In recent years, record numbers of Americans have fallen prey to heroin addiction. Florida is no exception to this trend, which claims more lives by the day. Deaths from heroin overdoses in the state have gone up every year this decade. Those who survive are trapped in a cycle of addiction, hurting their lives and their families.
Florida’s young people are particularly susceptible to heroin addiction. Experts say that people aged 18 to 29 are more likely than other groups to overdose on the drug. More young Floridians have died from heroin use than any other age group in recent years.
Narcotics such as heroin have been around for years. Heroin is, in fact, one of the oldest and best-known illegal drugs and until this decade was not widely used in Florida. Cocaine and methamphetamines were much more common. They were imported to or manufactured in Florida and were cheaper and easier than heroin to get.
Heroin only recently became big business in the state, because of the collapse of the opioid industry.
Opioids are synthetic drugs that are similar chemically to heroin. Opioid use in Florida reached a crisis point in the early 2010s, when a massive opioid supply industry emerged in the Miami area.
South Florida was home to hundreds of “pill mills” — the storefronts where rogue doctors oversupplied pain pills. That industry began to decline for two main reasons: increased government oversight and cost.
Florida’s government chose to crack down on opioid production and distribution. Florida’s laws governing opioids were the slackest among large states. That’s why the state was the site of so much production in the first place.
Eventually, the state corrected those excesses. The legislature restricted the amount of opioids patients could receive. Those restrictions are backed up by a database that tracks every opioid patient, their prescriptions, and how often those prescriptions are filled. Patients now get a safe amount of opioids, reducing the chance that they’ll develop a chemical dependency. Medical practitioners can no longer provide blank prescriptions to heavy users or street dealers.
When Florida began to enforce limitations on production and suppliers, opioids became increasingly scarce. Heroin is a widely available and much cheaper alternative. Opioid users who were still dependent on the drug switched to heroin. Opioid addiction is no one’s idea of fun. But heroin addiction is much worse.
Every street heroin user is exposed to potentially fatal risk factors: violence, bloodborne disease, and overdose.
Heroin makes its way into Florida by way of drug cartels, mostly from Mexico, who distribute their products through street gangs or their own enforcers. Cartels will often package heroin with methamphetamine. They require their street agents to sell both in order to get their regular methamphetamine stock. That increases the supply of heroin in the state and the chances that drug users will take heroin up.
Both businesses are extremely lucrative and entirely illegal. As a result, heroin gangs are able to use violence and intimidation to secure new distribution territory and expand their customer base.
Dealers bear the brunt of the violence, but heroin users are also at high risk of assault or homicide. Just being around drug dealers makes anyone vulnerable to stray bullets from rival gangs. In 2015, two Orlando area drug dealers exchanged gunfire while weaving through heavy traffic.
Chemical dependence on heroin makes users vulnerable to violence, sexual assault, and extortion by dealers.
Additionally, heroin users are also at extremely high risk of contracting deadly, bloodborne diseases. If heroin users can’t easily obtain new needles to inject the drug, they often share or reuse them, putting them at extremely high risk of contracting HIV, AIDS and hepatitis.
HIV positive users often do not know that they carry the disease. Symptoms of HIV and Hepatitis C don’t become apparent, in most cases, until years after a person has been infected. Many infected people simply do not know that they’re carriers, and, unknowingly, can infect other users or even their family.
Heavy drug users don’t often get tested for HIV because they avoid interaction with medical professionals as much as possible. Drug users may be in denial about their dependency and don’t want to talk about it. Doctors would rightfully recommend rehab if they met an addict.
Some addicts who use illegal drugs such as heroin are also afraid that interacting with hospitals puts them at risk of arrest. Heroin users have some of the most serious healthcare needs of any group of people, but, sadly, strong and perverse incentives keep them living outside society.
Finally, the most serious risk to heroin users is the drug itself. Heroin is manufactured by criminal groups, so it is not subject to government safety and purity standards. Supplies of criminal drugs can be hard to come by in certain areas depending on the activity law enforcement and disruptions in production.
As a result, street heroin bought from the same supplier over time can have vast changes in its strength. Those variances are extremely dangerous to heavy heroin users. A dose of heroin far and above a user’s tolerance can be fatal.
On any given day, a user might inject heroin that is five times stronger than what they used the week before. Even if people are consistent about their dosage and measure it carefully every time, they still run a risk of overdosing if the international supply chain changed its suppliers.
A similar danger comes from drug mixing. Frequently, if heroin supplies are short in a dealer’s turf, they might mix their heroin with a similar drug, such as fentanyl. It’s a more dangerous version of a bartender blending top shelf whiskey with the cheap stuff.
Heroin users might think they are injecting heroin, but might be injecting a drug they have never encountered before. Fentanyl, one of the most common drug mixers, is an opioid that is often much stronger than heroin.
Fentanyl produces a similar high, and long-term heroin users can switch to fentanyl without many side effects in controlled conditions. However, if a heroin user injects a fentanyl-heavy heroin mix, they run a high risk of fatal overdose.
Floridian’s heroin use has become a crisis that requires a coordinated response. There are a few proven public health methods that can mitigate its worst effects.
Needle exchanges are service agencies that provide injection drug users with fresh syringes and needles. Needle exchanges are proven methods of reducing the transmission of diseases such as HIV and AIDS among groups of intravenous drug users. The state legislature approved a law in March 2016 that allows for the operation of such programs. One facility opened at the University of Miami’s Miller School of Medicine in December 2016.
Exchanges often include a safe injection site for their clients. Safe sites can reduce exposure to the street crime that accompanies drug dealing. They also reduce the risk of death from overdose. Safe injection sites are staffed by medical professionals who can intervene when drug poisoning is in progress. Those workers can also direct people to rehabilitation treatment.
Treatment is the key to undoing the heroin crisis. Harm reduction measures such as needle exchanges and injection sites are helpful, but they don’t fix the problem. The only way to end the dangers of heroin addiction is ending heroin use.
Heroin is a fundamentally dangerous drug, and all long-term users are exposed to the risks described above. The longer a person uses heroin, they more likely they are to die or become permanently injured or disabled.
Residential rehabilitation treatment centers are the best means for heroin users to battle their addiction. The medical staff at such a facility can ease people through the difficult detox process and manage withdrawal symptoms.
These trials are best borne in a climate of support and compassion from other recovering users, under the continual supervision of caring and knowledgeable staff. Both are found in residential treatment centers.