A man shoots up heroin behind a dumpster in Los Angeles. 
A man shoots up heroin behind a dumpster in Los Angeles.  - 
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The governor of Vermont, Peter Shumlin, gave his State of the State speech yesterday and devoted the address to a single issue, the heroin epidemic in his state. The number of heroin overdoses in Vermont has doubled since the previous year. Shulmin pressed lawmakers to increase the state's budget for treatment facilities, a much less expensive alternative to prison.

Vermont is not alone. Heroin use is on the rise in rural and suburban counties all across the U.S. In the latest federal survey of drug use found the number of people who used heroin recently nearly doubled to 335,000 in the last five years.

At the same time, the use of prescription opiates, like Oxycotin and Vicodin, has also risen. Prescription overdose is now the leading cause of death in at least 29 states, far larger than heroin. "That's a dramatic change over the last decade," says Jeff Levi , executive director of Trust for America's Health. "And that is reflected by the huge increase in prescriptions written for these drugs."

In response to the rise in prescription overdoses, the federal government and the medical community restricted access to prescription opiates. A secondary effect of that restriction says Levi, is that "many people have been turning to more accessible and less expensive approaches -- including heroin."

Dr. Christopher Jones heads the prescription drug overdose team at the CDC. His research found that many heroin users started on other opiates. "When you ask those people to report which drug they used first, about 77 percent of the time they say they used opioid analgesics prior to initiating heroin," says Jones.

The cost of the rise in heroin use is paid in a number of ways. Incarceration rates go up, crime increases, which lead to higher law enforcement costs, and ultimately there is the human cost. "I think about the families that are broken apart by this and the things that could have been," says University of Vermont sociology professor Andrew Golub.

He believes there is no single solution to solving the problem of addiction. "Each case is different, collectively they add to create a tragedy and loss of society, not just in crime, but loss of participation in community and economic sector."

According to the latest data available, heroin related deaths are up to just over 3,000. Still, five times as many people died from prescription opioids during the same period.

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Follow David Weinberg at @@randomtape