The fact that abuse of OxyContin and other pain-killing opioids is a major public health concern and in some cases is leading people to heroin addiction cannot be overstated, said Robin Rothermel, director of the Pennsylvania Bureau of Drug and Alcohol Programs.
"We see a lot of people, because of accidents or surgery, being prescribed OxyContin or Vicodin, [becoming addicted] and finding it's easier and cheaper to go out and buy heroin." At $10 a bag, heroin is far cheaper than the $80 street cost for an 8 milligram OxyContin pill.
The most significant increases in such drug abuse have occurred in suburban and rural areas, she said.
"I think slowly -- more slowly than we would like -- people are beginning to see the seriousness of this problem, and the fact it is not an inner-city issue," she said. "It doesn't matter what your role in society is, drug abuse has an impact on you."
Drug abuse is estimated to cost the nation more than $193 billion a year in public costs related to crime, health and especially productivity, according to the 2011 National Drug Threat Assessment by the National Drug Intelligence Center headquartered in Johnstown.
The NDIC study found a rise in heroin availability, created by increased production in Mexico. That and an increase in purity levels to historic highs have resulted in a jump in heroin-related overdoses in more than 60 U.S. counties, including Allegheny, Indiana, Blair and Dauphin in Pennsylvania.
Recent news stories illustrate the findings. On Sept. 21, state police arrested a pair of Indiana County sisters, ages 30 and 27, for burglarizing four homes that month and taking televisions, guns, money, credit cards, computers and jewelry to feed their heroin habits.
The next day, two Pittsburgh brothers were arrested on charges of distributing more than $1.5 million of heroin in the region over the past year.
Ms. Rothermel said the state must focus on prevention and treatment of the problem. As part of that strategy, an attitude shift must occur, she noted.
"We're continually trying to dispel the stigma that unfortunately goes along with substance abuse. These people did not wake up one day and say they wanted to become addicted to opiates, just like someone doesn't decide to get cancer or to be a diabetic.
"Just like it's said it takes a village to raise a child, it takes a community to promote recovery. That's a big key.
"Sometimes it's easier to see the problem somewhere else than your own community or your own home, and work needs to be done with parents, telling them that this can happen to your child," she said.
Robert N. Breit, a South Hills pediatrician, agreed. He said he encounters increasing numbers of "completely shocked" parents coming to him with concerns that their child is on drugs.
"They're devastated; it's not something they ever expected from their child," Dr. Breit said. "Certainly availability is a big problem. I think also it's something so quiet, it's hidden, and people can't come together as a community to do something about this."
Dr. Breit, who has a family member who was addicted to heroin, said he suspects his hometown of Mt. Lebanon and other upper-middle-class communities are reluctant to talk openly about having drug problems.
"I was just as complacent as everyone else a few years ago, thinking that it wasn't happening here. It was very foolish.
"I do worry about image as part of this. If property values are part of why schools won't discuss it and why the community isn't more open about this problem, then those kids who do become addicted are just viewed as acceptable losses."
Dr. Breit noted that several years ago when MRSA, a contagious staff bacteria, was discovered in Mt. Lebanon High School, parents and the school district reacted swiftly and decisively to deal with the issue. That same determination should be brought to bear on drug abuse, he said.
"We can't do anything unless we admit we have a problem."