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switched to heroin are at high risk for accidental overdose because unlike with prescription drugs, heroin purity and dosage amounts vary, and heroin is often cut with other substances like fentanyl (House of Representatives, 2015). The magnitude of the opioid epidemic has driven this prob- lem to the forefront of many law enforcement agency’s concerns. As part of the House of Representatives (2015) hearings, the DEA reported the percentage of law enforcement respondents who reported heroin as the greatest drug threat in their area had grown from 8 percent in 2007 to 38 percent in 2014. Several approaches have been attempted across the U.S. to deal with this vexing social issue. The default option for handling opioid use and associated crimes like theft, trespassing, and va- grancy is arrest and incarceration. This approach, however, has been insufficient alone in solving the problem. Arrest, incarcera- tion, and release results in a vicious cycle of offender recidivism without solving the underlying problem. Lieutenant Leslie Mills of Washington Department of Corrections captures the essence of the problem, stating: We could not incarcerate these people or arrest our way out of the problem. You want to arrest a person, they’d be in jail for 20-30 days. They would get sober. They would start using again, we’d continue to arrest them (Frontline, 2015). As a result, local law enforcement agencies have ap- proached opioid addictions with many different non-traditional responses, including: / Routing drug cases through state drug courts rather than traditional criminal courts (ONDCP, 2017). / Equipping law enforcement officers with naloxone to provide immediate life-saving means to those arriving to the scene of drug overdoses (ONDCP, 2017). / Law Enforcement Assisted Diversion (LEAD) and other diversion programs focused on treatment over incarceration (Frontline, 2016).

Quinones, author of Dreamland , stated on Frontline (2016), “the cartels were the first to realize that the pill market was essential- ly priming the heroin market.” This is supported by a statement from the National Institute on Drug Abuse that: Mexican heroin production increased from an estimated 8 metric tons in 2005 to 50 metric tons in 2009—more than a six-fold increase in just four years. Domination of the U.S. market by Mexican and Colombian heroin sources, along with technology transfer between these suppliers, has increased the availability of easily injectable, white powder heroin. In a recent survey of patients receiving treatment for opioid abuse, accessibility was one of the main factors identified in the decision to start using heroin (House of Representatives, 2012). As a result of persistent demand for opioids, combined with the inability to obtain these drugs through other means, the number of deaths from illicitly manufactured and supplied heroin and synthetic opiates has skyrocketed. The National Cen- ter for Health Statistics reported that overdose deaths involving opioids rose from 28,647 in 2014 to 33,091 in 2015, with overdose deaths attributed to heroin increasing 23 percent and overdose deaths due to synthetic opioids increasing 73 percent (ONDCP, 2015). In 2015, the House of Representatives (2015) held another hearing to address America’s growing heroin epidemic. This hearing revealed that: / Increased demand for, and use of heroin is being driven by both increasing availability of heroin in the U.S. market and by individuals with opioid use disorders using heroin (House of Representatives, 2015). / The majority of new users come to heroin with experience as nonmedical prescription drug users, while previously, heroin had largely been confined to urban centers with large heroin using populations (House of Representatives, 2015). / Individuals with opioid use disorders who have recently

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