BC-US--Heroin Across America,ADVISORY, US

Editors:

Long a scourge of the back alleys of American life, heroin is spreading across the country. The death of actor Philip Seymour Hoffman in February only underscored a problem many American communities already were combatting, the rising use of — and deaths from — heroin.

In the Cleveland area, heroin-related overdoses killed 195 people last year, shattering the previous record. Some Ohio police chiefs say heroin is easier for kids to get than beer. In Vermont, the governor devoted his entire State of the State speech this year to heroin, which threatens to overwhelm courts with related crime. And this month, Massachusetts' governor declared a public health emergency over heroin and opiate abuse, directing that first responders be equipped with an overdose antidote.

In a multi-part package of stories, photos and video, The Associated Press examines the personal and financial toll of heroin addiction and efforts to address the growing national concern.

HEROIN ACROSS AMERICA

On a beautiful Sunday last October, Detective Dan Douglas stood in a suburban Minnesota home and looked down at a lifeless 20-year-old — a needle mark in the man's arm, a syringe in his pocket. Fresh out of treatment, this man was Douglas' second heroin overdose that day. "You just drive away and go, 'Well, here we go again,'" says the veteran cop. In Butler County, Ohio, responding to heroin overdose calls is so common that the EMS coordinator likens it to "coming in and eating breakfast — you just kind of expect it to occur." A local rehab facility has a six-month wait. One school recently referred an 11-year-old boy. "There are so many residual effects," the sheriff there says. "And we're all paying for it." Heroin is spreading its misery across America, and communities everywhere are indeed paying. The death of actor Philip Seymour Hoffman spotlighted the reality that heroin is no longer limited to back alleys. The drug has spread to the country and suburbs, gripping postcard villages, middle-class enclaves and sleek urban cores. Police, doctors, parents and former users are struggling to find solutions and save lives. By Amy Forliti, Dan Sewell and Nigel Duara. 2,300 words. Photos. Moved in advance for print release on Sunday, April 6. Abridged version moved. Available online by 10 a.m. EDT April 5.

With:

— HEROIN-STATES, a glance examining the problem, via new statistics on use, deaths or treatment, in specific states. By Andrew Welsh-Huggins. Moved in advance for print release on Sunday, April 6. Available online at 10 a.m. EDT April 5.

— Also, glances of statistics in some individual states, to move on those state wires. UPCOMING at 10 a.m. EDT Saturday, April 5.

HEROIN-SEEKING SOBRIETY

NEW YORK — As the ranks of heroin users grow, increasing numbers of addicts are looking for help but are failing to find it — because there are no beds in packed facilities, treatment is hugely expensive and insurance companies won't pay for inpatient rehab. Some users overcome their addictions in spite of the obstacles. But many fail. In the course of Salvatore Marchese's five-year struggle with heroin, he was denied admission to treatment facilities again and again, often because his insurance company wouldn't cover the cost. Then one night in June 2010, a strung-out Marchese went to the emergency room, frantically seeking help. The doctors shook their heads: Heroin withdrawal is not life-threatening, they said, and we can't admit you. Marchese and his sister stayed up all night calling inpatient treatment centers only to be told: We have no beds. We'll put him on a waiting list. Call back in two weeks. Later that year, after a short stint in inpatient rehab paid for with public funding, Marchese would die of an overdose. By Meghan Barr. 1,600 words. Photos. Video. Moved in advance for print release on Monday, April 7. Abridged version moved. Available online by 10 a.m. EDT April 6. Video story about obstacles to treatment moving at 1 a.m. EDT, April 7.

With:

— HEROIN-SEEKING SOBRIETY-FACTS, glance of fast-facts related to treatment. Moved in advance for print release on Monday, April 7. Available online by 10 a.m. EDT April 6.

HEROIN-CODY'S STORY

AURORA, Ill. — Just out of Cook County Jail after being arrested with 15 bags of heroin, Cody Lewis had $11 in his pocket. Almost immediately, he spent $10 on yet another bag of smack, making the buy on the Chicago streets last May as he headed to a police station to retrieve his cellphone. He shot up in a grocery store parking lot, then continued on his way. By then, Lewis was a $100-a-day addict. Heroin was no longer fun. He needed it to get rid of the sweats and the shakes, the body cramps, the aches in his bones. "I had to use," he says, "to feel normal, like a regular person." Sitting in a coffee shop near his house in Aurora, an hour west of Chicago, Lewis speaks openly about his struggles, eager to offer an unvarnished account of the pain he caused himself and his family. By National Writer Sharon Cohen. 1,423 words. Photos. Video. Moved in advance for print release on Tuesday, April 8. Abridged version moved. Available online by 10 a.m. EDT April 7. Video story focusing on Cody Lewis' personal struggle moving at 1 a.m. EDT, April 8.

With:

— HEROIN-FIVE THINGS TO KNOW. Moved in advance for print release on Tuesday, April 8. Available online by 10 a.m. EDT April 7.

Also available will be two stories that moved earlier in the year. Time elements have been updated, and these will move Friday for use:

HEROIN-ANTIDOTE

CAMDEN, N.J. — As deaths from heroin and powerful painkillers skyrocket nationwide, governments and clinics are working to put a drug that can reverse an opiate overdose into the hands of more paramedics, police officers and the people advocates say are the most critical group — people who abuse drugs, and their friends and families. Supporters say the opportunity to save potentially thousands of lives outweighs any fears by critics that the promise of a nearby antidote would only encourage drug abuse. By Katie Zezima. 1171 words. Photos. Moving Friday for use anytime.

HEROIN-FENTANYL

POINT PLEASANT, N.J. — On an icy night in January, a man entered a grocery store here, walked past the displays of cake mix and paper towels, and went into the bathroom, where he injected himself with heroin. Hours later, the man was found dead in the bathroom with a needle still in his arm, authorities said. They believe he was one of more than 80 people across the country who have died after injecting heroin laced with fentanyl, a powerful synthetic opiate. As the number of people who use, and fatally overdose on, heroin has risen in recent years, authorities are seeing the return of an alarming development: heroin that, often unbeknownst to the user, is spiked with fentanyl. By Katie Zezima. 722 words. Moving Friday for use anytime.

INTERACTIVE:

An interactive tracking U.S. drug statistics over time will be available to interactive customers. Statistics include overall use, drug-related arrests, drug-related emergency room visits, treatment and state-by-state trends. Drugs studied include heroin, cocaine, marijuana and others.

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