For many Hoosiers, the crisis of opioid and heroin abuse has come as a surprise and a mystery.

Heroin used to be a drug used chiefly in the worst slums of major cities.

Today, the typical heroin user may be a white, middle-class young person between the ages of 18 and 25. Experts say heroin use has been increasing in recent years among men and women, most age groups and all income levels.

The rise in heroin abuse goes hand-in-hand with the explosion of addiction to opioid pain pills — drugs such oxycodone, hydrocodone, and methadone, often known by brand names such as OyxContin and Vicodin.

During the new century, the volume of prescription opioids sold in the United States has increased by nearly four times. Deaths from those drugs has grown at the same alarming rate.

At a town hall meeting last week in Auburn, state legislators expressed shock when learning that in the most recent reports for Indiana, doctors wrote 109 painkiller presscriptions per 100 persons — more than one for every Hoosier — in the course of one year.

Indiana among the 13 states with the highest levels of opioid prescriptions.

As a result, Indiana is one of the top dozen states for opioid dependence — higher than 1 percent of people age 12 and older.

Opioid pain drugs often wind up in the wrong hands. A friend or relative shares unused pills from a prescription, or sells them, or they are stolen.

When teenagers take pain relievers without a prescription, one study shows they have nearly a 50 percent chance of becoming addicted.

Four out of five new heroin users started out by misusing prescription opioid painkillers. Why do they turn to heroin? In a 2014 survey, 94 percent of heroin users said they switched to the drug because prescription opioids were far more expensive and harder to obtain.

Technically, heroin is an opioid, too. It differs because it is completely illegal, while opioid pain medications are legal when used properly with a prescription.

All opioids react with the brain and nervous system to produce pleasurable effects and relieve pain. Over time, it takes more opioids to get the same effects.

To make matters worse, along comes Fentanyl, a drug 50 times more potent than heroin. Illegal suppliers mix Fentanyl into the heroin they sell, making it more potent, but often making it deadly.

Add up all those factors, and every day across the nation, emergency rooms are filling up at unprecedented rates with people who have overdosed on drugs.

State legislators are struggling to find answers. The Indiana Senate alone is considering 20 different bills dealing with drug problems.

“We’re looking at every little angle we have,” said Sen. Dennis Kruse, R-Auburn.

One proposed solution calls for building a new, 150-bed mental health hospital in Indianapolis. That will put a small dent in the numbers of addicts.

Other addicts will need to be treated in their home communities. Another bill would provide $185 million over two years for addiction treatment and rehabilitation across the state.

“We have to treat them,” Rep. Ben Smaltz, R-Auburn, said about addicts. “Otherwise you lock them up, and they come out and they’re addicted.”

State leaders are coming to the realization that this newest drug crisis cannot be solved only with a crime-and-punishment approach.

“We need to find some way to save some of them,” Smaltz said about Hoosiers we are losing to opioids. It won’t be easy, and it won’t be cheap, but Hoosier leaders seem ready to get serious about the effort.

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