Since PSH’s death I’ve been thinking about all the people I have known that followed a similar path. People who had years of abstinence from drugs and alcohol and returned to using. People who then sometimes accidentally died from an overdose.
Some of these random thoughts led me to write here about what I know from my experience and to look into some more recent findings that may or may not be relevant to PSH but are relevant to the drug culture in the United States as it stands today. Add the following factors up and you have our present predicament.
1. A path from pain killers to heroin?
In the media there are reports that Hoffman had been using pain medications prior to his use of heroin. A recent report from the Substance Abuse and Mental Health Services Administration (SAMSHA) notes that prior non medical use of prescription pain killers increased the likelihood of people initiating heroin use 19 times in the age group from 12-49.*
2. The new heroin: too much of a bad thing
In case you haven’t been up on the news regarding heroin, it is more potent and in greater supply than ever before. According to the US Drug Enforcement Administration’s System to Retrieve Information from Drug Evidence (STRIDE) between 1992 and 2007 (the last year that data was publicly available) the purity of heroin increased by 60% and the price decreased by 81%. (Similar trends can also be found for cannabis and cocaine.) Essentially you can get better heroin for less money. Word on the street is that a bag of heroin that was once $20 is now $10. For PSH cost was not an issue but purity may well have been.
3. The whole is greater than the sum of its parts
Several prescription drugs were also found in PSH’s apartment. Several drugs in combination with heroin might have contributed to his death. Polydrug intoxication can become lethal when two or more drugs in combination have a greater effect than each would have had if used alone.
4. Alone and using again
And then there is the prospect of the person using alone, isolated from those he or she loves. Where does the impulse to use take over in the face of losing all that one has in life- home, children, partner, successful career, friends? Heroin is not a drug that is recreational. It is a drug of annihilation; the pleasure is in a total escape from the pain of existence. It is fueled by shame. It feels better to be alone when you are ashamed of what you are doing. It also makes it harder to find you in time if you get in trouble with more potent heroin.
As a result
Being at home alone and using a drug of unknown potency possibly with other drugs and alcohol can be a lethal combination. Unfortunately this was the result for Phillip Seymour Hoffman and for all the other not-so-famous people who are dying in similar ways every day.
It doesn’t have to be this way…..
*Substance Abuse and Mental Health Services Administration, Center for Behavioral Statistics and Quality Data Review. (2013, August). Associations of Non-Medical Pain Reliever Use and Initiation of Heroin Use in the United States. Retrieved from http://www.samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.pdf