Among those who favor lowering sentences for heroin traffickers, the surge in overdose deaths is a problem.  They understand that the public is unlikely to want to water-down the penalties for the people helping to produce the surge.  Thus it has become a popular refrain that the major driver of the problem is not smack pushers but, instead, opioid addiction driven by "Big Pharma" and unethical pain doctors.

A new, peer-reviewed article in the New England Journal of Medicine contradicts the White House claim that the huge increase in heroin overdose deaths--440 percent in the past seven years--is directly related to prescription pain killers and changes in prescribing policies aimed at making them harder to obtain and abuse.

The article, authored by some of the federal government's leading addiction researchers at the National Institute on Drug Abuse, the Food and Drug Administration, and the Centers for Disease Control and Prevention, surveys dozens of recent, peer-reviewed studies on heroin use, initiation patterns, overdose deaths, and the effects of policy changes in prescribing opioids. Ultimately, they find "there is no consistent evidence of an association between the implementation of policies related to prescription opioids and increases in the rates of heroin use or deaths." Instead, the authors conclude that "heroin market forces, including increased accessibility, reduced price, and high purity of heroin appear to be major drivers of the recent increases in rates of heroin use."