Merry Doerr has spent her whole life in the American farmbelt, a rural pocket of green tucked into the middle of Ohio. She's close to her family, living with her mother and 4-year-old daughter.
With her blond hair and blue eyes, Doerr embodies the classic American look -- and says she grew up with classic American values.
"When I grew up, my mom had raised me in Christian beliefs," she said, "and I knew ... right from wrong based on the Bible. I was a cheerleader. I had a lot of friends."
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But life is different now. Doerr, who is five months pregnant and preparing for her second child, is not like other young mothers. She's a heroin addict.
"I wake up at 4 o'clock in the morning, dope sick with my stomach in cramps and sweating," she said, describing the symptoms of heroin withdrawal. "I have to get up out of bed at 4 o'clock in the morning, and go and use. And then I go back to bed and I wake up a few hours later and have to go use again."
Doerr said she uses heroin to keep that pain at bay.
"This is what I need to be normal," Doerr said. "You know I have to do dope every day to be normal. If I didn't have my dope this morning, I would be laying in bed right now thrashing around and vomiting. I wouldn't be able to function. I need [heroin] to function every day."
'Snowing Heroin' in Rural Ohio
It turns out that in the rural heartland of Ohio, halfway between the big cities of Cleveland and Columbus, heroin is everywhere.
"I would say it's up to epidemic proportions as far as the heroin," said Dane Howard of the Huron County Sheriff's Office. "Everywhere you go, it's like it's snowing heroin."
People here say heroin is indeed blanketing the main streets of tiny towns such as Plymouth, Ohio, where Doerr grew up. Doerr's mother, Patti Case, a schoolteacher, said so many people in their town of 1,800 were addicted to heroin that she moved her family, hoping to distance her daughter from the problem. But they found that the problem stretched across the region.
"There's probably not a family here, not just Plymouth but the surrounding area, that hasn't been touched by heroin," said Charlie Doan, chief of the Plymouth Police Department. "I think a lot of that started with Oxycontin."
In the mid-1990s, OxyContin, the highly addictive prescription pain killer, was being widely abused in rural communities like this one.
"About a decade ago, OxyContin got a strong foothold here in this whole region" said Howard. "The dealers drove the price up."
Cheap and Easy
As the street costs of OxyContin rose to about $80 per pill, drug dealers introduced heroin, which provides a similar high for less money.
"Nightline" heard the same story over and over from addicts who started on painkillers and ended up hooked on heroin.
"I started out snorting Vicodins or Percocets," said one former heroin addict, who now works as an undercover informant for local police. "[I] eventually went to Oxycontins .[Heroin] was a lot cheaper and a lot better high than the Oxys."
The informant is now clean and asked that his identity not be revealed.
He assists police by cooperating in undercover drug buys. "Nightline" rode along with him and the police to Columbus, about an hour and a half away, where he buys black tar heroin directly from what he and police say is a network of Mexican dealers.
"The guys I get it from sell it in what's called balloons," he said. "Some of the guys sell it in actual balloons, but the guy I'm getting it from today, he wraps it in tinfoil. They still call it balloons because that's the street name. Typically, people get seven to 10 of these balloons for $100, or $20 apiece."
He later slipped into the dealer's car, and bought $100 worth of heroin while driving around a leafy, residential neighborhood in broad daylight. The informant said when he was actively using drugs, he would make this trip at least once a day, buying enough drugs to support his own habit and also to sell to other heroin addicts in his town.
'It's Like a Plague'
Doerr has been making that trek to Columbus for years. In fact, when ABC News first encountered her in July, she had just come back from a trip to Columbus with her on-and-off-again boyfriend. They have been shooting up together since they were high school sweethearts in Plymouth, Ohio. He asked us not to reveal his name.
"I mean, when I'm not using drugs, I'm a totally different person," he said. "Really, I mean when I'm on dope it's just like, it twists me inside out, and I just become a totally different person. I'm ruthless, I'm conniving, I'm a cheater, I'm a liar I'm ..."
"A thief," Doerr chimed in.
He said, "It's become an epidemic," describing the heroin abuse in his hometown. "It's like a plague, seriously. People I went to school with are no longer around, dead [or] in prison." He said he knows 17 people who have died from using heroin.
Later, the two shoot up, mixing a hard chunk of heroin with water and boiling it down into a dark, brown liquid that filled their syringes. Doerr struggled to find a vein that hadn't already collapsed, and as she looked for one, she showed us the bruises that cover her body, evidence of her seven-year heroin addiction
But she said she wanted help. And soon after that, Doerr was treated at a Columbus hospital in a detox program specifically designed for pregnant addicts.
The hospital got her off heroin using the drug methadone -- which is accepted as a safe method for pregnant women, and their unborn children, to wean their bodies off a narcotic. But there is no methadone clinic back at home for her to maintain that treatment.
The next time "Nightline" met up with her, in August, she was shooting up again.
Doerr said she resorted to heroin because she can't quit cold turkey.
"It's like food to my baby," she said. "It's like food everyday. That's why I'm saying it has to have it everyday. Just like I do.
"The fact that I've been using for seven years, each time you get strung out and each time you go through detox it gets worse and worse," she says. "And the fact that I'm using, you know -- the amount that I'm using a lot -- I've cut back half of what I was using. I was using six balloons a day. Now I'm using maybe three."
Detox Facilities Hard to Find
Total detox, Doerr says, is unbelievably difficult.
"I might make it to the second day and I'm just spazzing out and panicking. And the second day I'm trying to find a fix. I can't do it," she said. "People say, 'Well, if you love your daughter, you will shape up.' It's not really a question of loving my daughter. I'm a mother. I love my daughter as much as any mother could love their daughter. It's a matter of loving myself enough and doing what I have to do, you know? It's not a matter of how much I love her."
Doerr often contemplates if her decision to raise Riley, her 4-year-old, was wise.
"Sometimes I wonder if I shouldn't have given her up for adoption," she said, crying. "Because she has to see me come in and out of her life, and it's not fair. It's not fair. And it gets harder the older she gets. ... As a parent nobody wants that for their daughter."
Doerr's mom, Patti, has custody of Riley, and cares for her while desperately trying to find help for her daughter. But help is hard to find in the heartland.
Despite the rampant heroin abuse here, there is no detox facility in the entire county, meaning most addicts must wean themselves off of the drug at home. Experts say while heroin detox is painful, it's not usually dangerous in the way other drug withdrawals can be. So emergency rooms usually turn down heroin addicts looking to detox, because hospital supervision is rarely considered medically necessary.
For most addicts, staying clean after detox requires a long-term rehabilitation program. And many of those programs require insurance, something few addicts have.
As a result, jails have become makeshift detox centers. "When I get out I'm going to try and stay off it," said one Richland County Jail inmate in Mansfield, Ohio. "Because this is the longest I've ever went without using it. I mean I've tried to quit several times but I never went past a week, if I even made it that long. I've been in here since June 4. It's been over two months."
"[This] is the longest I've ever been clean," said Sue Mills, another inmate who had been without heroin for eight days since getting into jail. "They don't have any methadone clinics here. They don't have needle exchange programs. You can't buy needles in Richland County. So it's a neverending cycle of sharing needles and hepatitis. It's just a nightmare."
It's a nightmare not just for the addicts but also for local law enforcement, which is overwhelmed by the crime heroin has brought to their communities. They've seen it affect all kinds of people.
"It could be the person that you know played football in high school," Doerr said. "It could be the person next door. It could be, you know -- just everybody is strung out, you just don't know anymore. You hear everyday stories of, oh, this person, so and so is using drugs. You know mostly you hear about mothers talking to mothers, just so many of their kids. So many people my age are strung out. But even people my mother's age in their 40s are strung, too, it's caught them too."
'I Have No Life Right Now'
Doerr said she is desperate to break free of the grasp heroin has on her.
"I have no life right now," she said. "I try to maintain a halfway normal life where I go and get what I need and I come back and I take care of my daughter. But even now I'm not fully here.
"I am sick much of the time even when I have dope. I'm sick all the time. I sleep all the time," she said. "Seeing myself clean is not out of sight yet. [And] I can't lose that. If I lose that then I have nothing."
For information about how to help those suffering from drug addiction, please visit the Partnership for a Drug-Free America.