Also, the AP article makes a botch of its attempt to connect heroin potency with a "spike in heroin overdose deaths across the nation." To begin with, 25 years of AP reporting indicates that high-potency heroin has been widely available for some time, so it's silly to start blaming it for a recent increase of deaths. And second, the AP gives no sense that its methodology, in which it counts 3,000 heroin deaths in 36 states in 2008, is the same as that used by the Centers for Disease Control and Prevention to count 2,000 deaths a year at the beginning of the decade. The comparison could be apples to oranges—or apples to salamanders. We just don't know.
Another problem with the AP piece is that it never defines death by heroin overdose. Is that a death in which only heroin is consumed? Or does it include deaths in which other drugs are taken in combination with heroin?
The question isn't pedantic. As it turns out, death by heroin alone is relatively uncommon, according to a 2008 study by the Florida Department of Law Enforcement and the Florida Medical Examiners Commission. The study (PDF) analyzed the cases of all 8,620 people 1) who died in the state during 2007; 2) whose death led to a medical examiner's report; and 3) who had one or more major drug (including alcohol) onboard when they died.
In only 17 of the 110 heroin-related deaths was heroin the only drug onboard. In most cases of heroin-related death, decedents take other drugs that depress the central nervous system—other opiates, alcohol, sedatives, etc. The dangers of "polydrug use," as some call it, have been well understood for some time. A survey of the medical literature published in Addiction in 1996 titled "Fatal Heroin 'Overdose': A Review" warns against attributing all deaths in which evidence of heroin is present as "heroin overdoses." The authors write:
In a substantial proportion of cases, blood morphine levels alone [the body converts heroin into morphine] cannot account for the fatal outcome of a heroin "overdose." It appears that a great many "overdoses" are in fact fatalities due to multiple drug use. ... For a substantial number of heroin-related fatalities, then, heroin "overdose" may be a misnomer.
Moral of the story: Don't take heroin, but if you must, never mix it with other drugs.
A final point. The AP story makes a big deal about how falling heroin prices make the drug irresistible. "To hook new users, dealers are selling heroin cheap—often around $10 a bag," the story reports. But there's nothing new about that price. As an AP story cited above reports, bags of "60 percent to 85 percent pure heroin" were selling for $10 in 2000.
Thanks to Riverfront TimesEditor Tom Finkel and his staff for the ultra-potent tip. Send your ultra-potent tips to firstname.lastname@example.org and OD on my Twitter feed. (E-mail may be quoted by name in "The Fray," Slate's readers' forum; in a future article; or elsewhere unless the writer stipulates otherwise. Permanent disclosure: Slate is owned by the Washington Post Co.)
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Previously, Jack Shafer dinged NBC's Today Show, the New York Times, the Washington Post, USA Today, and Newsweekfor their stupid drug coverage. The Washington Postand USA Todayare repeat offenders. He has also scolded the press corps for its stupid coverage of mothball abuse and Salvia divinorum. Why does drug reporting suck, he asked in 2005.
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