Prescription painkillers are often a pathway to heroin. A recent federal report found that four out of five new heroin users had previously used illicit pain pills.
That's how Nick Gore got hooked.
Gore said his childhood in suburban Bartlett -- 35 miles west of Chicago -- was normal. But in his early 20s, Gore developed a boulder-sized kidney stone that required multiple surgeries. And prescriptions to deal with the pain.
After a couple stints in detox -- and a couple in jail -- Gore took his first trip to rehab where he met a woman, a heroin addict. Soon, they started to date; he took her to a concert downtown and before he knew it, they were on the West Side of Chicago.
"We got off at Cicero and before I knew it, we not only bought our first bag of dope but we were snorting it,” Gore recalled. "It made me so sick, just throwing up. And I was itchy and disgusted but I got that warm feeling, like I was invincible...that euphoria that they talk about. And I wasn't addicted the first time I did heroin -- but I was hooked. It just hooked me.”
Soon, the nice hockey star from Bartlett was a twice-convicted felon. Gore stole to feed his habit, to continue chasing that first high. But he said he didn't feel much of anything -- just sick, cycling in and out of withdrawal -- until his second trip to rehab.
For the first time in his life, Gore said he started to feel things.
"I was being honest and it killed me, I was being honest about all the stupid shit I did and it killed me. Brought a lot more chaos into my life than into anyone else's because I took a butcher knife and decided to cut my Achilles tendon cause I just needed to feel something,” Gore said.
Now two years into his recovery, Gore doesn't want to see anyone else get caught up in the heroin cycle. He said he'd consider it a win if he can stop one person from trying heroin. So he shares his story at heroin summits in the western suburbs.
DuPage County Coroner Dr. Richard Jorgensen said the fight to stop the spread of heroin use has been a losing battle for much of the community. Forty-three people have died so far this year as a result of heroin, and Jorgensen said there are at least three other suspected cases, pending toxicology reports.
Jorgensen analyzed the last two years of heroin-related deaths -- the period when the numbers jumped well above the annual average. In 2012, there were 38 deaths, a dozen more than the previous five years. Jorgensen looked for a pattern, an explanation, perhaps a hot spot.
Jorgensen said if heroin users don't end up in the morgue, they will probably end up across the street with DuPage County State's Attorney Bob Berlin. That's why the two teamed up to spread awareness. They hold forums anywhere they're welcome: at schools, at local hospitals and community centers.
But Berlin said that getting people to show up and listen has been a struggle.
"We're dealing with the ‘not my kid syndrome.' Many parents unfortunately hear about heroin and they take the position ‘Well geeze, it's not my kid, I don't have to worry about this.' And we're trying to tell them it may not be your kid today but that doesn't mean it that it might not happen tomorrow,” Berlin said.
Berlin said he isn't interested in sending addicts to jail.
"Someone who's an addict, they're stealing money to support their habit, putting them in prison for a year or two years where they'll serve half the time and get out doesn't really solve the problem because they continue to do the same things if you don't treat the drug addiction,” Berlin said.
Non-violent defendants are still prosecuted for a felony but they're not incarcerated. They get counseling and regular drug tests. And if they complete the program, they're less likely to reappear in the criminal justice system. DuPage County's drug court is one of the most successful programs of its kind in the area. The typical rate of recidivism for felons is about 30 percent within three years. For drug court grads, it's eight percent.
But when it comes to drug dealers in DuPage County, the state's attorney takes a hardline approach. There is no drug court and no breaks.
"We are aggressively prosecuting those people that peddle the poison in our community,” Berlin said.
To Berlin, there is a clear, black-and-white difference between a user and a seller; but to Roosevelt University drug policy researcher Kathie Kane-Willis it's gray and problematic.
Oftentimes, she said, both are heroin dependent and both will engage in acquisitive crimes that enable them to buy drugs. And to avoid withdrawal. Kane-Willis hasn't just researched this issue, she lived it as a former heroin user.
"There were many times that I was delivering drugs because I was the one who had the time to cop drugs and so I would buy them and people would give me money, and I would give them the drugs; that's distribution, that's a sales offense. So was I a drug seller when I did that or was I a drug user or was I both? I was drug dependent," Kane-Willis said.
She said law enforcement is sending dependents mixed messages. On the one hand, they'll say it's not a problem that society can arrest its way out of. On the other hand, anyone caught selling drugs can expect a stiff penalty and some jail time.
The potential punishment can be especially harsh for anyone found to have supplied a fatal dose of heroin. In DuPage County, the charge is drug-induced homicide, a Class-X felony that carries up to 30 years in prison.
DuPage County has three-such cases pending. Nineteen-year-old Nolan McMahon was charged this past summer in the death of a 15-year-old Bartlett High School student. McMahon is accused of delivering the heroin that the other teen ingested before overdosing in his parents' home.
Dealers bear responsibility in these deaths, according to Berlin.
"The drug dealers know how dangerous these drugs are and how strong they are…and they need to be held accountable for what happens when people use these drugs and die, it's that simple. And that's the risk that they take," Berlin said.
But Kane-Willis said there's a greater and deadlier risk associated with the charge.
"I think every drug-induced homicide charge that is made sends a ripple through the using community to not call 911 and might result in somebody else's death,” Kane-Willis said.
Illinois's Good Samaritan Law protects anyone from prosecution for possession if that person has fewer than three grams of heroin and, in good faith, calls 911 to save the life of someone who has overdosed.
If the overdose victim cannot be revived, the law does not provide protection from a drug-induced homicide charge.
Kane-Willis said the general perception of the relationship between a user and a seller is misunderstood.
"It's not what people think; there's not someone lurking around the corner trying to sell you heroin...that's not what heroin use and purchasing looks like,” she said. "Generally, people are seeking it out, they're drug dependent; and to provide drugs to someone who is in withdrawal, I'll say this from my own personal point of view, is not an evil thing to do, it's an act of mercy. And so I think some of these cases, these are merciful people who are being charged with murder, and that's just wrong.”
Kane-Willis said it's important to understand that the victim and the perpetrator are very much the same kind of people.
Katie O'Brien is a WBEZ reporter. Follow her on Twitter @katieobez.