nowadays, however, users tend to shift to heroin, which is much cheaper and easier to get, since doctors are becoming increasingly reluctant in prescribing painkillers and due to physical changes that made these pills harder to crush and snort for a high.

Drug dealers were not long to flood New England with heroin, for them the region has become a much profitable open market, where law enforcement is less present and drug users are willing to pay up to $ 30 for a bag of heroin worth $ 6 in New York City. Northern New England is a growing market with a low-priced, high-grade heroin ($ 30 for a bag of heroin is still half the cost of a prescription painkiller) which multiples the number of drug abusers and overdoses.

A White People’s Epidemic

The American “War on Drugs” has never ceased, it has merely changed. When the crack epidemic began to surge across the United States, back in 1984, it used to affect poor, predominantly black areas primarily. At that time, the public response was defined by “zero tolerance” and stiff prison sentences for all crack-related offenses, even nonviolent ones.

Today’s heroin epidemic is quite different. Although heroin use has increased among all demographic groups, it has grown to epic proportions among whites – nearly 90 percent of first-timers are white. Moreover, heroin addiction affects middle and upper classes, especially in New England, rather than the poorer classes.

This rather unlikely demographic profile has had a positive outcome though: since drug users’ and overdose victims’ families and parents are somewhat more committed and empowered – they know how to call a legislator, how to hold insurance companies accountable and how to start lobbying and advocacy actions – they eventually managed to change the public response to the epidemic to less punishment and more compassion and understanding.

Stop imprisonment. Time for prevention and treatment

Although one can only be pleased to see the US authorities gradually abandon the “zero tolerance” policy, one can only deplore the authorities’ double-standard approach to drug policy depending on whether one is poor and black or white and rather affluent.


Times have changed, this is true. And American politicians, the police and judiciary are now beginning to realize that the drug problem will not be solved with more prison sentences, but with more prevention and treatment. However, such compassionate policies applied to Northern heroin addicts, should also be applied to Black or Latino crack users nationwide.


Lifetime likelihood of imprisonment in the US

Sentencing policies brought about by the American “war on drugs” have resulted in a dramatic growth in incarceration for drug offenses – with the number of drug offenders in State prisons having increased thirteen-fold since the beginning of the 80’s.

Utah State Prison (Draper, Utah, United States)
Worse, the 1986 and 1988 Anti-Drug Abuse Acts have established excessive mandatory minimum penalties, solely applicable to crack cocaine, even for low-level drug offenses. Perpetrators who relate to other drugs avoid such mandatory penalties – including heroin and even cocaine users, although crack cocaine and powder cocaine are pharmacologically identical substances! Not only are these excessively severe imprisonment sentences shattering the lives of those concerned but they also are ripping apart entire families and communities!

With the rapidly approaching UNGASS 2016 – that is the Special Session of the General Assembly of the UN on the world drug problem – it is time that the United States set an example by expanding this policy based on prevention and treatment, rather than punishment, in the whole country and for all illicit drugs! Thanks to this first step, the world will be closer to a necessary reform of the general framework of the drug control system, to implement more compassionate drug policies, geared towards a public health- and human rights-based approach, rather than on criminalization and prohibition.