New wave of heroin claims Hoffman and others

NEW YORK — Heroin was supposed to be an obsolete evil, a blurry memory of a dangerous drug that dwelled in some dark recess of American culture.But smack never really disappeared. It comes in waves, and one such swell is cresting across the nation, sparking widespread worry among government officials and driving up overdose deaths — including, it appears, that of Oscar-winning actor Philip Seymour Hoffman.

Fueled by a crackdown on prescription pain killers and an abundant supply of cheap heroin that's more potent than ever, the drug that has killed famous rock stars and everyday Americans alike is making headlines again.

"Heroin has this sort of dark allure to it that's part of its mystique," said Eric Schneider, a professor at the University of Pennsylvania who wrote the book "Smack: Heroin in the City," a historical account of the drug. "What I've heard from heroin users is that flirting with addiction is part of the allure: to sort of see how close to that edge you can get and still pull back."

Medical examiners have not made an official determination of the cause of the 46-year-old actor's death, but police have been investigating it as an overdose. Hoffman was found in a bathroom with a syringe in his arm.

Authorities say a number of factors are fueling the drug's use, including relatively low prices and a less demonized image than it once had. Rather than seeing heroin as the point-of-no-return drug of strung-out junkies — in his 1967 song "Heroin," Lou Reed called it "my wife and ... my life" — some users now see it as an inexpensive alternative to oxycodone and other prescription opiate drugs.

"People think that it is someone who is a bum, who's homeless, who has no money and who is sort of living at the very bottom," said Michael Clune, a former addict who wrote the memoir 'White Out: The Secret Life of Heroin.' "When the truth is, it really is everywhere."

The number of recorded heroin overdose deaths nearly doubled from 1,842 in 2000 to 3,036 in 2010, according to the most recent statistics available from the Centers for Disease Control and Prevention. Heroin deaths still account for a relatively small percentage of total drug overdose deaths: less than 10 percent in 2010, for example.

Last month, the governor of Vermont devoted almost his entire State of the State address to the state's heroin problem, calling on the Legislature to pass laws encouraging treatment and seek ideas on the best way to prevent people from becoming addicted.

The striking thing about heroin's most recent incarnation is that a drug that was once largely confined to major cities is spreading into suburban and rural towns across America, where it is used predominantly by young adults between the ages of 18 and 29, said Jim Hall, an epidemiologist who studies substance abuse at Nova Southeastern University in Fort Lauderdale, Fla.

"We haven't really seen something this rapid since probably the spread of cocaine and crack in the mid-1980s," Hall said.

The very first American heroin users in the early 20th century were white, working-class residents of New York City, which was the epicenter of heroin use for much of the century and the key entry point to the U.S. market.

Heroin is processed from morphine, which itself is derived from the opium poppy. It originated in inner-city Chinese opium dens in the late 1800s, when people switched from opium smoking to heroin because it was much easier to smuggle. The drug was even marketed by the Bayer Co. in 1898 as the "wonder drug" of the arriving 20th century, sold as a cure for the wracking cough caused by tuberculosis.

Schneider said after World War II, heroin became a drug primarily used by blacks and Puerto Ricans in the Northeast and by Mexican Americans in the West. In the late 1960s, at the height of the hippie drug experimentation era, there was a surge of heroin use among young white people in New York's East Village and in San Francisco's Haight-Ashbury district. Crime spiked among heroin users who were desperate to keep up the habit.

Heroin's reputation in the 1970s was "a really hard-core, dangerous street drug, a killer drug, but there's a whole generation who didn't grow up with that kind of experience with heroin," said New York City Special Narcotics Prosecutor Bridget Brennan, whose office was created in 1971 in response to heroin use and related crime. "It's been glamorized, certainly much more than it was during the '70s."

In the 1990s, there was another wave of attention when the term "heroin chic" became ubiquitous as a description for pale, thin supermodels like Kate Moss.

The earliest heroin came to the U.S. from Chinese opium fields, Schneider said, and then Turkey became the leading source after World War II. After that, U.S. servicemen began smuggling the drug back from Southeast Asia and drug traffickers opened up a supply from Latin America. Today, Afghanistan is the world's largest heroin producer.

In the past, the people who were most susceptible to heroin use were the ones who didn't have to go to work every day, from the very poor to the very wealthy, Schneider said. Heroin was the drug of choice for 1950s bebop jazz musicians who used heroin in Manhattan swing clubs, he said, followed decades later by rock stars like Janis Joplin and Kurt Cobain.

That's not the case anymore. Most heroin addicts at Maryhaven, a substance abuse treatment center in Columbus, Ohio, got hooked on prescription painkillers like oxycodone after sustaining some type of injury, said Paul H. Coleman, the center's president and CEO. When the cost of buying prescription opiates became prohibitive, and those drugs were reformulated in ways that made them harder to abuse, they turned to heroin.

About half of the center's patients — it treated 7,000 people last year — are heroin addicts.

"I've had several patients tell me, 'I never thought I would end up putting a needle in my arm,'" Coleman said.

Heroin never loses its freshness and intensity, which is why it's so addictive, said Clune, who first tried the drug at a Manhattan party in 1998 and was addicted for four years before getting clean. He was lured in by the idea that trying heroin was an extreme life experience, like skydiving. His brain changed forever after just one try.

"Insofar as heroin is a romance, it's a totally phantom romance. It's imaginary," Clune said. "It's an allure that promises you something that you can never really get."