Washington, like much of the United States, has seen increases in the use and harms associated with heroin. Because direct measurement of heroin use is difficult, various indicator data are used instead. Police evidence provide a close to real time picture of what is available on the street. Treatment data tend to lag behind heroin availability and onset of use by several years. Deaths are a lagging indicator as well, though King County data show an increase in deaths involving heroin among those under 30 in 2012, indicating that the lag may not be as long as expected. The rate of all opiate deaths (heroin and/or Rx-type) has nearly doubled in the past decade.