SOMETIMES IT takes a celebrity’s death to galvanize attitudes about a drug epidemic that has already ruined, or ended, the lives of many lesser-knowns. So it was when University of Maryland basketball star Len Bias died from a cocaine overdose in 1986. So it may be with actor Philip Seymour Hoffman, whose death last month coincided with government statistics showing a rise in heroin use and overdose deaths among 15- to 34-year-olds.
In the latest sign of a more vigorous governmental response, Attorney General Eric H. Holder Jr. devoted his weekly video message Monday to what he called an “urgent and growing” public health crisis. Significantly, Mr. Holder emphasized education and treatment measures as well as stepped-up law enforcement, suggesting that the Obama administration does not want to repeat past unduly punitive anti-drug campaigns.
At the same time, there is a key difference between this heroin epidemic and previous ones, as Mr. Holder noted: It is related to the abuse of chemically similar legal drugs, prescription opioids, whose use — licit and illicit — has exploded in recent years. Properly administered, these painkilling drugs can bring patients necessary relief. Diverted to unintended and unauthorized use, as they too often are, these highly addictive drugs function, in many cases, as a gateway drug to heroin.
Federal and state authorities have been trying to curb opioid abuse, by monitoring the supply chain more closely and requiring manufacturers to produce pills that cannot be easily crushed into powder.
This, in turn, has spawned criticism that the government’s supply-curbing effort forced numbers of addicts to seek heroin — while denying pain medication for legitimate needs. Mr. Holder usefully, if implicitly, rejected this criticism, noting that increased heroin abuse is a “symptom of the significant increase in prescription drug abuse that we’ve seen over the past decade” — in other words, addicts began turning to heroin well before the government started cracking down on prescription opioids. The reason, experts on addiction note, is that heroin was already cheaper and more accessible than prescription medicines.
The government’s crackdown, such as it has been, did not prevent doctors from writing an estimated 241 million prescriptions for opioids in 2012, which was down 2 million from 2011 but still 97 million more than in 2002, according to data from IMS Health that were first reported in the Milwaukee Journal Sentinel.
It’s hard to argue that this immense figure represents a shortage for legitimate uses. More to the point, government had no choice but to act in the face of an epidemic of abuse and addiction that killed 4,030 people from prescription opioid overdoses in 1999 — and 16,651 people in 2010, far more than from heroin.
To the extent heroin abuse has spiked because of recent policy changes, this represents a regrettable but unintended and probably transitory cost. Government at all levels is more than justified in curbing pain-pill abuse; if that effort continues, the levels of both prescription drug addiction and the heroin addiction that so often follows it should subside.