text: TROY WILL BE BACK TO PINPOINT THE TIMING OF TODAY'S STORMS. THAT'S COMING UP IN LESS THAN TWO MINUTES. PATROLS ARE BEING STEPPED UP AT ONE TROUBLED COMPLEX IN ORANGE COUNTY AFTER A SPIKE IN DRUG OVERDOSES. POLICE SAY AT LEAST ONE OF THEM WAS DEADLY. THIS IS NEAR THE BEACHLINE AND ORANGE BLOSSOM TRAIL. DEPUTIES SAY IN THE LAST 24 HOURS, AT LEAST 11 PEOPLE OVERDOSED ON HEROINE IN THAT AREA. THE SHERIFF SAYS SOME OF THE VICTIMS ARE ONLY IN THEIR 20'S. WHILE IT IS AN OLD DRUG, IT IS NEW TO MANY PEOPLE. PEOPLE DYING OF HEROINE OVERDOSES AND WHAT HAVE YOU, THEY ARE IN THEIR 20'S, 30'S, THEIR 40'S. THESE ARE NOT INDIVIDUALS USING IN THE '60S, THE '70S AND THE '80S. 
   
   ORANGE COUNTY, Fla. - 
   
   The Orange County Sheriff's Office said Thursday that at least 11 heroin overdoses were reported in a 24-hour span in the area of Blossom Park. 
   
   Deputies said many of the overdose victims have ended up in the hospital, and some of the victims have died. 
   
   OCSO said deputies were sent to the the area to ensure there is a high visibility of law enforcement in hopes of preventing the sale and usage of heroin in the area. ||||| CEDAR RAPIDS — One narcotics law enforcement officer says taking heroin is similar to grabbing a loaded gun and spinning the chamber. 
   
   Even worse, he added, heroin use is spreading in Iowa, and its deadly reach is likely to continue to grow. 
   
   Heroin overdoses, for example, have surged in Cedar Rapids in the past five years. 
   
   In 2009, authorities responded to nine reported heroin-related deaths and non-fatal overdoses, which represented 45 percent of all overdoses in Cedar Rapids. 
   
   Through June 5 of this year, there have been 52 reported overdoses in the city, 44 of which were heroin-related. Heroin has accounted for 85 percent of all overdose calls this year. 
   
   “It's a serious issue — not just the presence of heroin, but the effects that heroin is having on the users,” Cedar Rapids Police Chief Wayne Jerman said. “The number of overdoses and the number of overdose deaths is very concerning.” 
   
   Cedar Rapids is not alone in facing a growing heroin epidemic. One way to gauge the prevalence of heroin in Iowa and where it is being found is through samples, or exhibits, submitted to the Iowa Division of Criminal Investigation Criminalistics Laboratory. According to statistics provided by the crime lab, 37 of Iowa's 99 counties have submitted suspected heroin to the lab for testing since 2005. 
   
   However, three Eastern Iowa counties make up a majority of the cases sent to the DCI lab. Of the 47 exhibits submitted to the lab in the first third of 2015, seven were from Johnson County and eight were from Linn County. Collectively, they account for nearly a third of all heroin cases submitted to the lab this year. 
   
   Scott County leads the state with 16 submitted cases through the first four months of the year. 
   
   Not only is heroin becoming increasingly common, but authorities warn that it's becoming deadlier, thanks to the presence of a synthetic opioid with 80 times the potency of heroin. 
   
   And one Iowa Division of Narcotics Enforcement agent warns that heroin shows no sign of slowing down in Iowa. 
   
   “I think it's going to be on the upswing,” DNE special agent-in-charge Dan Stepleton said. “I think it's going to get worse and worse.” 
   
   Metro hubs 
   
   Heroin is a highly addictive opioid produced from opium poppy. Usually injected by the user, heroin also can be smoked and is a powerful painkiller. It is similar to fellow opioid morphine, but 10 times as powerful. 
   
   The heroin found in Iowa is produced by Mexican cartels and distributed through metropolitan hubs, such as Chicago, which helps to explain why Scott, Linn and Johnson counties in Eastern Iowa see more heroin cases than the more populous Polk County. 
   
   “Because you have a predominant heroin source of Chicago and those are the closest three counties to Chicago in Iowa and they're metropolitan counties,” Stepleton explained. 
   
   Stepleton said heroin usually is distributed by gang members with Chicago affiliations. Criminal investigations often begin with an overdose death, he explained. 
   
   “Unfortunately it's usually already a done deal when we get involved,” said Stepleton, who covers a 24-county swath of Eastern Iowa. “We are working toward the source of supply and not just waiting for an overdose to happen. We're trying to avert those as much as possible.” 
   
   According to a study released by the Centers for Disease Control last month, heroin use is rising across all demographics, with women and 18-to-25-year-olds seeing the biggest increases in recent years. Experts point to the rise of prescription drug abuse, especially among young people. 
   
   “What we're seeing is young people — high school and college age — will get addicted to Vicodin, oxycotin,” Stepleton said. “When they run out of the prescriptions, they'll resort to heroin because it's 10 times the potency of that drug. Unfortunately you're already hooked at that point. 
   
   Related story: 
   
   Change in law makes heroin death convictions more difficult to prosecute 
   
   “It doesn't take long to make the switch from oxycotin to heroin, which in essence is going to make you a lifelong addict.” 
   
   Heroin is not a high-volume drug — it lags far behind more common illegal substances in Iowa such as marijuana and methamphetamine — and it's highly expensive. One ounce of heroin is a “huge amount,” Stepleton said, and most dealers work in shipments of 10 to 50 grams. 
   
   Heroin is purchased for about $200 to $250 per gram and is usually sold for about $50 for a 10th of a gram. 
   
   “It's a very expensive habit,” he said. “That's why most of your heroin users have to be dealers. You just can't afford to get the drug.” 
   
   Because of its expensive and addictive nature, heroin abuse often is associated with property crimes such as thefts and burglaries. 
   
   “Addicts will do what they need to do to obtain the next fix,” Jerman said. 
   
   Lethal 
   
   While there is no definitive ranking in Iowa on the most lethal drugs, heroin probably would be near the top of the list in terms of deaths with respect to the number of actual users, according to one state official. 
   
   “It would appear that heroin is more lethal than many other substances,” said Dale Woolery, associate director for the Governor's Office of Drug Control Policy. 
   
   Woolery said it appears that a greater proportion of heroin users experience overdoses than users of more common drugs in Iowa, such as methamphetamine. 
   
   “There are a lot of Iowans that have a strong appetite for methamphetamine,” he said. “But it's rare, if it ever occurs ... that you hear of a methamphetamine-overdose death. I think it does occur, but I'm talking very few.” 
   
   Heroin typically is sold at a purity of three percent to five percent, Stepleton said. 
   
   “After that, it gets very, very lethal,” he said. 
   
   However, it's not an exact science and some dealers might not be as careful about diluting their drugs. 
   
   “There's no FDA involved in this,” Stepleton said. “He might dilute it down to 7 to 8 percent ... Taking it at 3 percent and taking it at 8 percent is a big freaking difference.” 
   
   Heroin is becoming even more lethal with the introduction of a drug called fentanyl. A synthetic opioid painkiller, fentanyl is 80 times as potent as heroin and a single piece of pure fentanyl the size of the grain of salt can kill a fully grown man. 
   
   “Now they're lacing heroin with fentanyl,” Stepleton said. “Now you have two drugs together and one is very much more powerful than the other. If I'm taking the same drug dosage unit and it's laced with fentanyl, now I end up with really severe problems ... You don't have long for this world.” 
   
   Stepleton said fentanyl and fentanyl-laced heroin has hit the East Coast hard in recent years, resulting in 2,500 to 3,500 overdoses in major cities. And it's making its way to Iowa. 
   
   Bruce Reeve, administrator for the DCI crime lab, said technicians have been seeing fentanyl in the form of patches prescribed for chronic pain relief for years. But more recently they are seeing heroin laced with fentanyl. 
   
   In January, the lab examined one case of heroin mixed with fentanyl. In April, there were three more. In May, half of the labs 10 heroin cases had samples cut with fentanyl. 
   
   “I think we're starting to see that a lot more in Iowa,” Reeve said. “It's a trend that's alarming. Fentanyl is a dangerous drug if it's not handled right.” 
   
   Stepleton puts it more bluntly. 
   
   “I think it's going to be an extreme problem,” he said. “I can't stress that enough. There is no FDA in illicit drug distribution. It's a crapshoot on what you're going to be buying and putting in your body. ... It's like putting a loaded gun in your hand and spinning the chamber every time.” 
   
   In July, the Cedar Rapids Police Department announced it had received federal funding that would allow it to hire another officer. Having that additional officer will allow the department to place a seasoned professional with the Eastern Iowa Prevention, Treatment and Prosecution Initiative. The officer will emphasize heroin-prevention efforts while also working on the investigation and prosecution of heroin-related crimes. 
   
   “From decades ago, (heroin) seemed to be confined to different areas,” Jerman said. “Now we see there are no boundaries ... It's making its way into all segments of society. 
   
   “Whether it's lower middle, upper middle or the upper class, that's what we're seeing.” 
   
   Change in law makes heroin death convictions more difficult to prosecute 
   
   A grieving mother displayed a photo of her son in a casket during a February sentencing of a man who had sold her child heroin, saying it's all she has left to remember him. 
   
   Stacy Iberg likely is one of many mothers over the past five years in Eastern Iowa who have either lost a child or had a child overdose on heroin. 
   
   Her son, Dustin Legrand, died from a heroin overdose last year after Ramon Freeman, 35, of Chicago, sold to someone who provided the heroin to Legrand. Freeman is now serving 30 years in federal prison. 
   
   Federal prosecutors say Freeman is only one of 75 people charged in U.S. District Court in the past five years for distribution of heroin, and 38 of those have been in Linn County. From 2011 to 2015, 14 defendants in the Northern District have been charged in cases involving heroin deaths and six have been charged with bodily injury that resulted from heroin overdoses. 
   
   But prosecuting these dealers has become more difficult after a 2014 U.S. Supreme Court decision involving an Iowa case in the Southern District, he said. 
   
   That case set a higher standard for prosecutors to meet in distribution cases involving death, Assistant U.S. Attorney Dan Chatham said. There must be sufficient evidence the heroin is what caused the death, according to the law. 
   
   Prosecutors previously only had to prove the heroin was a “contributing cause.” In many of these cases, users may take other drugs along with the heroin. 
   
   In an overdose causing bodily injury, Chatham said, there has to be evidence that the user was at high risk to die without medical intervention. 
   
   Some cases haven't been able to meet that standard to convict for a heroin death, but Chatham and Patrick Reinert, also an assistant U.S. attorney, said they can argue in sentencing for more time based on other factors, such as previous convictions, purity of heroin or how close the dealer is to the main source. 
   
   In the sentencing for Freeman in February, Chatham argued for more prison time based on the purity — in that case, 68 to 73 percent — of heroin he was selling, and Freeman's position in the chain of distribution. Dealers with higher purity levels typically are closer to the main source, he said. 
   
   Chatham said the overdoses usually occur because the purity is so much higher than what the user is used to. In the past, the heroin might have been cut with another substance, so the dealers could have more product and make more money. 
   
   Chatham said there also are cases in the district where users have overdosed because it's mixed with another drug such as fentanyl, used to treat severe pain and often used after surgery. 
   
   There were two defendants indicted in June from Cedar Rapids for distribution of heroin/fentanyl and conspiracy to distribute heroin/fentanyl that resulted in bodily injury. ||||| Related video from New Jersey 101.5: 
   
   This week, we're taking a special look at heroin's increasing grip on the Garden State. 
   
   On Thursday, we'll conduct a special town hall — including a live chat where you can get your questions about addiction and treatment answered by New Jersey experts. It starts at 7 p.m. on NJ1015.com . 
   
   Authorities tell us New Jersey's heroin epidemic isn't letting up — even with powerful new tools like the antidote Narcan to battle overdose deaths . 
   
   The numbers back them up. Heroin use is spiking throughout the state — and it's making its way into the suburbs, as once-sleepy towns find themselves hotbeds of drug activity. 
   
   Here's a look at the statistics : 
   
   781 
   
   It's a troubling number that just keeps on rising. In 2014, there were 781 heroin-related overdose deaths in New Jersey, according to data by the state Department of Criminal Justice. That's more than twice as many as in 2010. 
   
   A report last year by New Jersey Advance Media notes that the per-capita rate of 8.3 heroin-related deaths per 100,000 people is more than triple the national rate reported by the Centers for Disease Control. In addition, heroin "now eclipses homicide, suicide, car accidents and AIDS as a cause of death in the state," according to the report. 
   
   For years, New Jersey's heroin death toll stayed comparatively stable, hovering in the mid-300s to mid-400s, and even getting as low as 306 in 2010. But it's been steadily increasing ever since then. 
   
   28,332 
   
   According to a report released by the Department of Human Services Division of Mental Health and Addiction Services last year , in 2014, 28,332 people were admitted into substance abuse treatment programs with heroin or another opiate listed as the individual's primary drug. That's nearly half of the 64,766 people entering treatment programs for substances overall in New Jersey. 
   
   Both figures are down from 2013, when 72,864 entered substance treatment, 32,607 for heroin or other opiates. 
   
   3,688 
   
   Of those seeking treatment for heroin or opiates, the most were in Ocean County. The 3,688 admitted for treatment in Ocean accounted for 13 percent of all those admitted through the state, even though Ocean only accounts for about 6.5 percent of the total state population. 
   
   But when the figures are broken down per 100,000 people, Cape May County leads the state for those entering treatment — at 1,138 (because of a statistical quirk, the per-capita number is greater than the raw number in Cape May; there are slightly less than 100,000 people in the county). Click on your county in the interactive map below to see how your county fares. Darker shades mean higher incidences of heroin and opiate treatment. 
   
   1,176 
   
   In 2014, 1,176 people in Newark sought treatment for heroin addiction — more than in any other municipality — according to a breakdown of the state treatment report by Patch.com . While the top cities for heroin use were urban centers — Paterson, Jersey City, Atlantic City and Camden round out the top 5 — there are several suburban communities among the top 20. Toms River was in sixth place, with 436 reported admissions, and Brick in seventh with 426. 
   
   Central Jersey communities of Middletown and Lacey are on the list, as are Millville and Lower Township in South Jersey. Patch notes Bloomfield, "long considered one of the safest neighborhood communities in Essex County," made its yearly analysis of the data for the first time, in 20th place 
   
   16.1% 
   
   A 2011 state breakdown found more non-Hispanic white people , per capita, dying from drug use than blacks or Hispanics. According to the report, 16.1 per 100,000 white people died of drug-related causes — compared with 9.8 for black people and 5.1 for Hispanic people. 
   
   That wasn't always the case — in 2000, more blacks died of drugs per capita (14.5 per 100,000 than whites (10). But drug deaths among whites have been steadily increasing, and blacks steadily decreasing — 2007 was the last time black deaths from drug-related causes outpaced white deaths. 
   
   1,000 
   
   Nalaxone, an opiate antidote marketed under the name Narcan, was deployed more than 1,000 times in 2014, according to Gov. Chris Christie's office . 
   
   Ocean County Prosecutor Joe Coronato told New Jersey 101.5 that it's been a help in his county — in 2013 there were 112 heroin deaths in Ocean County, and that number dropped to 101 in 2014. But he stressed it's a "temporary save," saying "there’s been several individuals that we’ve sprayed two or three times already,” he said. But sometimes by the third time they’ve not survived, they’ve died. That’s not truly addressing the problem. The problem is the addiction.” 
   
   2% 
   
   The 2013 New Jersey Student Health Survey (the most recent available) found that 2 percent of high school students had used heroin at some point in their lifetimes. That's about half as many as in 2001, though the figure's held steady for several years. 
   
   Also according to the survey: 
   
   • 7 percent had used Ecstasy; 
   
   • 6 percent had used hallucinogens; 
   
   • 5 percent had used cocaine; 
   
   • 3 percent had used methamphetamines; 
   
   • 2 percent had used a needle to inject an illegal drug. 
   
   15% 
   
   The 2013 New Jersey Student Health Survey also found 15 of students had attended school under the influence of drugs or alcohol during the previous 12 months. 
   
   — Note: This is an update of a report first run in the summer of 2015. 
   
   Related video from New Jersey 101.5: ||||| A view of Washington, Pa. Last week, Washington County recorded 16 overdoses in 24 hours and 25 over two days. Three people died. (Marvin Joseph/The Washington Post) 
   
   The first call came at 7:33 p.m. last Sunday: Two people had overdosed on heroin in a home just a few hundred yards from the station where firefighters were awaiting their nightly round of drug emergencies. 
   
   Six minutes later, there was another. A 50-year-old man had been found in his bedroom, blue from lack of oxygen, empty bags of heroin by his body. 
   
   At 8:11, a third call. Then another, and another, and another and another. 
   
   By 8:42 — 69 minutes after the first report — a county of slightly more than 200,000 people had recorded eight overdoses, all believed to be caused by heroin. There would be a total of 16 overdoses in 24 hours and 25 over two days. Three people died. Many of the others were saved by a recent decision to equip every first responder with the fast-acting antidote naloxone. 
   
   The toll wasn’t from a supply of heroin that had been poisoned on its journey from South America to southwestern Pennsylvania. Nor was there an isolated party where careless junkies miscalculated the amount of heroin they could handle. Last week was simply an extreme example of what communities in parts of the country are enduring as the heroin epidemic rages on. 
   
   Valerie Mack, left, is comforted by family friend Carla Stormy Efaw in Washington, Pa. Mack lost her brother, Sammy Mack, to a heroin overdose. (Marvin Joseph/The Washington Post) 
   
   “It’s absolutely insane. This is nuts,” said District Attorney Eugene A. Vittone, a former paramedic who is trying to hold back the tide of drugs washing across Washington County, a Rust Belt community 30 miles south of Pittsburgh. On any day, Vittone said, the county averages five to eight overdoses, almost all from heroin. More are recorded each day in towns just over the county line. 
   
   “There’s been a progressive increase in overdoses the last two years, and it just went out of control,” added Rick Gluth, supervising detective on Vittone’s drug task force. “I’ve been a police officer for 27 years and worked narcotics for the last 15, and this is the worst. I’d be glad to have the crack epidemic back.” 
   
   [Cheap fix: Heroin’s resurgence. ‘And then he decided not to be’] 
   
   The United States averages 110 overdose deaths from legal and illegal drugs every day. The heroin death toll has quadrupled in the decade that ended in 2013, according to the Centers for Disease Control and Prevention. By all accounts, it has only grown worse since. In Washington County, there have been more than 50 fatal overdoses this year. 
   
   The national drug-death total, larger than that from auto accidents, is disproportionately concentrated in the Rust Belt, the Great Lakes region and the Northeast. 
   
   “There is a growing sense of community outrage that we can’t accept this like we are accepting it,” said David J. Hickton, U.S. attorney for western Pennsylvania and co-chair of the National Heroin Task Force established by the Justice Department in April. “We just can’t go on like this.” 
   
   In this working-class community near the Monongahela River, where drilling for gas deposits has begun to stoke an economic revival, there is little sign that anything will change soon. 
   
   This man who only wishes to be identified as Sonny, learned that his daughter had a heroin overdose at a nearby Walgreens store in Washington, Penn. (Marvin Joseph/The Washington Post) 
   
   “I’m destroyed. I’m totally destroyed,” Valerie Mack said Thursday on the front porch of the home she shared with her brother and several other people on a modest block here. 
   
   Her brother, Sammy Mack, the second overdose victim in the Sunday night skein, was found dead in his bedroom, curled in a fetal position. Near his body were “stamp bags” of heroin — small paper packets that most closely resemble chewing gum wrappers. They bore the supplier’s brand, “MADE IN COLOMBIA.” 
   
   The label is one of two flooding the area, Gluth said. The other is stamped “BLACK JACK.” Authorities are still investigating but believe both types of heroin are laced with fentanyl, a powerful synthetic opiate that increases the drug’s potency and may have contributed to the rash of overdoses. 
   
   Sammy Mack had long had problems with alcohol and was not unknown to law enforcement authorities. But as so many others have, his sister said, he turned to heroin after treatment with narcotic painkillers prescribed for an ankle injury he suffered a few months ago. Mack’s divorce was recently finalized, she said. His four children are living with his ex-wife not far away. 
   
   [When life begins in rehab: A baby heals after a mother’s heroin addiction] 
   
   As he began to use heroin, Mack’s habits and personality changed, she said. He became withdrawn, spending more time in his room. That Sunday, she was fixing him a chef’s salad and became suspicious when he didn’t respond to her calls. She tried to push open his bedroom door but couldn’t. A neighbor finally forced his way in. 
   
   Mack’s prized possession, a Harley-Davidson motorcycle, still sits in the home’s back yard. He had promised it to his 14-year-old son upon his high school graduation. “I’ll just have to follow through,” Valerie Mack said. 
   
   With so much awry in Sammy Mack’s life, his sister said, “Maybe the Lord intervened and decided just to take him.” 
   
   Jessica Neal, 26, another of last week’s overdoses, is still alive after a close call. She was found unconscious in a bathroom at a local Walgreen’s on Monday, her 2-year-old strapped in a stroller in the stall with her. She was revived with naloxone. 
   
   Her father, Sonny, who has a different last name that he requested not be used to protect his privacy, said he threatened to have her committed to the psychiatric unit of the local hospital that same day after Neal spoke of committing suicide. Instead, she agreed to sign herself in. She was released Friday and headed to jail. The child is in her father’s care, he said. 
   
   “She doesn’t need jail,” Sonny said outside the home where the two lived with Sonny’s wife, who suffers from amyotrophic lateral sclerosis (ALS), until last week. “She wasn’t out stealing or doing crimes. What she needs is help. She needs to be in rehab. And after rehab, she needs to be in a halfway house.” 
   
   Nationally, there are only a small fraction of the inpatient drug rehab beds needed for addicts, but Hickton, in an increasingly common stance for prosecutors, has agreed that users need help more than they deserve incarceration. Even as he has stepped up prosecution of dealers, he is taking a multifaceted approach to the current problem. 
   
   “If they’re using and trafficking, I prosecute them,” he said. “If they’re just using, they need help.” 
   
   Hickton promises to bring homicide charges against any seller he can link to a death. But that is easier said than done. There are no open-air drug markets in this epidemic like the ones that captured public’s attention during drug outbreaks of past decades. Much of the commerce is conducted on cellphones and by word of mouth. 
   
   With many more middle-class people addicted via prescription opioids this time around, heroin is bought and sold in bars, nightclubs, homes and more unlikely places, said Neil Capretto, an addiction psychiatrist and medical director of Gateway Rehabilitation Center, which has 20 locations in the Pittsburgh area. 
   
   Gluth said he has undercover detectives all over the streets making buys, painstakingly working their way up the chain in search of bigger dealers. 
   
   He believes the latest load of heroin came from New Jersey, but Washington County’s location makes it particularly vulnerable to drug traffic. Not far from the Ohio and West Virginia borders, it sits at the intersection of Interstates 70 and 79, east-west and north-south conduits for drugs and everything else. Vittone said the county receives drugs from New York, Newark, Washington, Chicago, Detroit and elsewhere. 
   
   “We’re kind of like ground zero,” he said. 
   
   On the streets here, prescription drugs are selling for about $1 per milligram, or $20 for a single dose. Heroin is much cheaper, at about $8 a stamp bag, Gluth said. It is also much more potent than the heroin of previous eras, Capretto said. Users often start with a single bag, but as their resistance grows, they need increasing amounts. 
   
   All of which signals more overdoses and deaths, at least until authorities can find ways to stem the demand and the supply. 
   
   “If we had a serial killer killing one-tenth as many [people], we’d have the National Guard here,” Capretto said. “We’d have CNN here every night.” ||||| Ravages Of Heroin Addiction Haunt Friends, Families And Whole Towns 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   Marion, Ohio, just north of Columbus, used to be an idyllic place to grow up. 
   
   Kelly Clixby and Beth Carey remember what it was like a generation ago, when they were young. 
   
   "I lived across the street from one of the big parks here," Clixby says. "We would rip n' run all day and all night and come in when the street lights were on." 
   
   "It was just a nice place to live," Carey says. 
   
   Today, Marion is different. It's grappling with a full-blown heroin epidemic, one that derailed Kelly Clixby's life and killed Beth Carey's twin sister. 
   
   This week on For The Record: one small town copes with the ravages of addiction. 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   Nationwide Crisis, Personal Cost 
   
   Deaths from heroin have been skyrocketing over the last few years — among all age groups, across all races and in all regions of the U.S. 
   
   According to a recent study by the Centers for Disease Control, more than 8,000 Americans died of heroin-related overdoses in 2013 — nearly three times as many as died in 2010. 
   
   But the risk hasn't dented demand. Heroin is cheap, abundant and accessible, and communities across the nation, from big cities to small rural towns, are struggling with the consequences. 
   
   In Marion, Ohio — once a thriving steel town — the trouble arrived around 2007, when the police started seeing balloons of heroin during routine traffic stops. 
   
   Since then, heroin has changed many lives in Marion. It took Chrystina Carey's. 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   Beth Carey had started worrying about her sister when they were in their early 20s. At that point, Chrystina was hanging around a different crowd than her twin, taking ecstasy while working as a dietary manager. 
   
   "She was on call all the time," Beth Carey says. "She said, about the ecstasy ... she was taking it to stay up when we would go out on the weekends." 
   
   At some point, Chrystina switched from ecstasy to the painkiller OxyContin — and then, eventually, to heroin. 
   
   "She OD'd and went to the hospital three times," Beth Carey says. "Out of the six or seven years [she was on heroin], she was probably incarcerated a good two, 2 1/2 years. 
   
   "But still continued to use drugs." 
   
   The last time Chrystina Carey got out of prison, she went to stay at an addiction recovery house in the next town over. 
   
   Kelly Clixby was living there, too, grappling with an addiction that began with prescribed painkillers and led to heroin. She knew Chrystina well. 
   
   "That was my best friend," she says. 
   
   Clixby remembers the night before Chrystina Carey died. She was heading out with someone known to be wrapped up in drugs and Kelly was worried. 
   
   "I said, 'If you leave with that person, you're probably going to die tonight.' And I was being sarcastic ... by no means did I mean it. 
   
   "And she left. And at 8 o'clock the next morning I woke up to a phone call that she had died. She had overdosed, after seven months of sobriety." 
   
   Witnessing the death of her friend had a profound impact on Clixby's own sobriety. 
   
   "It terrified me," she says. "For a long time after that I stayed clean just ... so I wouldn't disrespect her, or so her death wouldn't be in vain." 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   'Burnt Every Bridge They've Ever Had' 
   
   Marion Police Chief Bill Collins has witnessed many overdoses like the one that killed Chrystina Carey. Back in May of this year, he said his team was responding to as many as two or three in a single hour. 
   
   "You walk in and you know, you see somebody that's blue. I mean, to you they appear to be dead," he says. Then the officers would administer a drug called Narcan. 
   
   "It's like a miracle drug," Collins says. "Within 30 seconds they snap out of it. They wake up. They look at you like they don't know what happened." 
   
   Collins would tell survivors how lucky they were to be alive, how close they came to death. 
   
   "We would get called to the same house and people had just seen somebody overdose and they would still do it," he says. 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   Collins remembers several years ago when all he had to worry about in Marion was crack cocaine. 
   
   And at least crack addicts, he says, could somehow hold a life together. 
   
   It's a different story with heroin users, he says. 
   
   "These people are not able to hold a job," he says. "They steal their family blind to the point where the family just pretty much disowns them. 
   
   "It doesn't take long for you to end up seeing a heroin addict that has burnt every bridge they've ever had." 
   
   The drug is the root cause for many of the other problems his department faces, he says. 
   
   "All of the property crimes we have — the shoplifting, the thefts, the robberies — all go back to one thing, and that's heroin." 
   
   Opiate Blockers Offer Some Aid 
   
   
   
   Narcan can save the lives of heroin users on the brink of death, but another drug, Vivitrol, helps addicts avoid getting there in the first place. 
   
   Vivitrol is a big reason Marion has been able to get some sort of grip on its heroin epidemic. 
   
   The drug is an extended-release opiate blocker. Kelly Clixby, Chrystina Carey's friend and a recovering heroin addict, explains how it works. 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   "I get a shot every four weeks and what it does is it sits on the opioid receptors in the brain," she says. "And if I were to use heroin or an opiate, it wouldn't be able to attach to that receptor, so I wouldn't get high — so it's basically a waste of time." 
   
   It's a powerful tool for helping addicts keep from relapsing, but Clixby is clear about its limits. 
   
   "A lot of people think it's a cure-all," Clixby says. "It's not." 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   And, because Vivitrol only blocks the effects of opiates like heroin, Collins says addicts dead set on getting high are looking elsewhere. 
   
   "We've seen a pretty big increase back into the crack cocaine market, because they can be on probation and be on the Vivitrol shot and still use crack cocaine and get high," he says. 
   
   "So they're still feeding their addiction: They've just switched to something different again." 
   
   Police, Recovering Addicts And Families Fight Onward 
   
   It's been almost eight years since heroin showed up in Marion, Ohio. Since then, Chief Collins says public awareness campaigns have helped with the problem, and more funding for drugs like Narcan and Vivitrol has saved lives. A couple of months ago his department brought down a major drug dealer. 
   
   They're not the aunt or uncle or daughter or son or sister that you used to know. They're a shell of a person that used to be great. 
   
   "You feel like you're in the ocean without a life jacket," he says. "And I at least feel like I have a life jacket on now." 
   
   After years of fighting her own heroin addiction, Kelly Clixby's life is on more stable footing. She's got her own apartment. She's regained custody of one of her five kids and she is working on her second marriage, although her husband is still battling his own addiction. 
   
   "I've really learned just to stay on my track and just keep trudging forward despite what he's doing," she says. "If he uses, I can't, no matter what." 
   
   And Beth Carey, for her part, thinks about her twin sister every day. 
   
   Chrystina Carey left behind two daughters. One is now 15 years old and lives with Beth's grandmother. Beth is raising the younger girl — Jazlen, age 3. 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   She calls Beth Carey "Mommy." 
   
   "When I first got her ... I was letting her call me Aunt Beth," Carey says. "And then after a while, she was going to daycare, and she would hear other people cry out for mommy. So she started calling everyone mommy, cause she didn't understand what that meant. 
   
   "And I knew that she needed to associate that word with someone." 
   
   Beth Carey is trying to look forward, but it's hard when so many other families in her community are also suffering the effects of heroin. Sometimes loved ones die, like her sister, and other times they just slip away. 
   
   Enlarge this image toggle caption Maddie McGarvey for NPR Maddie McGarvey for NPR 
   
   "They're just zombies at this point. They're just on a mission and lying and stealing and manipulating and cheating," she says. 
   
   "They're not the aunt or uncle or daughter or son or sister that you used to know. They're a shell of a person that used to be great."
target: – The Washington Post takes a look at the country's surging heroin epidemic by zeroing in on Pennsylvania’s Washington County, a place one local detective refers to as "ground zero" for heroin in the area. Last Sunday, in less than 70 minutes, eight heroin overdoses were recorded in the county of about 200,000 people. By a day later, that number had jumped to 16; by two days later, 25—three of which were fatal. As the Post notes, this period of time wasn't an isolated case but rather "an extreme example of what communities in parts of the country are enduring." In a Florida community earlier this month, 11 people overdosed on heroin in a 24-hour span, WKMG reported; this year, Cedar Rapids, Iowa, had seen 44 heroin overdoses by June 5, the Gazette reported; New Jersey saw 781 overdose deaths related to heroin last year, 101.5 reported. Just yesterday, NPR ran a story on Marion, Ohio, a small town whose police chief says that his team sometimes responds to as many as three overdoses in just one hour. One of the reasons heroin is booming: It's cheap—cheaper than the prescription drugs that, for some, start them down the road of addiction. And one of the reasons there are so many overdoses? Nowadays, the drug is even more potent. The US attorney for western Pennsylvania is one of a growing number of prosecutors who aren't interested in jailing users, the Post reports: "If they're using and trafficking, I prosecute them. If they’re just using, they need help," he says. But finding dealers—including any linked to fatal overdoses, who will be charged with homicide—is no easy task, as these days drugs are sold via cellphone or even, with more middle-class people addicted now, in unlikely locations like homes. The county's supervising detective sums up the "out of control" heroin problem: "I'd be glad to have the crack epidemic back." Click for the full Post article.