I've been working as a paramedic for the last 25+ years, and I can absolutely tell you it's a bigger problem today then years ago. The heroin is stronger today, it is cut with not only other opiates like Fentanyl, but even with cardiac drugs, and who knows what else. It takes more Narcan to wake people up these days, and then they sometimes go apeshit because of whatever else they're on, and that includes people already on Methadone to try and kick their habit. It's rich people, poor people, young, old, professionals, classic junkies, and everything in between.
I recently brought a heroin OD to a local hospital, and within 15 minutes after we arrived, 3 more arrived, from the same town, to an ER that was already overcrowded. Someone obviously was sellin' some god stuff that night in that town.
Also, a growing trend in hospital emergency rooms is to not prescribe opiates at all for pain, and use alternatives instead. Some people who would have otherwise not tried heroin are absolutely doing it because they can no longer get Oxy or whatever they got hooked on.
It's a huge problem in this country, and it's getting worse. I don't know what the answer is, but I do know this - we are not winning the war on drugs.