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I was in high school in the late 1960s when the news began to report on soldiers from the war in Vietnam coming home addicted to heroin. Now, most troops didn’t take heroin but there was enough to make it something to talk about. This may have been the beginning of America’s modern day awareness of heroin addiction.

I remember those days and how the drug seemed so awful, especially because it was associated with injection, crime, and a lifestyle that most of us can’t relate to in the least. Then Hollywood took over and showed us a sometimes realistic and sometimes exaggerated view of heroin use. I’d say we had a very negative view of heroin and everything related to it. I’d also say that I was afraid of the drug and would never have tried it. My reaction then was kind of like the reaction of many kids today with methamphetamine. I saw it as a “dirty” drug.

But times change and people sometimes forget. Heroin addiction and related problems have never gone away but our general consciousness about the drug waned for a number of years. I remember when I first moved to northern Nevada 25 years ago, the prevailing wisdom was that there were very few heroin addicts in the area. Not true.

Fast forward to a year or two ago. Painkilling, opiate based prescription drugs are becoming a much talked about issue. At the same time, we begin to notice that youth coming to treatment are showing up more and more for heroin. Adults, too. But this is a smokable heroin. The old fashioned heroin “junkie” of the 60s and 70s seems gone.

But what happened that heroin just seemed to jump back on the drug scene? First of all, it never left. But I will say that I think today it’s reaching a wider audience and, like the heroin epidemic of the 60s, we’re noticing it more because it’s affecting younger people and even teens. And for some, injection is still part of the culture of use.

What’s different now is that we are seeing a pattern of use that seems to start (for many) with prescription painkiller use. Then, for some, abuse. Finally, for some of those that abuse, heroin. So far we’ve been seeing and hearing about smokable heroin. But now treatment providers and others are noticing more injection use of the drug, as well.

I bring this up because while we’ve been focusing on methamphetamine and more recently on prescription drugs, heroin has been making a major comeback. JTNN is looking into the reasons and will be reporting more as we learn more from the data. But for now, we are looking at the fact that heroin use and addiction is still with us. More to come later.