The drug is hitting New England especially hard, where overdoses are spiking and a new, even more dangerous form of heroin is killing people. Chicago suburbs have also seen a dramatic increase in fatal heroin overdoses.
Heroin use spiked in 2006, dropped back down in 2008, and has risen steadily after that to reach record highs in 2012, according to data from the Substance Abuse and Mental Health Services Administration. In 2012, an estimated 669,000 people used heroin.
Lawmakers and politicians in New England have called the increase in heroin use a crisis.
There are several likely explanations for why heroin has become more popular and spread to the American suburbs. Interestingly, the prescription drug epidemic is partly to blame for the spike in heroin use.
As painkillers increased in popularity in U.S. suburbs, states began cracking down on abuse, making the pills more expensive and less readily available than they once were. This crackdown has provided an opportunity for Mexican drug traffickers to push heroin in the U.S. Heroin provides a similar high to painkillers, and it's a lot cheaper.
For some suburbanites who start out using prescription drugs, like one high school student The Christian Science Monitor interviewed, it's easy to switch to heroin because it's so much more readily available than painkillers.
The National Institute on Drug Abuse points out that three recent studies have found nearly half of young people who inject heroin reported abusing prescription opioids before starting to use heroin.
Heroin might also be more enticing to first-time users because these days it can be inhaled or smoked rather than injected with a needle, which is stigmatized and particularly risky. Eventually, once users are hooked on heroin, they typically move to IV use because it's more efficient.
Heroin still isn't as widely used as marijuana, prescription pills, or cocaine, but it has a higher dependency rate and is more likely to cause fatal overdoses than some other drugs.