Every time her son, Tod, relapsed, Maureen Barrett sat with him all day at a rehab facility, hoping she could save him.
Tod died last spring, after years of abusing opiates everything from heroin to oxycodone. His death left Barrett, of Davie, to mourn the third child she lost to drugs.
Years earlier, Palm Beach County resident Karen Perry sent her son off to college, not knowing hed gotten hooked first on oxycodone, and then something cheaper and stronger: heroin.
At some point, it became expensive to buy prescription pills, so he started buying heroin, she said, reflecting on her sons fatal overdose.
Following a statewide war against prescription drug abuse, there are early signs of growing heroin use as an alternative to opiate pills, which are becoming harder and more expensive to get.
In an analysis of drug-related deaths for 2011, the Florida Department of Law Enforcement flagged heroin as one of the years most harmful drugs. Heroin deaths statewide increased by 18.8 percent to 62.
Fifteen of those heroin-related deaths happened in Miami the second-highest number in the state, according to the FDLE report. Orlando was the first with 18 deaths. Fort Lauderdale had three.
Historically, heroin deaths statewide are lower than they have been in the past two decades. Deaths from the drug have been declining since a high of roughly 270 in 2001, according to FDLE data.
Still, experts say the recent increase is worrisome. Miami-Dade drug rehabilitation experts said they have seen a small but definite increase in patients who have switched from oxycodone or other prescription drugs to heroin within the past year.
When I ask my patients, they say, Yeah, I couldnt get oxycodone, and now Im using heroin, four or five bags, said Dr. Patricia Junquera, a University of Miami assistant professor of psychiatry and a doctor at Jackson Memorial Hospitals detox unit. I think more people are switching to heroin.
The change could mean big problems for Miami-Dade, which some doctors say is desperately lacking in detoxification facilities for the rich and poor alike.
There are only a handful of facilities in Miami-Dade County that provide detox services, both inpatient and outpatient, said Dr. Juan Oms, medical director of Miami Outpatient Detox, and the need is growing.
I think its desperate at this point, Oms said. There is so much opiates and heroin out there.
The trend is the result of changes to state law and crackdowns by law enforcement in recent years, in an effort to rid South Florida of its status as the pill-mill capital of America.
After the Florida Legislature realized the state was the focal point of a national prescription drug abuse epidemic, Gov. Rick Scott signed HB 7095 in June 2011, which put strict restrictions on prescription drug distribution.
The bill drastically cut back on who could dispense narcotics and expanded penalties for pill-mill operators.
If Florida was the focus of the pill-mill problem, Broward County was epicenter.
In 2007, the county had four pill mills. By 2009, that count had jumped to 130, Broward Sheriff Al Lamberti said. BSO mounted an effort to get rid of the pill mills, and three years later there were about 50 left, Lamberti said.
With some suppliers run out of business and laws preventing new mills from opening up, the price of pills jumped. Oms said the price of 30 milligrams of oxycodone jumped from about $10 to about $30 in 2012.
Some types of heroin are as cheap as $10 a hit, and addicts are going to pick the cheaper option without worrying about the painful detox process, said John Schmidt, founder of the Miami-based drug rehabilitation clinic Marvins Corner.
Dr. Paul Adams, attending emergency physician at Jackson Memorial Hospital, said drug trends are all about economics.
When theres no supply, he said, then all of the sudden you will fall back to other drugs, heroin being the standby.
JMH detox specialist Junquera said she saw the number of heroin patients increase by about 50 percent at her clinic during the first six months or so of 2012. She said she sees about 25 people a week for inpatient heroin detox.
Schmidt said he has seen a steadily increasing stream of heroin addicts at his center. He expects the problem, growing slowly now, to avalanche into a large-scale drug problem much like the nationwide prescription drug abuse epidemic.
For Barrett, she hopes people will take notice so addicts can get help before its too late, as it was for her two sons and daughter-in-law.
The need for help for the addicts, in terms of detox and recovery, has just risen tremendously, and of course we dont have the funds, she said. I tried everything. Everything. I cant tell you how many times my kids were in detox and rehab.