There's good news and bad news in these numbers. The good news is that opioid deaths actually fell in 2012 for the first time as authorities have cracked down on prescription drug abuse. The total drug overdose death rate is also down slightly. On the other hand, users who've developed a opiate habit may be switching over to heroin as painkillers become more expensive and harder to get. The increase in the heroin death rate seems to reflect that reality.
On the other hand, heroin use rates are currently so low that they literally have nowhere to go but up. And heroin is considerably more lethal than just about any recreational drug out there. So even small upticks in use are going to lead to noticeably more overdose deaths.
There's a real public health conundrum at work here. Policymakers failed across the board to realize that making prescription painkillers harder to get would be a boon for the heroin market. Now, in order to keep heroin deaths from rising sharply, they're going to have to get creative.
A program currently underway in Vancouver offers one innovative solution: make the drug available to addicts via prescription. The idea is that heroin made in a lab, at a standardized purity and potency, is safer than the stuff you buy from a guy in an alley somewhere. And studies have shown that treating addicts this way is cheaper and leads to better outcomes than giving them methadone. Or simply throwing them in jail, for that matter.
But there's currently no such program in the United States.