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Why heroin use has become an epidemic

Use of the illegal narcotic heroin is on the rise across the nation and in New York state. In the last decade, the number of people hooked on heroin is estimated to have doubled. And it is claiming lives from actor Philip Seymour Hoffman to SUNY Oswego students. This week on WRVO's health and wellness show "Take Care," Hosts Lorraine Rapp and Linda Lowen, speak with The New York Times reporter J. David Goodman, who has reported extensively on the causes and effects of the heroin epidemic.

Lorraine Rapp: Why do you think there is a rise in heroin use? What’s behind that?

J. David Goodman: What I’m told is that the DEA [Drug Enforcement Administration] and other law enforcement agencies have sort of noticed a steady rise in the drug coming into the country over the border in say the last five to seven or eight years. It’s unclear exactly what was driving that. But what is clear, is that among users there was a connection between use of heroin-like pills – these opioid analgesics like oxycontin – and eventual abuse of those pills and then eventual migration over to heroin.

Lorraine Rapp: I’m curious about the type of high a person gets from heroin, because that might help us understand who is most likely to use it. What exactly is heroin and what does it feel like to be on it?

J. David Goodman: Well, I can’t speak from personal experience. But what I can say is that this is a drug that makes you physically dependent. It’s something that you build up a tolerance for it. It binds to certain areas of the brain. Essentially what causes an overdose is your body tells you to stop breathing, and you do, and you die. Heroin is a naturally occurring, as most people know it comes from poppy plants. It is then sort of chemically reduced down to a paste, and then a powder. It’s very light. You need a very small amount of heroin to get a high. And it’s a sort of euphoria. It’s a feeling that everything is good, and it works for pain.

Linda Lowen: We are hearing more and more about heroin overdoses in the news. Users are taking it now in different forms. It used to be that, you know, you saw the classic heroin user ties up, shoots. What are the forms of heroin now available?

J. David Goodman: One thing that’s been notable about this rise in heroin abuse is that it’s affected  upper middle class, middle class, and working class communities that hadn’t seen the same sorts of heroin infestations during the last time this was a big deal, 30 or 40 years ago. And in part, at least from the users that I talked to, it came about because they started on pills. These were teenagers, in some cases, who, if they weren’t prescribed the pills, the pills were around because, say, their mother or father had gotten a prescription. And they got 180 pills for a month, and they were sitting around in the medicine cabinet. The kids learned that this is something that could get you high. They played around with them on the weekends. And it seemed low risk. [It] carried almost less of a stigma than smoking marijuana – there’s no smell, you could do it at school, which disturbingly a lot of kids I talked to did do, you could buy and trade it at school. They didn’t realize the extent to which they were going to get hooked. I talked to very few heroin addicts who went straight to the needle. It was something they developed a dependence for. Generally, the progression is, you start taking a pill orally, they would start crushing the pill to snort it to get the full effect, and then those who did move to heroin, would start by sniffing heroin. So it was kind of the same thing, it didn’t seem that different. But after a while, they went after the greater high, and the more immediate high that you could get from injecting it directly.

More of this interview can be heard on "Take Care," WRVO's health and wellness show Sunday at 6:30p.m. Support for this story comes from the Health Foundation for Western and Central New York.