Small Cities Struggle to Battle the Rise in Heroin Abuse

There’s a whole new generation of heroin addicts in rural areas and smaller, struggling cities, which have few resources to fight the epidemic and its affects.

The death of actor Philip Seymour Hoffman from a heroin overdose shed new light on a startling truth: The drug has not only resurfaced, but is back with a vengeance. And unlike the 1970s and 1980s when it devastated inner-city neighborhoods, this time heroin is spawning a whole new generation of addicts in rural areas and smaller, struggling cities. 

The amount of heroin seized each year at the Mexican border increased 232 percent from 2008 to 2012. Meanwhile, the number of new heroin users jumped by almost 80 percent over a similar time period, according to surveys by the federal Substance Abuse and Mental Health Services Administration. This has put a lot of pressure on cities already suffering from years of economic decline. These cities, some with multiple generations of heroin users, are worried they don’t have the resources to fight this latest scourge, which is being blamed on a successful crackdown by law enforcement on prescription painkillers.

“People who use heroin find it debilitating, which makes it harder to hold down a job compared to other drugs you can abuse,” says John Roman, a senior fellow with the Justice Policy Center at the Urban Institute. “That means more users are looking for ways to get money to purchase their drug. It drives up crime and disorder.” Large cities, including Baltimore, Minneapolis and Philadelphia, have seen increases in heroin overdoses in recent years. But the problem has hit smaller jurisdictions particularly hard: In Taunton, Mass., 64 people overdosed and five died in less than two months earlier this year. In Newburgh, N.Y., a city of 30,000 about a 90-minute drive north of New York City, gangs have taken to running open-air drug markets in recent years, making it one of the most dangerous small cities in America.

The return of heroin and the surge in overdoses has led a number of city police departments to not just increase crackdown efforts, but to also start carrying an antidote, naloxone, a nasal spray that can quickly reverse an opioid overdose. Several city police departments in Massachusetts mandate that their officers carry the kits with them, as do police departments in Indianapolis and Ocean County, N.J.

But the police are just one part of a city’s public safety and criminal justice system that must cope with the upswing in heroin. The courts, corrections, parole and probation workers are also drawn into the battle. It puts cities that are less viable and have fewer resources at risk. There is no one simple solution, but Roman suggests cities consider drug courts. Started in 1989, drug courts are an effective tool that has been successful in just about every medium-to-large city and county court system at reducing drug-related recidivism, according to a study by the Urban Institute.

Drug courts work to help nonviolent, substance-abusing offenders recover and return to productive lives. But there are not enough of them, according to Roman.

Despite the rise in heroin abuse, cities may still be able to combat the growing epidemic by focusing on antidrug education. Roman points to a recent study by the University of Michigan that found that less than 1 percent of high school students claimed to have had tried heroin. “They’re scared of it,” he says. 

Tod is the managing editor of Governing and the contributing editor of our sister publication, Government Technology. He was previously the editor of Public CIO, e.Republic’s award-winning publication for IT executives in the public sector, and is the author of several books on information management.