The suburban youth drug culture is graduating.
Marijuana, alcohol and the occasional acid trip are being replaced by powerful painkillers and the drug blamed for more local overdose deaths: heroin.
"It's in your backyard. You just don't know it," Chad Sabora said.
Sabora is a recovering heroin and painkiller addict who lives in south St. Louis County and lived, rehabilitated, relapsed and rehabilitated again in the metro-east. He grew up and became a drug addict in Chicago -- while serving as a prosecutor for Cook County.
The 35-year-old knows the youth drug culture. He lived it as a teen in the 1990s, doing everything from crack to heroin. He took a hiatus from recreational drugs in his college years, but became addicted to sleeping pills after a prescription for insomnia in law school. He fell back into addiction around age 30 after his father and mother each died within a year.
Heroin addiction was his living hell.
"You wake up every morning dope-sick if you are out of dope."
Being dope-sick means diarrhea, hot and cold flashes, vomiting and insomnia, said Brian Muller, a recovering 24-year-old drug addict from O'Fallon.
"It's not that they're getting high. They're getting well," Muller said.
Muller and Sabora escaped.
Muller said he has been to at least 10 funerals this year for friends who died of drug overdoses. Since the beginning of 2008 there has been a spike in local heroin deaths.
Many of these overdose victims were youths, a couple as young as 17. Roughly a third of all drug overdose victims between 2006 and 2010 in Madison and St. Clair counties were 35 or younger, according to coroners' files. Almost 70 percent of their deaths were caused by drugs known as opioids, which include heroin and prescription painkillers such as oxycodone, morphine, methadone and hydrocodone.
Amy Warren, the clinical supervisor at Gateway Foundation Alcohol and Drug Treatment in Belleville, where Muller was treated for substance abuse, has seen the abuse of heroin and painkillers increase the past seven years.
"There is just a tremendous increase in heroin use and opiate use overall," Warren said.
Gateway's heroin patients tend to be middle class, white and 25 years old and younger.
"It's our next-door neighbor," she said.
Muller is that next-door neighbor. He is confident and articulate and has the sturdy body of someone who has been working in manual labor, even through his addiction, since he was 13.
Muller grew up and lives in O'Fallon, where his divorced parents provided what he described as a stable home life. His drug friends were from all parts of the local suburbs, including Belleville, Edwardsville, Shiloh and across the river in south St. Louis County.
Muller started with marijuana and progressed to hallucinogens. By his sophomore year, he was taking prescription pills.
Muller and his school friends would trade drugs. One person would have a pocketful of Vicodin, someone else a pocketful of Xanax.
"We weren't dealers," he said.
Muller didn't get into heroin until after high school.
"I wasn't getting high to get away from (stuff)," he said. "I was getting high because opioids felt good. Once you get that high, you're hooked. That's it."
But that high became harder and harder to maintain and turned into something less desirable: a never-ending quest not to be dope-sick.
He paid $5 a pill for Percocet, a drug that is a combination of acetaminophen and oxycodone. As his tolerance increased, so did the cost of his habit. He needed $50 worth of pills when before $10 would do it.
So when his normal dealer in East St. Louis wasn't there one day and another dealer offered him a line of heroin to snort for $10, he did the math and some reasoning.
"An opiate's an opiate," he said.
The painkillers were similar to heroin, except for one thing: "(Heroin) was the same high times 10. It was so much better," Muller said.
Muller's rationales are what is driving up heroin use and overdoses in the area, according to law enforcement officials. It's not just in the metro-east; the city of St. Louis has recorded at least 63 heroin fatalities each of the past two years after not topping 38 in the previous eight years, according to the St. Louis Office of the Medical Examiner.
Since 2008, Mexican drug gangs have marketed a purer form of heroin in the United States, according to Harry Sommers, the special agent in charge of the Drug Enforcement Administration's St. Louis Division. The consequence has been that a drug, which since the 1970s had been used by a stagnant minority of addicts who injected it, has grown in popularity.
"Now the heroin is very usable without injection," Sommers said.
Not to say addicts won't eventually get around to injecting heroin. Muller said he got to the point he was injecting heroin in between his toes so people couldn't see the needle marks.
Shooting up provides a faster and more intense feeling than snorting or smoking the drug. Heroin users feel the effects within seconds if they inject it into a vein, a minute if injected into a muscle and about 15 minutes if they ingest the drug orally, said Illinois State Police Master Sgt. Joe Beliveau, who oversees the Metropolitan Enforcement Group of Southwestern Illinois.
Sommers said addicts in the metro-east can get heroin from two main sources: Dealers at an "open air market" in north St. Louis and north St. Louis County and Mexican gangs from Chicago that sell in the metro-east.
Beliveau has his own evidence supporting an increased prevalence of heroin. In 2010, MEGSI seized 11 times more heroin than in 2006.
The most commonly found heroin in the metro-east is "Mexican heroin," Beliveau said. It is usually brought over from Missouri and sells for $100 to $150 per gram.
A personal use amount, dubbed a "button," is a tenth of a gram and costs $10 to $20. Many heroin dealers are also users, making the drug difficult to find in the area and causing buyers to purchase in small amounts, Beliveau said.
Muller said he sold heroin himself in the metro-east to pay for his own habit, which grew to $200 to $300 per day. He also went to the north St. Louis neighborhoods that Sommers cited. He said 20 to 30 dealers would be on a corner selling the drugs.
From pills to smack
Like Muller, Sabora said he switched to heroin after first abusing prescription drugs. Nobody starts on heroin, he said.
"We all said we would never do heroin."
Pill users switching to heroin are asking for trouble, he said. They don't know what they are buying and could easily take too much.
"These kids have no idea what they're putting in their arms," Sabora said.
Dr. Wilson Compton, director of the Division of Epidemiology, Services and Prevention Research for the National Institute on Drug Abuse, said pill users have shifted to heroin because they could not obtain prescription pills or the pills became too expensive.
"That is a new phenomenon," he said. In the past, heroin addicts would sometimes seek pills if heroin were not available, he said.
Beliveau has seen the same trend on the streets.
"A lot of the people we run across have been prescribed pain meds," Beliveau said. "Then they exceed the prescribed amounts and it's not working anymore, so they use more and it gets costly."
Beliveau has another theory for the local rise in heroin use. He believes it is a byproduct of the state's crackdown on methamphetamine.
Heroin was popular in the metro-east in the late 1990s, but not a huge issue as far as overdoses because it wasn't as potent, Beliveau said. By 2002 heroin users had switched to meth, which could be made cheaply at home. The trend reversed in 2005 when Illinois implemented stiffer penalties for meth-related offenses and threw more law enforcement resources at the problem by forming seven meth response teams.
New laws put nasal decongestants made with pseudoephedrine, an ingredient sought by meth makers, behind the counter at pharmacies and required customers to show a driver's license and be recorded in a state database.
"Since 2005, it's been an increase in heroin again," Beliveau said. "Now meth users have turned to heroin. In the last two years, we've seen more heroin cases than in the last six years. That's the only thing I can attribute it to."
The spike in fatal heroin overdoses could be attributed to several things, Beliveau said. Some have said current strains of heroin are cut with bad ingredients or are more pure and potent.
Combining heroin, painkillers and other drugs that depress the nervous system can be deadly, according to Dr. Christopher Long, director of forensic and environmental toxicology at the St. Louis University School of Medicine. Alcohol with drugs is a big killer, Long said.
Most fatal overdoses in the metro-east were because of a combination of drugs.
"Some people are able to do it," said Long, whose lab conducts toxicology tests for local coroners' offices. "And other people make mistakes. We see the ones that make mistakes."
Just because Sabora, the former prosecutor, isn't dead doesn't mean he hasn't paid for his addiction.
His law license was suspended in 2010, two years after his arrest for heroin possession. Addiction also ended his engagement and cost him friends and family.
He said an opiate addict will lie, steal and cheat. They transform into somebody they never thought they could be.
"It completely destroyed my soul," Sabora said.
Treatment saved him. Heroin addicts must find a new way to live and find something spiritual in their lives, he said.
"I hope people start understanding this is a disease, not a moral deficiency," he said.
Pressure from the justice system and law enforcement led Muller to stop using heroin.
Three years ago, he was arrested for heroin possession in north St. Louis after he had just scored the drug. While on probation, he failed five drug tests after testing positive for drugs he said he was prescribed for legitimate medical issues. He was told by the judge he would be sent to prison if he didn't clean up.
He decided to quit, but on the way to rehab shot up heroin one final time.
"I knew it was my last time," Muller said.
Muller recently completed treatment at the Gateway Foundation and got off probation.
He hasn't relapsed this time because he is afraid his tolerance is so low that he will die if he shoots up again.
The only drug he takes now is Xanax for post-traumatic stress disorder. He gets panic attacks constantly from his drug experiences.
"I have had friends OD in front of me," Muller said.
He has replaced his addiction.
"I jog a lot," he said. "It's still an addict thing. I'm still jogging to get that runner's high."