The Truth About Teens and Heroin

By Tony O'Neill 08/29/12

More teenagers are using heroin than ever before, thanks in part to the opiate introduction they’re getting prescribed. Just another way the War on Drugs is missing the mark.

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Teenage wasteland Photo via

It was the British novelist LP Hartley who famously wrote, “The past is a foreign country, they do things differently there.” Nowhere is this truer than in the world of the junkie, where the landscape changes so quickly and dramatically that the dope fiend of 1998 now looks like some lumbering victim of evolution to the younger using set. 

The most startling thing about the new breed of heroin addict is both their age and social status. Newspaper reports from across the country tell us that heroin use is skyrocketing among middle class, suburban teens. From La Crosse, Wisconsin to Chicago, Illinois, the stories are eerily familiar: suburban teens are turning to heroin in greater number than ever before, after first getting their habit going with prescription painkillers. NBC News’ recent piece on rising teen heroin use only served to confirm the narrative: the spiraling use of painkillers among teens is leading to an epidemic of heroin use. Indeed, by the DEA’s reckoning, Americans consume 40 percent of the prescription drugs in the world, despite only making up four to five percent of the population.

It’s little wonder that a generation weaned on prescription opiates would soon turn to heroin. The cost ratio is stark. According to, a user-contributed site that collates “the latest street prices for prescription drugs,” the standard black market cost of Oxycodone is approximately one dollar per milligram. By contrast, heroin in New Jersey can go for as low as $50 dollars a bundle (approximately one gram) and, according to anecdotal evidence on forums like opiophile and bluelight, a 0.1 “stamp” of heroin can run as little as five bucks and can be snorted or injected without any of the added hassle of grinding and filtering pills.

When they’re broke and withdrawing, risking that shady five-dollar bag of dope suddenly seems a whole lot more appealing to the novice user.

Then there’s this: according to the Substance Abuse and Mental Health Services administration [SAMHSA], initiations to heroin have increased 80 percent among 12- to 17-year-olds since 2002. More troublingly, young people are dying in greater numbers, too. In 1999, the number of fatal overdoses in young people between 15 and 24 was 198. Ten years later, it had risen to 510. 

Frank Greenagel has been on the front line of this issue in New Jersey, a state whose officials claim its rate of heroin abuse is twice the national average. Greenagel is a recovery counselor at Rutgers University—the site of the oldest Recovery Housing program in the world—and the current chair of the New Jersey Task Force on Heroin & Other Opiates.

He tells me that when he was hired in 2009, there was one student with an opiate problem. At a time when the program mostly consisted of young people struggling with alcohol use or drugs like marijuana or cocaine, a heroin addict on campus was considered something of a novelty. “Then, in 2009 and 2010, more and more young people started coming in strung out on Oxy,” Greenagel says. “I was amazed at how many people were suddenly coming into the program with opiate addictions. During the fall of 2011, eight out of 32 were on campus with various opiate addictions, heroin included. This year, we have 22 kids in recovery housing and the majority of them—12 in all—are addicted to either heroin or pain-pills.”

Heroin has been around for a long time. How does Greenagel account for the recent upswing in popularity?  

“Look, a lot of these kids wouldn’t have tried heroin because of the name,” he muses. “It has that whole inner city, needle association. But a pill? Something created in some multi-national corporation’s pristine laboratory? Their grandmothers take this stuff; it’s the same goddamned thing! They’ll take a pill made by Perdue before they’d buy a bag of dope from a stranger in an alley.” 

But financial imperative often makes the switch inevitable. “Around here. a 25 milligram pill costs 25 bucks on the black market,” Greenagel says. “When they’re broke and withdrawing, risking that shady five-dollar bag of dope suddenly seems a whole lot more appealing to the novice user.”

Whitney, a 25 year-old recovering heroin addict from a middle class family in the small town of Cody, Wyoming, can attest to that. “I had a wonderful childhood and a very supporting and loving family,” she recalls. “I was a very good student, played many sports and had many friends. And even though I started experimenting with drugs and alcohol when I was 13, it never got in the way of my education or other activities I participated in.”

Whitney’s experience was echoed in a number of the young people I interviewed. Alex, a recovering addict in her early 20’s from Portland, Oregon, recalls that as a young child, she was adopted by people who were “were middle class and for the most part stable,” and that she was sent to “good schools and got fair grades” until she went to high school. 

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Tony O'Neill, a regular contributor to The Fix, is the author of several novels, including Digging the VeinDown and Out on Murder Mile and Sick City. He also co-authored the New York Times bestseller Hero of the Underground (with Jason Peter) and the Los Angeles Times bestseller Neon Angel (with Cherie Currie). He lives in New York with his wife and daughter. You can follow Tony on Twitter.