The death of Philip Seymour Hoffman last week, apparently of a heroin overdose, says a lot about the epidemic of opiate abuse gripping the United States.
That epidemic, which I've spent the last year researching for a forthcoming book, is rooted in a 20-year revolution in medicine that has resulted in far wider prescribing of opiates. Narcotic painkillers are now prescribed for chronic back and knee pain, fibromyalgia, headaches, arthritis and other ailments. According to the Centers for Disease Control and Prevention, consumption of these opioids has risen 300% since 1999, making them the most prescribed class of medicines in America.
After Hoffman's death, reports surfaced that the actor, a onetime heroin addict, had been abusing prescription opiates, which ultimately led him back to heroin. That's a common path, in part because of economics.
On the street, opiate pain pills sell for $1 a milligram, according to police and addicts I've interviewed across the country. An addict can need 150 to 300 milligrams a day. A comparable high from heroin is a fifth to a tenth the price, which is part of the reason its use has almost doubled between 2010 and 2012, officials say.
Marketing is another big part of today's heroin story. Heroin is a commodity. To differentiate their product, dealers market aggressively, which has helped propel its spread.
I read that packets stamped with the Ace of Spades brand were found in Hoffman's apartment. In the classic East Coast heroin markets — New York City above all — dealers can't fully control the quality of their imported product. So they brand, which allows a trafficker to create buzz for a commodity that he'd have a harder time selling in an unmarked baggie.
Among the most prolific heroin traffickers in America today is a loose-knit entrepreneurial group I've been researching from the tiny county of Xalisco in the Mexican state of Nayarit, where opium poppies flourish. They market through customer service.
Police and rehab counselors say that many new addicts are middle-class white kids reluctant to venture to skid row or some menacing drug house to procure drugs. So the Xalisco Boys, as a Denver police narcotics officer has dubbed them, have dispatchers take calls and send drivers to meet addicts at suburban strip malls — delivering dope like pizza.
They give out free samples outside methadone clinics, customers tell me, and offer deals: one balloon of heroin for $20 or seven for $100, thus turning addicts into salesmen, hustling enough orders to get the price break. Some dealers even call their buyers later to make sure they're happy. If addicts get a bad (read: less potent) dose, they can complain to customer service and get a free replacement.
Try doing that on skid row.
Their customer-focused marketing has helped the Xalisco Boys expand to 20 states and fuel a surge in heroin in cities that include Indianapolis, Nashville, Charlotte, N.C., and Columbus, Ohio.
Hoffman was the second celebrity to have apparently overdosed on heroin recently; Cory Monteith, of the TV show "Glee," died in July. Each time, news shows have discovered the supposedly new surge in heroin, which is really about a decade old.
But that's the point: This epidemic has spread in part because it's quiet.
Most drug scourges come with public violence. As a crime reporter in Stockton in the early 1990s, I wrote about crack-related drive-by shootings, carjackings and gang feuds. But with this opiate epidemic, the private home, like the one where Hoffman died, has replaced the public crack house. It seems the drug has narcotized public outrage, along with millions of young Americans.
Keep in mind though: Since the rise of the American automobile, traffic fatalities have been our leading cause of accidental death — until now. More people now die of drug overdoses — about 38,000 a year, according to the latest numbers from the National Center for Health Statistics. The largest category of drugs represented within that number is prescription opioids (16,000 roughly), according to the CDC.
So in the last seven months, I'm guessing something like 10,000 Americans who weren't famous died from overdoses of opiate painkillers or heroin.
Meanwhile, many parents' lives are mangled though their children remain alive. Their kids have shape-shifted into lying, thieving slaves to an unseen molecule, and these parents await calls that a daughter has been arrested for hooking or that a son overdosed in a McDonald's bathroom. These parents' pain is as searing as the chronic pain that doctors treat with opiate painkillers. No one talks much about it — not even the ashamed parents — until a celebrity dies.
That's changing. I've met parents who are organizing — from Simi Valley to Portsmouth, Ohio, — because crying in a bedroom, arms around a photo album, makes no sense to them. But they have day jobs, and powerful market forces are arrayed against them.
So here's hoping that Hoffman's death, which encapsulates much of this epidemic, will also rouse us to a thing that is deadlier and quieter than any drug plague we've seen before.