1. Heroin Rising: the Resurgence of Heroin and Opiate Abuse
Eryck Kratville
Chief, Heroin Interdiction Team
Office of the Special Narcotics Prosecutor for the City of New York

2. Heroin: A Growing Problem… again
2007 – 2014: 145% increase in heroin use nationwide
2007 – 2014: 174% increase in heroin addiction nationwide
Just under 1,000,000 Americans used heroin sometime in 2014
More than 500,000 Americans were addicted to heroin in 2014
Source: Substance Abuse and Mental Health Services Administration 2014 report

3. Heroin: A Growing Problem… again
Particular problem: Americans 18-25
In 2007, one American addicted to heroin for every five addicted to cocaine (61k v. 300k)
By 2014, four Americans addicted to heroin for every three addicted to cocaine (152k v. 114k)
Source: Substance Abuse and Mental Health Services Administration 2014 report

4. Source: Substance Abuse and Mental Health Services Administration 2014 report

5. Heroin Epidemic Takes New Shape
1960’s / 1970’s
Today
Urban, poor users
Suburban, rural, middle class users
Drug injected
Drug snorted, smoked
Gateway:
Marijuana
Addictive Pills
Source: Bridget Brennan, 2015 NYPTI Lecture

6. Precursor: Abuse of Legal Drugs

7. Precursor: Abuse of Legal Drugs
About 1/3 of opioid pill addicts become addicted to heroin
Doesn’t matter if originally used pills for medical or recreational reasons
Average of three years from first pill to first use of heroin (median)
Heroin: cheaper and more accessible than pills
Source: Study presented at RxStat meeting 9/17/15.

8. Precursor: Abuse of Legal Drugs
WARNING SIGNS
High-dose opioid pills (>= 10mg oxycodone)
Nasal inhalation of pills
Physical dependence (withdrawal)
Reduced heroin stigma in social circles
Source: Study presented at RxStat meeting 9/17/15.

9. The Overdose Epidemic (New York City)
2000 – 2013: over 10,000 overdose deaths due to opioid abuse
Heroin overdose rate has more than doubled since 2010
Nearly 80% of all drug overdoses in NYC involved opioid pills or heroin, more than half involved heroin
Source: 1 – Bridget Brennan 2015 NYPTI lecture; 2,3 – RxStat meeting 9/17/15

10. NYC: 2010 –11 Heroin Death Rates
Source: Bridget Brennan 2015 NYPTI lecture

11. NYC: 2012-13 Heroin Death Rates
Source: Bridget Brennan 2015 NYPTI lecture

12. The Overdose Epidemic: Naloxone
Naloxone – Can prevent overdose deaths, EASY TO LEARN
NYS Dept. of Health website can direct you to training programs and free kits
In 2014, more than 400 overdose deaths were prevented with naloxone administered by Suffolk County Police
Source: RxStat meeting 9/17/15

13. The Increasing Heroin Supply
Heroin seizures in the US increased 87% over the past five years
Doses are tiny: a single kilogram of heroin can be broken down into as many as 50,000 single-use glassines
Source: 1 – Bridget Brennan 2015 NYPTI lecture

14. The Increasing Heroin Supply

15. New York
Mexico DR
Colombia

16. Source: Office of the Special Narcotics Prosecutor

17. Methods of Concealment: Banana Leaves (2010)
Source: Office of the Special Narcotics Prosecutor

18. Methods of Concealment: Container Crate of Sofas (2012)
Source: Office of the Special Narcotics Prosecutor

19. Methods of Concealment: Coffee Beans (2013)
Source: Office of the Special Narcotics Prosecutor