Heroin is a highly addictive and illegal opioid drug that is derived from morphine, a natural substance extracted from the seed pod of certain varieties of poppy plants. Heroin can be injected, smoked, snorted, or inhaled, and produces a euphoric rush followed by a state of drowsiness and relaxation. However, heroin also has serious and potentially fatal consequences, such as overdose, infection, addiction, and withdrawal.
According to a recent study by the RAND Corporation, a nonprofit research organization, the United States consumes more than 80% of the world’s heroin, spending about $43 billion on the drug in 2016. The study also estimated the heroin consumption rates of 25 major U.S. cities, based on various data sources such as drug seizures, drug purity, mortality, and wastewater analysis.
The study found that San Francisco had the highest heroin consumption rate among the 25 cities, with an estimated 16.5 metric tons of pure heroin consumed in 2016, equivalent to about 2.3 grams per person per year. This is more than twice the national average of 1 gram per person per year, and more than four times the consumption rate of New York City, which ranked second with 4 metric tons of pure heroin consumed in 2016.
Why San Francisco?
The study did not provide a definitive explanation for why San Francisco has such a high heroin consumption rate, but suggested some possible factors that may contribute to the situation. These include:
1.) The availability and affordability of heroin in the city, which is influenced by the proximity to Mexico, the main source of heroin for the U.S. market . The study estimated that the average price of pure heroin in San Francisco was $267 per gram in 2016, lower than the national average of $374 per gram.
2.) The presence of a large and diverse population of heroin users in the city, including homeless people, injection drug users, and people who use heroin in combination with other drugs, such as methamphetamine, cocaine, or fentanyl . The study estimated that there were about 24,500 heroin users in San Francisco in 2016, representing about 3% of the city’s population.
3.) The lack of adequate and accessible treatment and prevention services for heroin users in the city, which may limit their options and motivation to quit or reduce their heroin use . The study estimated that only about 6,000 heroin users in San Francisco received medication-assisted treatment, such as methadone or buprenorphine, in 2016, leaving a large gap between the demand and supply of treatment.
What are the consequences?
The high heroin consumption rate in San Francisco has significant social, economic, and health impacts on the city and its residents. Some of the consequences are:
1.) The increased risk of overdose and death among heroin users, especially those who use heroin contaminated with fentanyl, a synthetic opioid that is 50 to 100 times more potent than morphine . The study estimated that there were 134 heroin-related deaths in San Francisco in 2016, accounting for about 17% of all drug-related deaths in the city.
2.) The increased burden on the public health system and the emergency services, due to the high demand for medical care, harm reduction, and overdose prevention interventions for heroin users . The study estimated that the total health care costs associated with heroin use in San Francisco were $232 million in 2016, including $77 million for hospitalizations, $72 million for emergency department visits, and $83 million for other health care services.
3.) The increased social and environmental problems, such as crime, violence, homelessness, and public disorder, related to heroin use and trafficking in the city . The study estimated that the total criminal justice costs associated with heroin use in San Francisco were $54 million in 2016, including $19 million for police, $18 million for courts, and $17 million for corrections.
Conclusion
San Francisco is facing a serious and complex challenge of heroin use, which affects not only the users themselves, but also the city as a whole. The study by the RAND Corporation provides a comprehensive and reliable estimate of the heroin consumption rate in the city, as well as the associated costs and consequences. However, the study also acknowledges the limitations and uncertainties of the data sources and methods used, and calls for more research and data collection to improve the accuracy and validity of the estimates.
The study also suggests some policy implications and recommendations for addressing the heroin problem in San Francisco, such as:
- Expanding and improving the availability and quality of treatment and prevention services for heroin users, especially medication-assisted treatment, which has been proven to be effective and cost-effective in reducing heroin use and its harms .
- Enhancing and coordinating the efforts and resources of various stakeholders, such as law enforcement, health care, social services, and community organizations, to prevent and reduce heroin supply and demand in the city .
- Evaluating and monitoring the impact and outcomes of the existing and new policies and programs for heroin use, and using the evidence and feedback to inform and adjust the strategies and actions .
By taking these steps, San Francisco may be able to reduce its heroin consumption rate and its negative effects, and improve the health and well-being of its people and its environment.