Heroin Policy for the Next Decade

The supply of heroin in the United States appears to have grown substantially in recent years, although it is not clear what impact this has had on consumption. Conventional indicators have shown only modest increases, but for a variety of reasons one would not expect increases even if we are in the early years of a new heroin use epidemic. It is even less clear what, if anything, should be done. Drug control resources are finite. Making heroin a new policy focus may impose substantial opportunity costs as resources are diverted from other worthy programs. On the other hand, the history of cocaine in the late 1970s and early 1980s demonstrates that “wait and see†can be an extremely expensive option. A prudent course may be to implement relatively low-cost interventions that one would not regret undertaking even if a new epidemic never materialized and to enhance monitoring. If these enhanced monitoring programs gave strong signs of increasing use, particularly by new users, bolder interventions might be warranted.