In our ED we seem to go through phases with the drugs of choice. These days it is heroin more than meth. Most of them get narcan and then try to leave AMA.
Slate Magazine has a great take on AP's "scare story reporting that new, cheap heroin is causing an increase in heroin deaths.
Drug scare stories are nothing new and are rarely based on any real documentation. Usually the source is local law enforcement and some questionable statistics.
In alarmist prose, the article asserts that the ultra-smack's purity ranges from 50 percent to 80 percent heroin, up from the 5 percent purity of the 1970s, and this potency is "contributing to a spike in overdose deaths across the nation." But reports of high-potency heroin being sold in the United States are anything but "recent." My source? The AP itself. Over the decades, the wire service has repeatedly reported on the sale of high-potency heroin on the streets.
Slate points out that AP's been reporting on high potency smack since the mid 1980s and while AP states new users are getting hooked due to cheaper prices -- AP's own reporting states that the price hasn't changed in over a decade. Moreover, Slate notes that the methodology for defining and comparing heroin ODs is pretty murky (if indeed any sort of methodology was involved.)
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 overdose."