From the beginning, the federal decade-long crackdown on prescription drug abuse has run an unsettling risk: that arresting doctors and shuttering “pill mills” would fuel an epidemic of heroin use, reports the Washington Post. State and federal officials have pressed the campaign against prescription drug abuse with urgency, trying to contain a scourge that kills 16,000 people yearly. The crackdown helped reduce the illegal use of some medications and raised awareness of their dangers. At the same time that pain medications have become less available on the street and pricier, many users have switched to cheaper heroin, because prescription pills and heroin provide a comparable, euphoric high. With the heroin problem gaining more attention after the death of actor Philip Seymour Hoffman from heroin and other drugs, experts say the federal actions contributed to the problem.
The war on drugs, they say, is a conflict where targeting one illicit substance can be an unintentional boon to another. “Absolutely, much of the heroin use you're seeing now is due in large part to making prescription opioids a lot less accessible,'' said psychiatry Prof. Theodore Cicero of Washington University in St. Louis. He co-wrote a 2012 study, cited in the New England Journal of Medicine, finding that a reformulation of OxyContin to make it harder to abuse caused heroin use nearly to double. Although policymakers “did the best they could at the time” in fighting prescription drug abuse, he said, “there were signs years ago that this was going to happen, and there was just a lot of inaction.” He said the government could have acted sooner to mitigate heroin's toll, by promoting the use of medicines to fight overdoses and ease withdrawal symptoms. Gil Kerlikowske, who became President Obama's drug czar in 2009, said the connection between prescription drugs and heroin “was not on the radar screen” during most of Obama's first term and that he “didn't do everything I should have” to raise awareness of the growing heroin problem. Now, he said, heroin is a “much larger concern.”