The death of Philip Seymour Hoffman underscores a surge in heroin use reminiscent of the 1970s. More than 660,000 Americans used heroin in 2012, health officials say — nearly double the number from 2007 — and users tend to be more affluent than before, living in the suburbs and rural areas rather than inner cities.
"It's reached epidemic proportions," said Rusty Payne, a spokesman for the federal Drug Enforcement Administration.
Mexican cartels are pushing large amounts of heroin across the Southwestern border, sometimes hidden in fake coconuts, bananas and lollipops, officials said. Heroin has flooded the Northeast and reached a large market of American pain-pill addicts seeking a less-expensive high. Overdoses and emergency-room visits have skyrocketed across the country, and more people are dying from a drug whose purity can be hard to judge.
"Increasingly, heroin addicts are former prescription drug abusers," said Sarah Pullen, a special agent in the DEA's Los Angeles office. "They become hooked on painkillers and move over to heroin because it is available for far cheaper."
In New York, one oxycodone pill on the street costs about $30 and is good for just one hit. For about the same price, buyers can get six glassines of heroin. "Who would have ever thought in this country it would be cheaper to buy heroin than pills and obtain them more easily?" said the DEA's Payne,
The consequences have been lethal. In 2010 — the latest year such data are available — heroin overdoses killed 3,038 people in the U.S., a 45 percent increase since 2006.
Hoffman's death comes just a week after Pennsylvania officials announced that a batch of heroin spiked with fentanyl, a powerful opiate usually given to cancer patients, had killed at least 22 people in January. Spiked heroin also has killed at least 37 people in Maryland since September, authorities there say.
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Heroin was a drug of choice for celebrities and inner-city addicts alike in the 1970s, often with fatal consequences. But its popularity declined in the 1980s as the HIV/AIDS crisis brought worries of infection-carrying needles. Crack cocaine supplanted heroin as a cheap, powerful option for poorer users.
Now, heroin is back. Americans' widespread abuse of prescription drugs has created a new market for the opiate, which gives users a powerful euphoria similar to that of pain pills.
"This last year, we've seen a big uptick in heroin use. It's become rapidly very popular," said Theodore J. Cicero, a professor of neuropharmacology at Washington University in St. Louis. "But now it's becoming a rural and suburban issue rather than an urban issue."
In some cases, overdose victims have been young people trying the drug for the first time. That was the case with Emylee Lonczak, a 16-year-old high school student in Virginia who died in August, after being injected with the drug by a friend.
Some officials fear that efforts to drive down abuse of prescription medications could be contributing to rising heroin use.
"What we're seeing, as pills become more difficult to access, is a shift to the black market and heroin," said Dr. Andrew Kolodny, the chief medical officer at the Phoenix House Foundation, a drug-treatment center in New York City. "It's not easy to get the opioid genie back into the bottle."
Heroin is particularly accessible in the Northeast, where officials say New York City serves as the transit point for heroin coming via road from the Southwest, via air from overseas, and via ship from South America.
Heroin seizures in New York state are up 67 percent over the last four years, the DEA says. A raid in the Bronx last week netted 33 pounds of heroin and hundreds of thousands of branded bags, some stamped "NFL," a timely nod to the Super Bowl.
Batches of heroin are named for celebrities or luxury products, or the very thoroughfares along which the drugs travel: Lady Gaga. Gucci. I-95. And they often indicate little about the quality or purity of the product.
"If you go to heroin, you don't know who you're getting it from, what it's cut with, what quantity can I handle," said Capt. Nancy Demme of the Montgomery County, Md. police's Special Investigations Division. "The results are that you have these overdoses and, in some cases, you have deaths."
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For law enforcement officials, Hoffman's death was a stark reminder of the dangers inherent in a highly addictive drug that ravaged urban communities in the 1970s.
"People who study drug trends talk about generational amnesia," said Bridget Brennan, a special narcotics prosecutor in New York. "We're now 40 years out from our last major heroin epidemic and I think people have lost their memory of that drug's devastation."
Indeed, she said, some of the most common heroin brands suggest as much: Grim Reaper; a skull and crossbones; D.O.A.
Contributing: New York Times, Washington Post