Philip Seymour Hoffman death: A cautionary tale about branded heroin?

He had about 50 bags of heroin, law enforcement officials say. Some of the envelopes were branded with an “Ace of Spaces” stamp. Others were labeled “Ace of Hearts.” There were used syringes, some prescription-pill bottles, and a small amount of cocaine.

This was the scene police describe at actor Philip Seymour Hoffman’s Manhattan apartment after he was found dead Sunday of an apparent (but still unconfirmed) drug overdose. A needle was in his arm, empty heroin packets in his waste-bin, according to news reports.

That scene reflects a larger-scale one on the rise in New York City, the proverbial hub of potent recreational drugs, and in heroin-laced towns and hamlets up and down the East Coast, where city dealers run a lucrative business.

It also offers a window into a seedy underworld of "branded" heroin, in which the drug is peddled in stamped bags and marketed with names that range from whimsical, such as the “Ace” stamps, to sinister. The brand names are an attempt to boost a product’s popularity, promising that the product will be the same every time, but they have no relevance at all to the drug and offer no such guarantee, experts say. Buyers have no way to know with what substances the dose of heroin has been cut – suppliers often cut costs by diluting their product – and that not-knowing can be lethal.

“You’re playing Russian roulette every time,” says Joseph Moses, a spokesman for the US Drug Enforcement Administration (DEA).

Heroin is a sedative processed from morphine, and about 23 percent of users become addicted, according to the National Institute on Drug Abuse (NIDA). For reasons that remain unclear, its rate of use has been growing rapidly during the past decade. The rise appears to be associated, in an unexpected and unfortunate twist, with the success of initiatives to curb prescription-drug abuse: Opiate addicts have not gotten clean, but have switched to heroin. It has also been linked to Mexican cartels raising their stake in the trade by expanding operations from America's Southwest to the Northeast, once dominated by South American suppliers.

Whatever the reason, heroin use has been on an upswing for at least a decade: Some 3,038 people died from heroin overdoses in the US in 2010, the most recent year for which DEA data are available, up from 1,879 heroin overdose deaths in 2004.

The geographic scope of the problem is also expanding. Last month, Vermont Gov. Peter Shumlin (D) devoted his entire State of the State speech to the heroin problem. In Vermont, the number of people receiving treatment for heroin addiction has jumped 250 percent since 2000, and about 40 percent of that uptick occurring just in the past year, the governor said in his speech.

Vermont, home to sleepy towns clinging to mountainsides, may seem an odd candidate for a drug problem associated with high-octane cities, but it is in good company. Even quiet swaths of New England have become hotbeds for heroin use, with dealers enjoying big price markups in out-there communities, according to statistics from the US Department of Justice. A bag of heroin that would net $6 in New York City fetches about $30 to $40 in parts of rural New England, according to figures Mr. Shumlin cited in his Jan. 8 speech.

“Heroin is no longer just an urban issue,” says Jack Stein, director of the Office of Science Policy and Communications at NIDA. “We’ve seen it pop up in suburbs and rural communities across the country.”

But if the problem has expanded to the rural and suburban US, it has not ebbed in its longtime hotbed, New York City. There, heroin remains cheap, or at least much cheaper than it is further down the distribution line, out in New England or on Long Island.

From 2010 to 2012, heroin-involved deaths jumped 71 percent in New York, up to 352 people in 2012, according to figures from the city's Department of Health and Mental Hygiene. That year, heroin accounted for more than half of all drug overdose deaths, those data show.

New York is where heroin, smuggled in from south of the US border, is sneaked into home-based production mills, diluted in coffee filters with chemicals that range from benign (such as cornmeal) to toxic (like powerful sedatives), divided into envelopes, and stamped with brand names.

The practice of stamping envelops with brands has been around for decades – and it is not universal. In Detroit, dealers put heroin in lotto tickets – but the brand names themselves are always changing, keeping pace with trends, says the DEA's Mr. Moses. In those names are nods to pop culture – “Twilight” and “Lady Gaga” – and to political hot buttons – “Obama Care” and “Government Shutdown.” They range from mundane to blithe to tongue-in-cheek morbid – from “Starbucks” to “iPhone” to “D.O.A.”

Three days before Mr. Hoffman’s death, city and state police, in tandem with the US DEA's New York Drug Enforcement Task Force, raided a Bronx apartment and confiscated 33 pounds of heroin worth about $8 million, authorities say. The drug was branded with names such as "NFL" and "Olympics 2012.”

But these brand names, if catchy, indicate little about the product: How potent is it? Is it cut with baking soda – or with something much more lethal, like powerful painkillers?

That’s because dealers who stamp the packets often get heroin from different suppliers, says Moses. Individual dealers might not even know what’s in their product, but they stamp each batch with the same brand regardless, creating the illusion of a consistent product, he says. The exact same batch of heroin is also often distributed by different dealers under different labels, he says.

That means it’s impossible for buyers to tell what they’re buying, even if they’re buying the same label each time, Moses says.

“You just don’t know what’s in the substance you’re using,” he warns.

The consequences of not knowing can be dire. In late January, heroin branded as “Theraflu” was linked to 22 deaths in Pennsylvania. The drug, it turns out, was cut with fentanyl, a painkiller 50 to 100 times more potent than morphine, and 30 times more powerful than undiluted heroin, says Moses. Fentanyl-laced versions of the drug sold under different brands have also been implicated in overdose deaths elsewhere across the Northeast and the mid-Atlantic in recent months.

Investigators have suggested that the heroin Hoffman used may have been cut with fentanyl, Reuters reports. The toxicology report, yet to be released, will show what was in it, and police are hunting for the dealers who sold Hoffman the Ace of Spades and Ace of Hearts heroin, the New York Post reports. It’s unknown what substances, if anything, the “Ace” brands of heroin include, or even if the "Ace" packets said to be in Hoffman's home are related to "Ace" envelopes seen before.

Regardless of what substance is used to dilute a batch of heroin, the odds that the drug is safe are still zero, says Dr. Stein. Heroin is, of course, still heroin, and overdose is always a possibility.

“Pure heroin is bad enough. This drug literally hijacks the brain." He adds: “Every time someone uses heroin, they are putting their life at risk.”