Heroin, Survivor of War on Drugs, Returns With New Face

http://www.nytimes.com/2015/11/23/us/heroin-survivor-of-war-on-drugs-returns-with-new-face.html?_r=0:  The crisis today is markedly different from its predecessors. It has settled not so much in large cities as in suburbs and rural America. New users are mostly white. Indeed, a study last year for JAMA Psychiatry, a journal published by the American Medical Association, found that in the last decade whites accounted for 90 percent of those who tried heroin for the first time. Typically, they were young people who initially got hooked on OxyContin, Percocet or other widely prescribed pain relievers belonging to a class of drugs known as opioids. Heroin, also an opioid, became desirable because it is a lot cheaper than those medications, and readily available. Its users are estimated at 330,000, triple the number a decade ago.

Something else is different about this crisis: In and out of government, among Republicans as well as Democrats, the pendulum has swung from the “lock-’em-up” ethos that long prevailed. The emphasis now is more ontreating addiction as a disease, not a police matter.

But compassion is the ascendant spirit. One reflection of this is a spate of state laws enabling relatives of addicts and other nonmedical people to administer the drug naloxone, known by its brand name, Narcan. It rapidly reverses an opioid overdose, and is a proven lifesaver. On Wednesday, the Food and Drug Administration approved a nasal spray to go along with injectable versions of Narcan already in use.  

Is it purely a coincidence that the pendulum swung from punishment to caring at the same time that heroin abuse became a crisis largely affecting whites, not blacks? Perhaps, although many would doubt it.

Might a strongly punitive approach make a comeback? It is always possible. Pendulums, by their nature, swing. But even if that were to happen, narcotics seem unlikely to disappear.

That was the sense of Daniel Patrick Moynihan, a four-term United States senator from New York. Mr. Moynihan, who died in 2003, wrote an essay in 1998 on the 100th anniversary of heroin’s introduction that offered this observation: “Since the desire of man to alter his state of consciousness is as old as human history, and technology continues to provide a breathtaking array of drugs capable of producing everything from oblivion to nirvana, I think it safe to assume that we may never win a ‘war’ against drugs.”