WESTMINSTER, Md. (AP) — It's a fight Carroll knows all too well, a struggle against a typically white or brown powdered substance that presents itself as a euphoric high and a warm sensation throughout the body.
Fifteen years ago, a group of residents banded together in an attempt to decrease heroin usage in the county. They made a 35-minute film titled "Heroin Kills." They grabbed national attention as grieving parents appeared on ABC's "20/20" news program and "The Oprah Winfrey Show," sharing the story of how their children became addicted to heroin, some of whom overdosed and died. And they watched as it seemed their campaign worked.
But now that Carroll's heroin-related overdose deaths jumped from two in 2011 to 13 last year, it appears the drug is back.
Officials are worried that the substance they worked so hard to combat has risen again due to a crackdown on prescription pill abuse. It's a trend local and state health and law enforcement officials have seen, as well as those who operate treatment centers and sober homes within the county.
"When I get a call from treatment centers or the hospital for guys coming in, if they say they're 18 to 25, I literally say, 'Heroin, right?'" said Tim Weber, who owns two local sober homes. "That's what they say, almost every time. It's always heroin or (oxycodone) pills."
About half of the clients at The Shoemaker Center — a detox and inpatient rehabilitation program in Sykesville — have a primary diagnosis of opiate dependence, according to program coordinator Meghan Graves. This statistic includes both heroin and prescription pills, and health officials said there's a reason why these two are interconnected.
Both are opioids. They have a similar high and a dose of either satisfies the same craving. This fact has led to the newest trend in drug usage: As painkillers become harder to find, users are moving to the next available product, which is heroin, said Kathleen Rebbert-Franklin, Maryland Alcohol and Drug Abuse Administration acting director.
This rise of heroin deaths in the county is on par with state trends, as heroin-related deaths saw a 54 percent increase, a jump from 245 in 2011 to 378 last year, according to the latest available Maryland Department of Health and Mental Hygiene data, as DHMH officials said statistics are released on an annual basis only.
Prescription opioid-related deaths increased locally as well, from five in 2011 to 17 in 2012 in Carroll, one of six counties to see a jump in this category. Comparatively, the rate declined almost 13 percent in Maryland, from 335 deaths in 2011 to 293 in 2012.
The reason behind the county's rise in prescription pill-related deaths isn't clear, said Sue Doyle, director of the Carroll County Health Department's Bureau of Prevention, Wellness and Recovery.
Over the course of 2013, Carroll added a unit in the county's drug task force specifically aimed at targeting the illegal resale of pharmaceutical drugs. And the tightening of the prescription painkiller market means the demand turns to a different drug, said Westminster Police Department Chief Jeff Spaulding.
"Now we're seeing people transition back to heroin because it's easier to get than to try to get illicit prescriptions," he said.
The price of heroin in the county fluctuates. The average hovers around $120 for a gram and $75 for half that amount, according to Steven Rogers, a Westminster Police detective assigned to the Carroll County Drug Task Force.
A prescription pill costs an average of $1 per milligram on the Carroll drug market and sometimes even more, depending on the seller, according to Rogers. For example, a 30 milligram pill that typically costs about $30 has been sold for about $35.
Anecdotally, prescription pills have become harder to come by for several main reasons, Rebbert-Franklin said. Police are monitoring pharmacies. Physicians are altering their prescribing practices. Residents are disposing of unused medicines at police stations. And the supply is dwindling in easy-access hotspots, said Linda Auerback, a Carroll County Health Department substance abuse prevention supervisor.
"You've got people who were stealing it from their grandparents', their parents' medicine cabinets, so eventually that had to dry up," she said. "They're already addicted, so what are they going to turn to? Heroin."
It's not hard to get, users and officials said. Hop in the car, drive about 40 minutes to Baltimore and ask around in the right neighborhoods — a recipe that worked almost every time for Sean O'Brien, a recovering heroin addict from Carroll who's been sober for more than 20 months.
"I got sold heroin, and that was it," said O'Brien, who used to make daily trips to Baltimore. "I found that it was a lot cheaper, and it did the job."
But, unlike a pill, heroin doesn't come with a label stating the exact dosage and how often it should be taken.
"They don't know what junk they're taking," Rogers said. "If one guy's got it, and they don't typically go to them, but the other guy doesn't have it, they'll call whoever. They're just rolling the dice."
And the unknown can cause an overdose if a user takes an amount that exceeds their tolerance, Rebbert-Franklin said.
Heroin — and its euphoric high, excruciating withdrawal and sudden overdoses — has become a vicious cycle both for the addict and for Carroll County.
It's a similar story as 15 years ago. Just the names and the faces have changed.
Information from: Carroll County Times of Westminster, Md., http://www.carrollcounty.com/