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Patrick Greco
Professor Sotirakopulos
Honors Composition 1102
14 December 2015
The Heroin Epidemic
While many people are aware of the dangers that come with heroin, the dramatic uptick
in usage over the last decade plus comes to the surprise of many. The National Survey on Drug
Use and Health studied trends in heroin use from 2002 to 2013. In these studies, they found a 63
percent rise in overall usage and a 286 percent increase in heroin related overdose deaths during
that timespan (Lipari). As frightening as those numbers may appear, the idea that there is no clear
reason for the rising epidemic is equally as frightening. I seek to explore the different causes
behind this rise.
Heroin is an illegal, highly addictive drug processed from morphine, a naturally occurring
substance extracted from the seed pod of poppy plants. It is typically sold as a white or brownish
powder that is cut with sugars, starch, powdered milk, or quinine. Pure heroin originates in
South America and parts of Southeast Asia, and dominates U.S. markets east of the Mississippi
River (Volkow). Highly pure heroin can be snorted or smoked, and may be more appealing to
new users because it eliminates the stigma associated with injection drug use. Black tar heroin
is sticky like roofing tar or hard like coal and is predominantly produced in Mexico and sold in
U.S. areas west of the Mississippi River (Volkow). The dark color associated with black tar
heroin results from crude processing methods that leave behind impurities. Impure heroin is
usually dissolved, diluted, and injected into veins, muscles, or under the skin.

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The effects of heroin are numerous; first, it leaves its users in a euphoric state of pleasure,
by stimulating the release of dopamine. This feeling is typically accompanied by a warm flushing
of the skin, dry mouth, and a heavy feeling in the extremities, which may result in nausea,
vomiting, and severe itching. After the initial effects, users usually will be drowsy for several
hours. Heart function slows; and breathing is also severely slowed, sometimes enough to be lifethreatening. The long term effects of the drug include the deterioration of the brains white
matter, drug dependency, overdose, and death. Needle-sharing among injection drug users also
increases the risks of contracting HIV and Hepatitis. Of the 17,000 new Hepatitis C infections
occurring in the United States in 2010, 53 percent were among injection drug users (Volkow).
Unlike the crack epidemic of the 1980s that ravaged the inner-cities, heroin is doing most
of its damage in affluent neighborhoods with mostly white populations. According to a 2014
study done by JAMA Psychiatry, nearly 90 percent of people who tried heroin for the first time
in the past decade were white (Cicero). Part of this increase in heroin use among whites is due to
the increase in the abuse of prescription opioids over the last 20 years. Over this time, pain
doctors have been competing with each other to win the business of opioid addicts. Keith
Humphreys, a psychologist who worked in the Office of Drug Control Policy from 2009 to 2010
puts it into perspective when he explains, If you are a dentist and you give someone thirty [pills
of] Vicodin, they wont bother you again. And if they develop a problem, no one blames you
(Wood). A chemical tolerance towards prescribed opioids leads addicts to seek a more intense
high. This reason, in many instances, explains the transition to heroin use and abuse, because it
is cheaper and in some communities easier to obtain than prescription opioids.
Year round sports and the pressure to play through injury are among the leading factors
that drive high school and college athletes to heroin. Take for example, the story of former

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Driscoll Catholic football standout, Louie Miceli. During Louies senior year of high school, he
suffered a serious football injury that sidelined him for several weeks. In order to get back on the
field in a timely manner, Louie was prescribed opioid pain medication to mask the pain. After
running through his prescription and recovering from injury, Louie wanted to continue taking the
medication, because he had access to opiate pain medication in his house keeping up the habit
was not hard. Eventually, he was fully addicted to Vicodin, Darvocet, OxyContin, and Xanax to
bring him down. Once the medication in his house, and other family members houses, were
depleted or hidden, he started buying and selling pills on the street. The cost of each pill was
around twenty dollars, and he was taking ten-plus pills a day. Because he was fully addicted, and
couldnt sustain the daily cost heroin, at ten dollars a bag seemed like a reasonable alternative.
At first, he started with one or two bags a few times a week, but of course that quickly escalated
to ten-plus bags a day and he found himself back in the same financial situation he was with the
pills. His daily focus now became, how can I get money for heroin?, and, how do I get
heroin? Without an income, he stole from his house on a regular basis and pawned whatever he
could silver coins from his dads lifetime collection, his state championship ring, silverware
from his parents wedding, Lladro sculptures, jewelry, an Xbox, and golf clubs among other
things. Unfortunately, there was no happy ending with Louie Micelis story. After receiving
treatment from some of the most highly acclaimed treatment facilities in the country, Louie
returned home claiming to be a changed man. Louies new-found-self was short lived,
however, and on August 9, 2012 Lou Miceli died of a heroin overdose at twenty-four years old.
Kristen Gutierrez, the older sister of Lou Miceli and founder of the LTM Heroin
Awareness foundation, explained in an interview how people like her brother, fall to heroin:

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Heroin takes over your higher power you abandon all the good, decent, and
truthful characteristics that you were brought up with, and you only act on behalf
of your heroin addiction. Louie was an amazing, charismatic young man with the
biggest heart you can imagine until he handed himself over to heroin then he
was lost. It was the same experience my brother Vinny went through Louie lost
his life and Vinny, with two years and almost 100 thousand dollars in rehab, was
lucky enough to emerge on the other side. (Gutierrez)
Louie Micelis story, however unfortunate, is not unique. Young people around the
country are falling victim to full blown heroin addictions in the same manner that Louie did.
University of Michigan researcher, Philip Todd Veliz, reported in a 2013 national study that by
the time high school athletes become seniors, approximately 11 percent will have used a narcotic
pain reliever such as OxyContin or Vicodin for nonmedical purposes (Veliz). Veliz, whose
longitudinal study included 743 male and 751 female adolescents in southeast Michigan, also
said in an interview with Sports Illustrated that, "male adolescent athletes who participated in
competitive sports across the three-year study period had two times greater odds of being
prescribed painkillers during the past year and had four times greater odds of medically misusing
painkillers when compared to males who did not participate in competitive sports" (Wertheim).
What can be done to stop this trend? Kristen Gutierrez offered some insight into this
question:
Like anything else, awareness and education. You dont know what you dont
know. Before I was immersed in the world of Heroin, because of my brothers
diseases, I knew nothing of the addictive nature of opiates. I had old opiate pill
bottles in my cabinet for years for my wisdom teeth and other injuries that I never

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took just because I didnt need it, not because I was opposed to using them. In
2010, after my dad told me what was going on with my brothers plight, I
educated myself. One of the first things I did was dump everything in my
medicine cabinet into the trash not just to safeguard my family but for anyone
who came into my house that had an addiction. So to reduce the number of opiate
and heroin addicts, overdoses, and deaths we need an increase in awareness,
education, regulation laws, stronger doctor ethics, and an overall increase in
respect for the fragility of life. (Gutierrez)

Works Cited

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Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The Changing Face of Heroin Use in the United
States: A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry. 2014;71(7):821826. doi:10.1001/jamapsychiatry.2014.366.
Gutierrez, Kristen. Personal interview. 3 December 2015.
Lipari, R.N. and Hughes, A. "Trends in Heroin Use in the United States: 2002-2013." National
Survey on Drug Use and Health. U.S. Department of Health and Human Services, 23
Apr. 2015. Web. 27 Oct. 2015.
Veliz, Philip. "Painfully Obvious: A Longitudinal Examination of Medical Use and Misuse of
Opioid Medication Among Adolescent Sports Participants." Journal of Adolescent
Health 54.3 (2013): 333-40. Web.
Volkow, Nora D. "What Is Heroin and How Is It Used?" National Institute on Drug Abuse.
National Institutes of Health, 2015. Web. 25 Nov. 2015.
Wertheim, L. John, and Ken Rodriguez. "How Painkillers Are Turning Young Athletes Into
Heroin Addicts." Sports Illustrated. Time Inc, 18 June 2015. Web. 1 Dec. 2015.
Wood, Graeme. "Drug Dealers Aren't to Blame for the Heroin Boom. Doctors Are." New
Republic. New Republic, 19 Mar. 2014. Web. 24 Nov. 2015.