The Center, also based on anecdotal reports from local law enforcement, says heroin use is growing outside the Northeast, where the drug has traditionally been a problem, and into areas such as Appalachia and Ohio. Law enforcement agencies in areas such as Maine, Alaska and Wisconsin told ABCNews.com that the drug is growing in popularity.
"Unfortunately, 18 to 26 is our big target audience," said Dave Spakowicz, a special agent at the Wisconsin Department of Justice who heads the Milwaukee High Density Drug Trafficking Heroin Initiative. "The price of Oxycontin has doubled in the last year and a half in the Milwaukee area. People are moving to heroin."
Nationwide, the number of people who said they used heroin in the last month grew from 119,000 in 2003 to 338,000 in 2006, the latest years for which statistics are available, according to the National Survey on Drug Use and Health. In 2006, 3.7 million Americans said they had used heroin at some point; about 60,000 were under 18.
While use of most illicit drugs by 8th through 12th graders is down, heroin use has remained steady over the last several years, with roughly one percent of high school students saying they had used the drug in the last year, according to the Monitoring the Future Survey. After a boom in heroin use among high schoolers in the last decade, the numbers have dropped since 2000.
But in some areas, particularly in the Northeast, the numbers are higher. Nearly twice as many New Jersey young adults admitted to using heroin at some point than the national average, according to national surveys. Similar results have been reported in Connecticut and Massachusetts.
"Heroin used to be thought of as a drug of the poor, in depressed areas," said Anthony Marotta, assistant special agent in charge of the DEA in Columbus, Ohio. "Here, it's across all lines. We have everything from well-to-do affluent areas to depressed housing."
Aside from the reduced cost, law enforcement experts say the increased purity of the drug is contributing to its prevalence. Kids are more apt to try the more potent drug, several times more pure than the drugs coming into the country in the 1970s, because it can be snorted or smoked, rather than injected.
"When you can snort it and you're already snorting other drugs, it becomes no big deal," said Lt. Chris Martin of the Brewer, Maine, police department.
The path from prescription pills to heroin was a common one among teens at the Daytop residential treatment center in Mendham, N.J., said Brian Gamarello, the clinical director. "Why am I taking 10 pills when I can do a bag [of heroin] and get 7 or 10 times as high?" Gamarello asked.
Dale Freeman said he didn't think much of it when a doctor prescribed Oxycontin for his daughter after she fell and fractured her tail bone.
But, after her treatment had dragged on for more than a year, Danielle was hooked to the powerful painkiller, Freeman said. "Two weeks after her surgery, her back was fixed," he said. "But her Oxy problem wasn't."
With her prescription having run out and pills running as much as $80 each on the street, Freeman said, Danielle, a one-time "A" student from a stable family, turned to heroin.