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The Global Heroin Epidemic's Impact on the United States:

In the United States, this competition between heroin suppliers brought unprecedented levels of heroin purity. "During the [1980s]," states the Drug Enforcement Administration, "the purity of street heroin ranged from one to ten percent; more recently, the purity of heroin, especially that from South America, has skyrocketed to rates as high as 98 percent."This newfound purity brought significant changes in the way the drug was used. In the past, when heroin had been of low strength, its use was limited to those who were willing to inject the drug to obtain a strong high. With this dramatic increase in the purity of heroin during the 1990s, however, it became possible for beginning users to use noninjection methods to obtain an extremely strong dosage of the drug. One method that gained popularity was the snorting of "lines" of heroin in the same manner that cocaine was used. Another popular method was heroin smoking, often referred to by users as "chasing the dragon" because of the curly, dragonlike wisps of smoke that rise from burning heroin.

This ability to use heroin through noninjection methods made the drug far more attractive and less frightening to many Americans.

Heroin came to have connotations of style and glamour with increasing numbers of middle- and upper-class adults, just as cocaine had in the 1970s and 1980s. Though heroin was still available on the streets of the inner city in twenty-five to fifty-dollar bags, spoons, or balloons, under nicknames such as H, horse, boy, skag, and smack, it was now also sold in chic nightclubs and suburban living rooms. A 320 percent usage increase between 1992 and 1994 alone created an unprecedented heroin epidemic in the United States, with entirely new demographics of users.

The drug's new popularity among adults was matched by increased heroin use among the nation's teens, as evidenced by the nearly quadrupled number of heroin-related emergency room episodes among youths aged twelve to seventeen between 1991 and 1995. Widespread addiction resulted among many of these illinformed young users. Dr. Alan Leshner, director of the National Institute on Drug Abuse (NIDA), notes, "Many young people have a naive belief that because they are snorting or smoking heroin and not injecting it, their heroin use is not addictive. This is a dangerous misconception."Throughout the 1990s, a growing number of young heroin users found that they had grossly misjudged the drug's addictiveness, and that their once-casual use had quickly become a daily habit. In 2000, statistics confirmed what health officials had feared about the widespread experimentation with heroin among teens: increasing numbers of them were turning to injection as a more efficient means of using the drug. Further, many adult users who had previously avoided the drug because of the social stigmas attached to the use of needles now found that they, too, had insatiable intravenous heroin habits—because their fear of injecting the drug had been surpassed by their fear of the drug's painful withdrawal symptoms.

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