A New "Heroin Epidemic"?

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Abstract
In New York City and elsewhere in the USA, there were many indirect indications that a new heroin epidemic was probably on the way. To what extent the decline in incidence of new heroin users and the number of active abusers in 1970-1972 was due to decreased availability of heroin or to the increased availability of acceptable treatment programs, including methadone maintenance and drug-free modalities was not clear. The decline in the heroin epidemic of the mid to late 1960s, preceded the heroin shortage of 1973. In the 1970s there was a rapid proliferation of addiction treatment services, especially of methadone maintenance programs. Personnel requirements during this rapid exceeded the availability of physicians, nurses, counselors and ancillary personnel. Over the past 2 yr (1973-1975) there have been substantial reductions in funding of treatment programs by federal, state and local governments, reducing the overall availability of treatment facilities. Federal guidelines for methadone maintenance treatment have been promulgated, placing unacceptable constraints on rehabilitated patients. Many successfully treated patients have left methadone maintenance treatment; many have turned to alcohol and polydrug abuse, and substantial number have returned to heroin abuse. The full impact of the recent increased availability of heroin cannot yet be anticipated. It is projected that by fall 1975 there would be increasing numbers of patients with addiction as a primary problem.

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