Introduction

Abstract

Heroin problems have been hitting the headlines recently, in the USA, in Europe and elsewhere. In the USA, heroin remains a serious problem, albeit less ‘newsy’ than cocaine. Although trends in the extent of use of heroin and related problems seem quite volatile, declining in some parts of that country whilst rising in others, a consistent trend in the mid-1980s has been the availability of heroin of higher purity (NIDA, 1985). In Britain and other European countries, there is no doubt that heroin has become widely available in many regions and neighbourhoods in reasonably high purity (see Chapter 1) and that it is the main drug of public concern — however minor its contribution to mortality and morbidity compared with the records of alcohol and tobacco. In the Third World, Pakistan — the country generally credited with supplying much of the heroin used in Europe in the 1980s — is itself caught up in an escalating cycle of heroin distribution and consumption; similar problems are to be found in several other Asian countries.