This past Sunday, as our nation readied itself to partake in the annual Super Bowl ritual of food, spirits, commercials and, of course, football, a man lay dead in his apartment across the river from MetLife Stadium. Too many chicken wings, Bud Lights and blue-green Skittles? Not at all. This man died from a presumed heroin overdose, possibly from a batch of heroin laced with fentanyl, which has caused numerous deaths in the past few months.  See the CBS News report here.

Paradoxically, as the focus on prescription drug abuse has tried to limit illegal access to opioid medication, those who are addicted to narcotics have turned to using heroin, as it has become cheaper to purchase than opioids. Pharmaceutical companies have reformulated their products to limit tampering and decrease the ability for pills to be used as street drugs. As a consequence, this has led to what some governors are calling a ”heroin crisis” in their states.

New Hampshire is caught in this deadly cycle of small towns, big business, cheap heroin, overdose and death. In 2012, 21 heroin deaths occurred in Maine, while New Hampshire had almost 40. Some of the terms to consider include used needles, Hepatitis C, HIV, prostitution, burglary and prison.  See The New York Times story here.   

One of the big questions that physicians must ask themselves is whether we are part of the problem, as prescribing more pain medication than is needed for longer than is needed can fuel this potential for opiate addiction and eventual street drug calamity. Clearly, not all heroin use comes from prescription medication use, but the connection is there.

Phillip Seymour Hoffman, at the time of his death on Sunday, was 46 years old; he was found in his bathroom with a needle sticking out of his arm. Elvis Presley died in his Graceland bathroom in August 1977 at the age of 42 with a rumored addiction to Valium, codeine, morphine and Demerol. Drug addiction and death can happen to anyone if the circumstances are wrong. Let’s learn from the present and past to protect the future.


Stuart J. Glassman, MD

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