If there is one thing that can be said with certainty, beyond any reasonable doubt, it is that America is currently facing a serious issue with heroin addiction and overdose. Every day, headlines can be found reporting heroin-related deaths and other stories related to what has been characterized as the “heroin epidemic” that is sweeping the nation. Some news sources even have separate sections dedicated solely to heroin updates and stories. Among the many searching for solutions are politicians, policy makers, judges, and law enforcement agencies. Most recently, more judicially initiated programs and changes have been reported across the country.
“’[P]ublic health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015,’ making overdose deaths ‘nearly equal to the number of deaths from car crashes.’”
Widespread issues with prescription painkillers and other opioids preceded the heroin epidemic. After efforts began to crack down on the over-prescription of such drugs in the early 2000’s, addicts began turning to heroin as a cheaper, more available high. According to the Center for Disease Control and Prevention (CDC), “between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled.” More recently, the New York Times reported that “public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015,” making overdose deaths “nearly equal to the number of deaths from car crashes.”
Heroin use and heroin-related deaths have increased among all ages, income levels, and genders. In fact, the CDC reported that “some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes.” The issue is also prevalent in all areas of the country, from east coast to west coast and from large cities to small towns, with rates climbing at a faster pace in rural communities than in urban. In Nash County, North Carolina, a small rural county of just over 90,000 people, “by the second week of January of  more people had died of heroin overdose than in all of 2015.”
Responding to heroin overdose calls has become a major part of emergency workers’ day-to-day jobs. In North Carolina, there are Good Samaritan laws in place that provide “limited immunity from prosecution for certain drug-related offenses for those who call for medical assistance because they fear they or someone they’re with may be overdosing.” In response to the high volume of emergency calls for heroin overdoses, police officers and EMS personnel have begun carrying Narcan, a nasal spray for the emergency treatment of a known or suspected heroin overdose.
The future of Narcan is unsure, as its widespread use to reverse the effects of heroin overdose has become very controversial. Not only is it taking a toll on emergency worker resources, but also the price of Narcan is soaring and citizens are concerned with the amount of tax dollars that go towards the life-saving drug and assisting heroin-addicts. In addition to its unpopularity, many communities are seeing an increase in Narcan-resistant heroin, usually due to the fact that it is laced with fentanyl, “a highly synthetic opioid that is 50 times more potent than heroin and 100 times more potent than morphine.”
“West Virginia is at the forefront of the heroin epidemic with ‘the highest drug overdose death rate in the United States.’ In August 2016, 28 people in Huntington, WV overdosed in a single day.”
Until recently, the majority approach to dealing with heroin users has been to arrest, charge, and imprison offenders. The need for a more advanced solution is evident as heroin overdose and death rates continue to soar, addiction spreads further across all areas and demographics, and recidivism rates remain high amongst heroin users. There is no quick fix, though, and lawmakers and law enforcers are testing out a few different approaches.
West Virginia is at the forefront of the heroin epidemic with “the highest drug overdose death rate in the United States.” In August 2016, 28 people in Huntington, WV overdosed in a single day. “Deaths in West Virginia have overwhelmed a state program providing burial assistance for needy families for at least the fifth year in a row” and the West Virginia Department of Health and Human Resources say “the state’s drug overdose epidemic…is partly to blame.” With numbers like these, it should not come as a surprise that West Virginia is beginning to take a more hardline approach to combatting the issue.
Joseph Goodwin, the federal district judge for the southern district of West Virginia, “rejected a plea deal for a man accused of dealing heroin and fentanyl.” The vast majority of federal criminal cases are resolved with plea bargains, in which defendants cooperate with the prosecuting attorney and plead guilty to an amended or lessened charge(s). “While judges have the authority to reject these bargains,” the Washington Post reported, “in practice they rarely do.”
Judge Goodwin felt it necessary to make this unusual move due to the severity of the heroin epidemic in West Virginia, which he referred to as “ground zero in a crisis that amounts to a cancer that has grown and metastasized in the body politic of the United States.” Judge Goodwin provides additional support for his decision to reject the plea deal by explaining that “the bright light of the jury trial deters crime, enhances respect for the law, educates the public, and reinforces their sense of safety much more than a contract entered into in the shadows of a private meeting in the prosecutor’s office.”
[L]awmakers in some parts of the country are seeing to it that “administering justice takes a back seat to the overarching goal of simply keeping defendants alive.”
In Winston-Salem, North Carolina, attorneys, city council members, and judges have been working together to revive and reinvigorate a drug treatment court that previously operated from 1996-2011. Proponents of the program hope that it will help to alleviate the “increase in fatal heroin overdoses, which occurred once every other month in Winston-Salem in 2010, but has now increased to more than one a day.” The Winston-Salem Journal reported, “the drug court will give nonviolent offenders the opportunity to plead guilty to their criminal charges, then serve highly intensive probation and go through addiction treatment rather than go to jail.” As a part of the treatment process, offenders will “submit to regular drug testing and report back to the court regularly.”
Drug treatment courts such as the one restarting in Winston-Salem are appearing in other areas of the country as well. In Buffalo, New York, the city is “experimenting with the nation’s first opioid crisis intervention court, which can get users into treatment within hours of their arrest instead of days, requires them to check in with a judge every day for a month instead of once a week, and puts them on strict curfews.” By adopting this rehabilitation model of approaching the heroin problem, lawmakers in some parts of the country are seeing to it that “administering justice takes a back seat to the overarching goal of simply keeping defendants alive.”
The Commission believes that this will be an important first step in combatting the crisis that is causing America to “endur[e] a death toll equal to September 11 every three weeks.”
On the federal level, President Donald Trump signed an executive order “establishing the President’s Commission on Combating Drug Addiction and the Opioid Crisis…[to] study ways to combat and treat the scourge of drug abuse, addiction, and the opioid crisis.” The Commission issued a report on Monday, July 31, “stating that its ‘first and most urgent recommendation’ is for the president to ‘declare a national emergency under either the Public Health Service Act or the Stafford Act.’” The Commission believes that this will be an important first step in combatting the crisis that is causing America to “endur[e] a death toll equal to September 11 every three weeks.”
The future of the heroin epidemic is unwritten and the success of the different efforts to combat it is uncertain, but concerned citizens and government officials across the country are working tirelessly to develop a solution. Regardless of whether the answer will come from a federal, state, or local level, or from the executive, legislative, or judicial sphere, it will have to be innovative and dynamic. One-size fits all solutions will not fare well against the one drug that is affecting all.