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Thursday, November 09, 2023

A Prosecutor's Perspective on the Heroin Epidemic

A Prosecutor's Perspective on the Heroin Epidemic

By: Michael T. Gmoser

Statistically, deaths from heroin continue to rise to epidemic proportions. If there is any doubt, for confirmation ask any county coroner in any county across the entire country. All segments of society are affected from the very poor to the very rich. Heroin has become an equal opportunity killer.

This scourge must be attacked like any epidemic we have faced in the past just as we attacked the polio epidemic sixty years ago when the lives of all our children were on the line. It will take a massive and coordinated effort and the consequences of inaction will be tragic with an ever increasing number of parents and grandparents losing family members by death and addiction from this deadly drug.

Before presenting my solution, please consider my perspective on the causes for this growing cancer among us. Regrettably, there are many, but those most frequently cited by survivors of addiction and those still addicted boil down to just a few. The first of these is the medical profession that was sold a bill of goods by a pharmaceutical manufacturer years ago that produced a "be all, end all" pain solution- an opiate pill- for common ailments without thoroughly presenting to the medical profession the addictive properties of the newly developed pain killers. Physicians should not be criticized for wanting to alleviate pain, but the consequences of easy, uninformed access to such medications and a demanding society intolerant of any pain have advanced the use and profits associated with opiate pain killers. When minor disorders like a simple sprain or strain resolve, the prescriptions end, but the addiction continues. When the insurance that paid for the prescriptions runs out, so usually does the physician, but the addiction continues, to their credit, physicians are now much more aware of these consequences and are more cautious with prescription pain killers. Those who do become addicted, however, often turn to the street where the once prescribed pill now costs eight times as much as a dose of heroin to feed their addiction.

The next cause of addiction and death is simple experimentation with tragic consequences. As a society we are curious in all things. It is after all a human trait. Our curiosity is what got us from the jungle to the shopping mall. Few, if anyone, ever died or became addicted from a first drink of alcohol or inhaling a cloud of smoke from a cigarette or marijuana joint. The same now cannot be said for experimentation with heroin. Peer pressure often adds to the motivation to experiment. Deaths from heroin often show that it was laced with fentanyl which is many times more addictive and deadly than heroin. I bear witness to parents who have exclaimed to me that "he or she only tried heroin once and it killed him or her." One such parent said the mantra in the fight against heroin should be "one and done." My mantra from the beginning of my fight for public awareness is "heroin takes your life and then it kills you" and this reality is repeated every day across our country.

Another cause, and often overly exaggerated for legalization debate purposes, is that marijuana is a primary gateway drug leading to heroin. However, one third of all addicts that I have spoken with do tell about using marijuana and eventually seeking heroin as something stronger with it as a figurative and literal dead end. For this reason, I am opposed to such legalization even if masquerading and disguised as a benefit for medical purposes. The underlying cause for marijuana use is often tied to self-medication for emotional problems and inability to cope with everyday stresses of life. After all, in these modern times there is a medication for anything that troubles us and in a society where we are advertised all manner of material things, there are many that cannot achieve such economic success no matter how they try leading to a solution in feel good medications both legal and illegal and usually highly addictive and deadly. Alcohol abuse has historically been the self-medication of choice and its troubling consequences have been tolerated because the addiction and damage occurs in slow motion compared to the frequent instant death brought by heroin.

Lastly, availability of intoxicating substances to our society must be considered as a logical cause although some may argue with merit that availability is only a consequence of a demand in our country. Cause or consequence makes little difference, however, and making heroin unavailable is a major part of the solution, but as history has shown it cannot be the only solution.

Like any pandemic, the solution requires massive, consistent and coordinated public involvement and a realization that there is no quick fix. My five point program has been developed by careful analysis from experts in all fields necessary for a solution and the five essentials are as follows:

Law Enforcement

The so called war on drugs was started with the notion that society could arrest and prosecute our way out of the scourge of drugs without more. That singular approach has failed, but should not be seen as diminishing the need for such deterrence. Interdiction at the southern border of our country is essential especially when Mexican criminals now claim a billion dollar market in our country. Every dealer in the chain from our cities to the assemblers of fentanyl in Mexico needs to be prosecuted by us and Mexican authorities and taken out of society.


Prosecutions need to be focused, efficient and relevant. Prosecutors are in a position to evaluate how to get the biggest bang for the buck when prosecuting the supply chain. Prosecuting addicts may be easy, but solves little unless we as a society intend our jail system to become the default treatment centers of an addicted populous. This option is now the direction we are heading and the cost will far exceed more thoughtful approaches. Regrettably, jails are also the educational source for higher crime so the graduating addict comes out prepared for other criminal pursuits. Cooperation with drug courts set up to handle the treatment of addicts involved in crime to feed their habits is thus essential to the extent possible where offenders are not violent or have not committed an associated heinous crime.


A key element to a united effort is legislation necessary to provide the tools required. The best place to begin an overhaul on how our society deals with this problem is through education that must begin at the elementary school age level. It is not enough to request schools to teach anti-drug programs and it must be a legislatively imposed curriculum. Consistent and uniform education must be mandated. Next, there must be legalization of needle exchange programs. Without legalization, technical violations of law involving possession and distribution of drug paraphernalia may result especially by some in law enforcement who oppose this initiative. Needles are an effect of drug use and not the cause. On a risk/benefit analysis, providing an exchange of clean needles among those addicted will reduce infection of hepatitis C and AIDS for which one case alone can cost enormous resources better spent elsewhere. Lastly, legislation must be initiated to formulate consistent and uniform statewide programs for drug addiction rehabilitative services including all forms of treatment and medications without cost to those who have no means or limited means of payment.


With sufficient legislative mandates, anti-drug education should be a daily event in the young lives of students. It should be as common place as the pledge of allegiance was every morning years ago. Young people must be told what will be coming at them and reliance cannot be on parents alone who may themselves be afflicted. In addition to anti-drug education, teaching coping skills is essential to prepare young minds for the material and social pressures they are bound to encounter that may lead to drug abuse.

Medical Treatment

Medical science has progressed to the point of knowing the full range of medical problems associated with drug abuse. It knows the science of addiction as well as what is required to treat and eliminate it. We need to take advantage of that knowledge by paying for the medical services available. I understand that no non- addicted person wants to pay for this, but such thinking is short sighted in the face of the cost without such services. Only when there are vacancies in available beds for treatment recovery, will we see success in the fight against drug abuse. Many courts are on board with alternatives to punishment for the addicted, but it is not uniformly presented. Such programs need to be mandatory and not discretionary depending upon where one lives. Addiction pays no attention to geographic or economic boundaries.

Recently, the President of the United States stated that if his executive action on gun control could save just one life it would be worth it. Heroin is no different than a loaded gun with a high probability of lethal consequences from abuse and should be considered with the same urgency. Our children and those already afflicted with the disease of addiction deserve better especially in a society that prides itself on accomplishing great things and with the ability to end this epidemic.

Michael T. Gmoser
Butler County Prosecutor
January 12, 2016