Iowa's Well-Intentioned Prescription Drug Crackdown Sparks Heroin Problem

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Iowa's crackdown on prescription pills has inadvertently backfired, instead turning users to heroin because it’s cheaper and more potent.

Fatal heroin overdoses throughout the state have jumped from one per year in the early 2000s and 19 last year. The New Hampshire Union Leader reported that heroin, either alone or in combination with other drugs, was responsible for 97 deaths in 2014.

Data from the U.S. Drug Enforcement Administration highlights that cost plays a major role in this. While a single pill of OxyContin can cost as much as $80 on the streets, a bag of heroin will sell for about $10.

The surge in cost came last October, when the Iowa Board of Pharmacy followed identical DEA protocol by classifying hydrocodone pills as a Schedule II drug. That meant prescribers could only give out one hydrocodone refill at a time instead of the previous five refills in a six-month period.

“They never started out as a heroin junkie,” said Pat Reinert, assistant U.S. attorney for Iowa's northern district office. “Nobody does."

Perhaps unsurprisingly, drug rehab clinics are now seeing all-time highs for heroin admissions, rising from .60% of all admissions in 2004 to 2% this fiscal year. Young people between ages 25 to 29 remain one of the highest demographics of heroin addicts seeking treatment.

“A lot of them were prescribed this medication to start with—for the younger people, it was a sports injury,” said Elie Hays, a counselor. “I’m not saying they didn’t have addiction tendencies earlier, because some may have been using marijuana at a younger age ... But I don’t think they think of it as their fault to start with. They just want to get better.”

Emergency medical personnel have also been required to address the problem head-on by carrying and learning how to administer the opiate overdose reversal tool known as naloxone. But the medication has been on the national shortage list for the last three years, leading the cost of a dose to double in the last year from $14 to $34.35.

“We have to over-buy that stock because I can’t keep it in our vending machines fast enough. We’re probably using triple what we usually use,” said Tony Sposeto, with the emergency medical services time in Des Moines, Iowa. “It’s definitely a life-saving drug, and one you can’t do without.”