Christopher Cook started snorting heroin at age 17 while living in New Castle, Pa., about an… Christopher Cook started snorting heroin at age 17 while living in New Castle, Pa., about an hour north of Pittsburgh. Four years later, Cook was injecting heroin as often as he could without dying.

“It’s like complete isolation, degradation,” Cook said. “There’s nothing. You feel empty. There was nothing left. I would’ve been fine living under a bridge as long as I had enough heroin to shoot.”

Heroin addiction is a disease that has increased in the Pittsburgh area at an alarming rate – particularly among adolescents. The addiction penetrates all socioeconomic backgrounds, but surprisingly, recent trends demonstrate a growing number of users living in the city’s affluent suburbs.

“I know of seven students, and we only have 1,400 all together,” said Jennifer Bowers, a guidance counselor at Pine-Richland High School in Gibsonia. “Seven years ago I had my first case. It has risen steadily since then from one, to now, with three, four, five a year, and they are just the ones seeking help.”

The number of teenage heroin addicts increased 1,000 percent in the past 10 years according to Neil Capretto, the medical director of Gateway Rehabilitation Center, located throughout southwestern Pennsylvania.

Capretto said that over the past six years, Gateway experienced a 600 percent increase in heroin addicts. The number of teenage users has also increased from five to 10 per year to 200 to 300 per year. Seventy percent of the teenage patients were from suburban areas outside of Pittsburgh, and 90 percent were white.

“People think it can’t happen there. It’s happening in places like Mt. Lebanon, Fox Chapel and North Allegheny school districts,” Capretto said. “It just started, and it has not slowed down at all.”

The heroin that is being purchased now is purer than it was 20 years ago, according to Capretto. The higher purity allows users to sniff it. More than 99 percent of the patients Capretto has worked with started by snorting heroin because it is more sociably acceptable than injecting it. Still, most addicts eventually switch to injecting the drug intravenously to get a faster high.

Cook, who is now a recovering addict and counselor at Gateway, said that he started like most users. At the age of 11, he began drinking alcohol and smoking marijuana. By 13, he progressed to cocaine, opiates in pill form and OxyContin – a prescription painkiller similar to morphine. By 17, he graduated to snorting heroin.

“That’s just the natural thing. It has less of a social stigma to it,” Cook said.

But he could not quit. And there was no stronger drug to which he could “graduate.”

“Heroin is usually the end after all other drugs,” Cook said. “Heroin is just cheaper than pills and stronger. You’re already taking OxyContin every day. It’s going to be attractive to any using person.”

Cook’s jump from OxyContin to heroin is all too common. At the least, Capretto said that he has talked to nearly 1,000 heroin addicts who were originally using OxyContin. What he has learned is that drug dealers have targeted adolescents with “innovative” sales techniques.

Heroin is usually sold in bags the size of a dime, with cartoon stickers like Scooby Doo or Superman on them, he said.

Last June, a bag labeled “Get High or Die Trying” was mixed with fentanyl, a synthetic narcotic used primarily by cancer patients and those in chronic pain. The mixture killed nine people in Allegheny County.

“After someone dies, you’d think people wouldn’t want it,” Capretto said. “Instead, people using say, ‘I want to try it.'”

At Allegheny General Hospital, emergency room visits related to heroin increased from about 200 to 350 over the course of seven years, according to Fred Harchelroad. He is the chairman of the department of emergency medicine and the director of the medical toxicology center at Allegheny General Hospital.

But despite the increase hospitalization because of illegal drug use, the police have not added officers.

“An increase in users doesn’t mean an increase in manpower,” Lieutenant Herald Cline, head of the narcotics unit for the Allegheny County Police, said. “We need to work with what we have.”

Cline said that the police have seen a large number of heroin cases in all the suburban areas surrounding Pittsburgh. Although officers work under cover to arrest the dealers, arrests are often time consuming and difficult.

“We made an arrest that recovered 11,000 stamp bags of heroin last year in an eastern suburb,” Cline said. “It takes undercover detectives months to work their way up and make arrests.”

Pittsburgh isn’t the only area where heroin has crept out to the suburbs. Darlene Munter, a counselor at Seabrook House, estimates that 95 percent of her young men’s group is addicted to heroin. Their ages range from 18 to 24, and most live outside of Philadelphia.

Mental health issues are byproducts of addiction.

“They no longer feel pleasurable moments,” Rodger Green, who works for student assistance programs in Pittsburgh city schools, said. “The brain no longer functions. They stop eating because they are not interested anymore. One thing that parents look out for is, do their kids no longer do the things they enjoyed anymore? They just need a hit of that drug.”

Some adolescent users identify themselves by their drug habits.

Eventually the addiction starts to control the user. When withdrawal sets in, the addict experiences weight loss, body aches, vomiting, other flu-like symptoms and sometimes severe mental health problems, Capretto said. The only cure to the symptoms is more heroin.

Heroin addiction is usually physically debilitating. According to Capretto, a user risks blood clotting, death from respiratory depression while overdosing and contracting HIV and hepatitis B and C, just to name a few. It also can lead to criminal activity and a loss of all self-respect.

“At that time, you don’t care at all,” Cook said. “Now looking back at it, it’s amazing I don’t have hepatitis or HIV. Incredible.”

Once a drug user becomes addicted, he or she is an addict for life.

According to Cook, curing this disease requires an expert on addiction along with a recovering addict counselor and a supportive community found through Narcotics Anonymous. Cook said that all three facets of recovery helped him quit.

“When all three are working together, it is a great thing,” Cook said. “That’s the best way to treat an addict.”