Also false. It's probably more of an epidemic in the poor/lower middle class black communities now than it ever was before. It has been spreading out into the suburbs since the late 1960s/1970s, and hasn't really stopped. Though the most out of control use is still concentrated in urban areas.
There are effectively three separate groups of "typical" opiate abusers.
1) The heroin-only group tended to be the most socioeconomically disadvantaged, were more likely to be minorities, had more physical problems, and more likely to live in large urban communities. They were also more likely to have gotten in trouble with the law. Typically they did not get started through abusing medication. While their numbers have increased, its been the smallest amount statistically over the last decade in the US.
2) Those who used both heroin and prescription pain killers. They tend to report more mental health problems and were more likely to visit the ER than either of the other groups due to overdose. People in this group were also most likely to have started using drugs in their teens and experience more severe substance problems overall. This is the group that is causing the most concern among political leaders in the US because they occur in previously "safe" or "drug free" communities.
3) The group who only used prescription painkillers. They are more likely to be married or employed, are the least socioeconomically disadvantaged and have less criminal justice involvement. They don't typically have the same mental, physical, and social problems of the other two groups and are least likely to live in large urban areas.
The largest group of drug abusers is group 3, but they receive the least attention. Group 1 is the one people imagine when they speak of opiate abuse, but they are the smallest population of users.
The major gateway to heroin now is abuse of prescription drugs.
One needs to have access to healthcare to get prescribed opiates. The way the US government pays for drugs mean that people on Medicaid are less likely to get prescriptions (US government is not allowed to negotiate for drug prices under this program so drugs are much more expensive). Under Medicare and the Veteran Administration, the government can negotiate with pricing of drugs.
We see this played by the fact that disabled vets and older people are prescribed opiates at a much higher rate than poor people. This in turn could explain why opiate abuse is higher among those two groups, per surveys performed by various government agencies, compared to younger, poor people. But to be clear, poor addicts are typically starting with heroin, whereas more middle and upper class users start with medication and then move onto heroin because of the costs in maintaining the addictive behavior.
Also false. It's probably more of an epidemic in the poor/lower middle class black communities now than it ever was before. It has been spreading out into the suburbs since the late 1960s/1970s, and hasn't really stopped. Though the most out of control use is still concentrated in urban areas.
Your perspective here is not supported by statistical reports by researchers. There has been a major generation and social shift between the average heroin user between different decades. Per dealers not typically being addicts, your perspective is akin to having a weed man that doesn't smoke weed. I am not saying that all peoples involved in illicit drug trade are addicts. The risks involved in being a low level dealer effectively means that only desperate people tend to do it. Once you go further up the supply chain, addicts are no as common.
These are just my opinion of course, but if you do a search for research by governments in EU and the US, much of their research aligns with my thoughts on this matter.
