“The quality of heroin now is such that it can not only be injected, it can be insufflated (inhaled or snorted), or smoked. There was always a social stigma, a syringe user was shunned, but now it can be used in a way that is more acceptable for some people,” he said.

The drug is also more potent than it used to be, and a recent trend across the country has seen heroin boosted with fentanyl, a powerful synthetic drug that makes heroin use even more dangerous.

“It is far more potent than it was and because it can used in ways other than injection, it’s more likely to be a drug tried out by people who would normally have stayed away from it,” McNamara said.

Another contributing factor to the drug’s increasing popularity could be its use by those who started out using prescription drugs but then lost their source or for whatever reason are unable to get those drugs any longer.

“Many heroin addicts start off with prescription drugs and when they can’t get them, if given the opportunity to use heroin, they will,” McNamara said. “They’re using what they can just to get something in their system.”

The drug is both physically and psychologically addictive, Haury said, and breaking an addiction to it can be brutal.