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Donald Rayfield, known on the street as 'Detroit', smokes crack cocaine in an underground storm drain on January 18, 2006 in Los Angeles, California.
Drug cartels are doing big business up and down the West Coast. When you travel by freeway, you’re driving a Silk Road of sorts for heroin, meth and cocaine.
This export industry is evolving. Drug experts say heroin is back on the rise, fueled in part by prescription drug abuse. And while the supply side of the business may change, the demand remains strong.
Heavy-duty prescription painkillers have something in common with heroin. They're both a type of drug called an "opiate" and the effect they have on people who get hooked is similar.
One difference? Heroin is usually cheaper and easier to get. That was true for Portlander Kevin Lehl. He said he got hooked as a teen when he was prescribed opiates to treat chronic pain.
"I was in love with it from the very beginning," Lehl said.
He says hunting for pills turned into a full-time obsession, and he eventually made the switch to heroin. It was everywhere.
"Once you're kind of like in this opiate world, you kind of know people that know people that know people," Lehl said.
Lehl said he's been clean since the beginning of the year. He's now taking community college classes in hopes of becoming a drug counselor. He's also found a new part of town to live in.
There’s an old joke that there’s a coffee shop on every corner in Portland. For Lehl, heroin was actually more convenient to get than coffee.
"In my old neighborhood, there's probably like seven people within a five block radius that sells heroin and pills," he said.
But unlike the fiercely competitive coffee market, drug experts say heroin dealers don't really need to advertise.
"They don't push their drug because this drug sells itself," said Lee Hoffer, an anthropologist who teaches at Case Western Reserve University in Ohio. His specialty is the heroin market. And he studies it the old-fashioned way. He just walks up to drug dealers and starts asking questions.
Hoffer said drug dealers generally rely on word-of-mouth advertising. Think of it this way: You move to a new town, "You're going to ask your friend, where's a good mechanic? Or what doctor do you use? This is how people find heroin dealers."
And after awhile, those dealers and other users become part of your social circle. That's what happened to Portland heroin user Linda Wickerham.
"Everybody kind of watches out for each other because they know what it's like to be sick when you don't have your heroin," Wickerham said. "And so even if I have a little bit, I'll share it with my other two friends because I know what it's like being sick."
Wickerham didn't come to heroin through prescription painkillers. An acquaintance offered her a dose about four years ago.
"I tried it once and have been on it ever since," she said. "I can't stop. It's hard."
I met her at a clinic run by Oregon Health and Science University that tries to help people addicted to opiates. Wickerham said she's come here about a half-dozen times in an effort to shake the habit. But it’s not going so well.
I ask her when was the last time she used.
"Today," she said. "Today I used."
Wickerham said she'd really like to quit. But going without heroin has proved to be just too difficult.
"If I don't use I'm going to be sick and that's a whole new different ballgame there," she said. "You can't even imagine what it's like when you don't have your heroin how sick you get."
And in a nutshell, that's why the business of selling heroin is so brisk. Dr. Amanda Risser of OHSU said addicts routinely tell her that trying to quit involves a willpower they just don't possess.
"The withdrawal syndrome is so awful and so, I mean when folks describe how they feel when they're in withdrawal, people really do feel like they're going to die," RIsser said.
But for many users, the withdrawal symptoms aren't the only thing standing in the way of quitting. They actually like the drug, said Caleb Banta-Green. He's a researcher at the University of Washington's Alcohol and Drug Abuse Institute.
"People begin wanting heroin more than they care about food and drink and love and things like that," he said.
And Banta-Green said dealers know how to tap into that addiction. Like any good salesperson, they offer discounts to keep their best customers happy.
"The issue with heroin is that most people who use heroin use pretty regularly," Banta-Green said. "They might use easily 20 days out of the month, so having a regular steady customer might be worth selling for a little bit less, because you're really working on getting repeated sales."
For Wickerham, the worst part about her addiction is the guilt she feels about allowing the drug to separate her from her family. She said she rarely sees her two daughters and her grandson because using heroin has thrown her life into chaos.
"People say 'you must not want to be with them that bad because you're still doing heroin,'" Wickerham said. "But it's not like that. It's not that easy. But for me that is my rock bottom, not being with them every day. Because either I'm by myself or with my friends that do heroin. And that's not the kind of life I want."
But it's the kind of life heroin producers and dealers want her to have. Because Wickerham and countless other addicts are the ultimate consumers: The kind who can’t stop buying the product even when they don't want it anymore.