At presidential campaign stops throughout the state, candidates were forced to respond to the problem when New Hampshire citizens demanded answers. Hillary has a $10 billion plan for prevention and treatment of abuse; Chris Christie prefers treatment to jail time for first offenders.
In August, Obama announced a $5 million initiative to combat heroin addiction and trafficking. New Hampshire has designated a drug czar. Senator Ayotte (R-NH) says “We’ve got to reduce the stigma.” Narcan, an opiate antidote that has been made widely available, is admittedly a band-aid. It saves lives from acute overdoses, but does absolutely nothing to stem the tide of abuse.
The solutions being touted by politicians and the media include: working together, police, citizens, and health- care facilities—though to what end is unclear—educating and reducing the stigma of heroin use—now that users are predominantly white and middle class we can re-label addiction a disease, not a crime—adding treatment facilities; and more police.
I call this salutary, but it almost entirely misses the mark. Overdose deaths and heroin users are at an all time high in the United States. Between 2 and 9 of every thousand Americans (0.2-0.9 percent of the population) is currently using heroin. In Maine, 8 percent of babies are born “drug-affected”—a stratospheric rise from 178 babies in 2006 to 995 babies in fiscal 2015.
Despite what you have heard, the cause of our current heroin epidemic is not as simple as doctors overprescribing narcotics. While heroin overdoses jumped from 1.0 per 100,000 in 2010 to 3.4 per 100,000 in 2014, the number of prescribed narcotics held steady over the same period. A 2015 UN document noted that “A recent [U.S. government] household survey in the United States indicated that there was a significant decline in the misuse of prescription opioids from 2012 to 2013.” According to the CDC, “they have programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as ‘prescription’ opioid overdoses.” That means illegally produced drugs in these categories are being designated as prescription drugs, when they are not. A further confounder is that heroin metabolizes to morphine, which is a prescription drug. So if fully metabolized at the time of autopsy, a death due to heroin will be characterized as due to a prescription narcotic. The true cause of the current heroin epidemic is massive amounts of heroin flooding into the U.S., exceeding what can be sold in our large cities, and now finding its way into even the tiniest hamlets. Here’s the problem with the Times’s and politicians’ solutions: 50 individual states and thousands of towns and villages cannot treat, educate, exhort, investigate, or imprison their way out of the heroin maelstrom. There are nowhere near enough police, social workers, prisons, treatment facilities, or sources of funding. Narcan and clean needles don’t cut the mustard. One possible solution is stemming the supply. In my September 7 blog post, I showed that 96 percent of U.S. heroin does not come from Mexico and Colombia, as claimed by U.S. government sources. Mexican and Colombian production is inadequate to supply even half the U.S. market.
Canada knows where its heroin supply comes from: “According to the Royal Canadian Mounted Police National Intelligence Coordination Center, between 2009 and 2012 at least 90 percent of the heroin seized in Canada originated in Afghanistan.” If one wants to get into the weeds on this issue, a 2014 RAND report titled, “What America’s Users Spend on Illegal Drugs: 2000-2010,” is a good place to start. The report, performed under contract for DHHS and released by the White House, looks at multiple databases and identifies many problematic issues with estimates of heroin country-of-origin. It shows that while Colombian opium was allegedly supplying 50 percent of a growing U.S. heroin market between 2001 and 2010, Colombian production actually dropped from 11 metric tons annually in 2001 to only 2 metric tons in 2009. Furthermore, U.S. government estimates for the 2000-2010 decade of Mexican production relied on a claimed 3 growing seasons per year, while it turned out there were only 2. RAND admits Mexican production estimates were inflated. Furthermore, historically Mexico produced lower quality, “black tar” heroin, while the influx of heroin to the U.S. has been of higher quality white powder. Meanwhile, according to RAND, “in recent years, there have been no [heroin] seizures or purchases from Southeast Asia [Myanmar, Laos, Thailand] by DEA’s Domestic Monitoring Program.” In 1992, DEA estimated that 32 percent of U.S. heroin came from Southwest Asia (mainly Afghanistan). Since then, Afghan opium production has tripled.
But in the years 1994 through 2010 only 1-6 percent of U.S. heroin had a southwest Asian origin, according to DEA’s Domestic Monitoring Program. Yet Afghan production accounts for 90 percent of the world heroin supply. It would be great if we could point to improved U.S. interdiction at the source, or to poppy field eradication to explain this anomaly. But neither is the case. Seizures of heroin in Afghanistan dropped from 27 metric tons in 2010 to 8 metric tons in 2013, according to the UN, figure 41. Only 1.2 percent of poppy fields were eradicated in 2014, also according to the UN. It is undeniable: there has been a profound, systematic inflation of the amount of heroin reaching the U.S. from Mexico and Colombia by the U.S. government, presumably to protect the actual sources of most U.S. heroin.
We know where and how to look for it: Afghanistan and Myanmar are the world’s number one and number 2 producers. Historically, heroin to the U.S. leaves these countries by air. There are a manageable number of flights leaving Afghanistan and Myanmar. We could put all the needed personnel in place, today, to fully inspect every flight. The fact that we have looked the other way and pointed in the wrong direction is itself the smoking gun.
