U.S. heroin overdose deaths have risen more than sixfold in less than a decade and a half. Yet one of the most widely cited sources of data on drug use says the number of Americans using heroin has risen far more slowly, roughly doubling during the same time period. Researchers believe that the National Survey on Drug Use and Health vastly understates the increase in heroin use, reports Five Thirty Eight. Many rely on the survey anyway for a simple reason: It’s the best data they have. The lack of data means researchers, policymakers and public health workers are facing the worst U.S. drug epidemic in a generation without essential information about the nature of the problem or its scale.
“We’re simply flying blind when it comes to data collection, and it’s costing lives,” said John Carnevale, a drug policy expert. There is anecdotal evidence of how patterns of drug use are changing, Carnevale said, “But the national data sets we have in place now really don’t give us the answers that we need.” Among key questions: Is the recent spike in deaths primarily the result of increased heroin use, or is it also due to the increased potency of the drug, perhaps because of the addition of fentanyl, a synthetic opioid that can kill in small doses? “Everyone thinks they know the answer,” said Prof. Daniel Ciccarone of the University of California, San Francisco’s medical school. “Well, show me the data. … When you don’t have data that leads to rational analysis, then what you’re left with is confusion, and confusion leads to fear, and that will lead to irrational consequences.” The National Survey on Drug Use and Health is based on 70,000 interviews, but the survey excludes people without a fixed address, meaning people who are homeless or transient — a category that includes many of the heaviest drug users.