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Heroin: Small cities, even rural towns face growing problems

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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.

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