Deaths from heroin overdoses have spiked in recent years, tripling between 2010 to 2014, according to the DEA National Heroin Threat Assessment Summary, released this week.
In 2014, the most recent year of the study, 10,574 people died, compared to 3,036 four years earlier.
The increased demand is being driven by greater availability, as well as prescription drug abusers switching to heroin for the cheaper price tag, according to the DEA.
Other possible reasons for the increase in deaths include an increase in new and inexperienced users, as well the use of highly toxic heroin adulterants such as fentanyl incertain markets, according to the DEA.
DEA Acting Administrator Chuck Rosenberg said last month that the agency is increasingly encountering counterfeit prescription drugs laced with fentanyl and fentanyl derivatives, as well as heroin laced with fentanyl.
“The trafficking of this drug [fentanyl], which is significantly more potent than street level heroin, presents a significant risk of overdose,” he said in his statement to the Judiciary Committee on June 22.
Heroin availability is increasing across the county, but the threat is particularly high in the Northeast and Midwest, where white powder heroin is used, according to the 2016 National Drug Threat Survey.
Over the five-year period covered in the report, the DEA said Mexican traffickers gained a larger share of the most lucrative heroin markets in the United States -- Baltimore, Boston and its surrounding cities, Chicago, New York City and the Philadelphia, and Washington, D.C.
Mexican trafficking organizations also moved operations into suburban and rural areas, where they believe they can more easily conceal their activities, the report noted.
What is not seen in these numbers, which end in 2014, is the steep rise in deaths caused by synthetic opioids such as fentanyl. More recent state numbers, however, show an alarming trend.
In Virginia, fentanyl overdose deaths went from 50 in 2012 to 218 in 2015. In New Hampshire, 283 died from fentanyl overdoses in 2015 and authorities expect to smash through that number this year.
However, the numbers do show that starting in late 2013, several states reported spikes in overdose deaths due to fentanyl.
DEA officials say they expect to see the deaths from fentanyl increase and perhaps outpace deaths from heroin. The drug is so deadly that a mere 2 milligrams can be lethal. It is increasingly showing up on American streets not just as an adulterant to heroin but pressed into pills that look identical to prescription painkillers.