Linking Heroin’s Recent Rise to the Fall of America’s Pill Mills

The death of Philip Seymour Hoffman from a suspected heroin overdose over the weekend has triggered a slew of articles reporting on an apparent surge in heroin sales in New York and around the country. What’s behind the uptick?

One theory, raised by several national outlets this week, including CNN, is that law enforcement’s effective crackdown in recent years against the illegal sale of prescription painkillers has created a black-market shortage, driving up the street price of opioid pills and inadvertently boosting demand for heroin as a cheap, available alternative.

It’s a theory that’s been quietly percolating for the past year in a place that’s long been on America’s front lines of prescription opioid abuse: Florida.

Not long ago, we wrote at length about Christopher and Jeffrey George, twin brothers in Florida who, according to federal authorities, were the largest illegal dispensers of oxycodone in the U.S. from 2008 to 2010. Local and federal authorities shut down the brothers’ chain of so-called pill mills—storefront pain clinics that sold large numbers of prescription painkillers to just about anyone—as part of a heightened effort to stamp out the illegal flow of prescription opioids around the state. Last year, in the aftermath of the crackdown, articles began to surface in Florida linking the resulting drop in prescription painkiller availability to a rise in heroin abuse.

“The state’s war on pill mills is making an impact, but there’s a troubling byproduct: a surge in the number of people now hooked on heroin,” the Sun Sentinel reported in February of last year. “Heroin is inching back in Florida, the unintended consequence of the state’s epic war on prescription pills,” according to a Miami Herald story in May. “Heroin use is on the rise in Florida and across the nation, an unfortunate side effect of the crackdown on pill mills,” Fox 13 in Tampa reported in August.

Now, in the wake of Hoffman’s death, the problem is for the first time receiving much broader, national attention, including a front-page article in today’s New York Times. “What we’re seeing, as pills become more difficult to access, is a shift to the black market and heroin,” Dr. Andrew Kolodny, chief medical officer at the Phoenix House Foundation drug-treatment center and president of Physicians for Responsible Opioid Prescribing, told the Times. “It’s not easy to get the opioid genie back into the bottle.”

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