Heroin is a powerful opiate that can be smoked, snorted, inhaled, or injected intravenously, and unsurprisingly, is the deadliest drug in the world. domjaves/Shutterstock.

The US is currently in the grip of a major public health crisis, often called the “opioid epidemic”. Much of the media attention understandably focuses on the comparatively new threats of fentanyl and legal prescription drugs like oxycodone, but new research shows that heroin use has reached a 20-year high in the US. Not only that, "the devil's drug" is now costing the US upwards of $51 billion a year.

Millions of Americans getting hooked on heroin is leading to huge social and economic costs, not just massive personal costs, according to the new study by the University of Illinois at Chicago, recently published in the online journal PLOS ONE.

"The opioid crisis didn't happen overnight," lead author Ruixuan Jiang said in a statement. The number of heroin users doubled between 2000 and 2013, rising from one heroin user per 1,000 people to two. Currently, over 1 million people are addicted to heroin in the US alone.

It’s thought the societal cost of each heroin user is $50,799 per year, considering the chronic health complications associated with using heroin, infections from needle sharing and “high-risk” sexual behaviors, drug-related hospitalizations, high rates of days off from work, and unemployment. That adds up to a total of $51.2 billion.

In terms of the link between heroin and health, chronic obstructive pulmonary disease cost $38.5 billion for 15 million patients, and diabetes $248.59 billion for 22.3 million patients. This rise in heroin use also brings a surge of overdoses, deaths, and hospitalizations. In fact, deaths from heroin overdoses have quadrupled since 2010.

Remember, this is not an issue of victim blaming. The "war on drugs" mindset and the idea that drug use is an individual's choice has evidently failed to both address and understand the problem. Opioids are a societal problem, created by society and dealt with by society.

The research also found heroin use is crawling out of the cities and becoming far more prevalent in rural areas, often where public health is harder to access.

One of the study’s lead researchers, pharmacoeconomist Simon Pickard, says this problem is only going to continue to spiral out of control unless strong public health efforts are taken. This could range from needle-exchange programs or, more ambitiously, tackling the roots of opioid addiction, such as poverty and lack of access to education.

"The downstream effects of heroin use," Pickard said, "such as the spread of infectious diseases and increased incarceration due to actions associated with heroin use, compounded by their associated costs, would continue to increase the societal burden of heroin use disorder."