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Heroin: Small cities, even rural towns face growing problems

For many communities, the extent of heroin addiction comes as a shock. Yet efforts to confront it, including town-hall meetings and support groups, are slowly gaining ground.

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Although heroin use has been expanding for a decade or more, many communities are just beginning to understand the extent of their own heroin problem. The Dane County Narcotics and Gangs Task Force, which includes personnel in Madison, Wis., reported last year that drug overdoses had risen from 31 in 2007 to 175 in 2011, most due to heroin. In Will County, Ill., just outside Chicago, heroin-related deaths rose from five in 2000 to 53 last year. In Missouri, heroin deaths increased from 69 in 2007 to 244 in 2011 – more than half of them in the age group 15 to 35.

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The National Council on Alcoholism & Drug Abuse – St. Louis Area (NCADA), which offers emergency counseling and other services, has seen a dramatic shift in heroin-related calls. Until recently, most came from middle-aged people in poor urban areas. But four or five years ago, that changed. “They were mostly from youth, which was shocking to us,” says Dan Duncan, director of community services. “And they were coming from the suburbs. In 2010, it just seemed to explode.”

Heroin use is still relatively modest. According to the most recent National Survey on Drug Use and Health, 8.7 percent of Americans had recently taken illicit drugs, mostly marijuana and cocaine. Only a quarter of 1 percent over the age of 12 said they had used heroin. But heroin raises additional concerns because, like other opiates, it is considered powerfully addictive and difficult to give up.

“I’ve been working at this for 29 years,” Mr. Duncan says. “I’ve seen people addicted to many things, and heroin is always the hardest to deal with.”

Heroin’s rising popularity reflects what the Centers for Disease Control and Prevention last year described as an “epidemic” of overdoses from prescription drugs, especially painkillers like OxyContin and Vicodin. Users often switch from painkillers to heroin because it’s cheaper and more readily available, experts say. A tenth of a gram, enough for two or three uses, sells for as little as $20. Moreover, heroin has become increasingly available in refined forms that can be sniffed or snorted. Many young people are introduced to heroin in a powder form but eventually switch to injections.

William Patrianakos is one of them. Mr. Patrianakos, who grew up in Lockport, just outside Chicago, tells people that “if there was a graduating class of first addicts to heroin around here, I was one of them.” He started by taking OxyContin pills he got from a girlfriend, and he switched to heroin when he no longer could get the pills. He had struggled with depression, he says, an drugs made him happy.

To finance the addiction, Patrianakos stole from his family, borrowed from friends, and taught himself to counterfeit $100 bills. Like many addicts, he entered treatment programs several times, only to return to heroin. He finally was arrested for counterfeiting and spent a year in a court-mandated drug program. Even then he relapsed for three months before, he says, he finally quit heroin for good.

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