With heroin becoming cheaper than a six-pack and as easy to obtain as pot, police and prosecutors are turning to more aggressive tactics against the drug, dusting off little-used laws to seek murder charges against suspected dealers and provide for longer prison sentences.
Angry suburban parents are joining the effort, too. They've organized anti-drug rallies and founded organizations to spread the word about heroin in affluent areas where it is usually considered a distant, unlikely threat.
The more assertive approach is not entirely new to the drug war, but it's being adopted more widely and in more areas that have rarely been so bold _ comfortable residential communities.
"We are going to treat every overdose scene like a crime scene. We are going to treat every overdose as a potential homicide," said Stephen Wigginton, U.S. attorney for southern Illinois. "Heroin is the bullet."
Once associated with rock stars and inner-city junkies, heroin has become far more dangerous and accessible in recent years. Mexican cartels a half-decade ago created a form of the drug so pure it can be snorted or swallowed instead of injected, making heroin more appealing to teenagers and suburbanites who don't want the stigma of shooting up.
The extreme purity _ often 50 percent or higher _ means today's heroin is far deadlier than in the past. As a result, heroin deaths have spiked over the past few years in some parts of the country.
Few places have been as devastated as the St. Louis area, where the city and county reported 116 heroin deaths in 2010 and 194 last year. The increase was even more pronounced across the Mississippi River in Illinois' Madison County, where the death toll has climbed from just five in 2008 to 26 last year.
Part of the problem is availability.
"Heroin is easier to get than marijuana now," said Jim Shroba, the Drug Enforcement Administration agent in charge of the St. Louis office.
It's also cheap: A "button" of heroin _ enough for one person to get high _ can cost as little as $6.
In the St. Louis suburb of Troy, Ill., young Shannon Gaddis finished off a snow day last year by snorting heroin. The overdose killed her.
The death of the animal-loving high school cheerleader "put this issue sharply into focus," said Madison County State's Attorney Tom Gibbons. "It showed us this was really happening in a way that would have the most serious and unfortunate consequences."
About a year ago, St. Louis County police began warning of the drug's risks at heroin town hall forums, which were held in small meeting rooms. The response was so great that the gatherings now fill high school auditoriums. Similar meetings are being conducted throughout the region.
Authorities are also redoubling their efforts to get users into rehab. St. Louis County officers now provide a small card to everyone arrested for heroin with a 24-hour phone help number on one side and police contacts on the other _ in case they want to turn in their dealer.
But the most intense efforts are focused on heroin dealers such as Tavis Doyle of East St. Louis, who was sentenced to life in prison in August for providing the heroin that killed a man. Prosecutors say Doyle refused to let anyone call 911 after the victim collapsed and instead tried to revive him by putting frozen meat in his pants.
In the five years before Gibbons became state's attorney, Madison County filed just one case of drug-induced homicide. In the 15 months since, Gibbons has filed six.
Among those charged was 20-year-old Taylor Kennedy, who is accused of supplying the heroin that killed Gaddis. He's awaiting trial.
Gaddis was "like a lot of other victims and other young people that have gotten involved with heroin _ kids from good families and good schools, with seemingly a bright future ahead of them," Gibbons said. "But one step down the path to drug addiction can be the last step."
Parents are fed up and pushing back.
Marilyn Smashey of Lake St. Louis lost her son, Taylor Wade Green, to an overdose in 2009. She grieved for 18 months, then decided to join the fight, starting her own foundation called STL Heroin Help. She speaks out against the drug at community meetings, high schools and anti-heroin rallies.
Near Chicago, Brian Kirk also is working to warn parents of heroin's danger. He co-founded the Heroin Epidemic Relief Organization with another father who lost a son to heroin. The foundation is hosting an anti-heroin rally April 13 at Lewis University in suburban Chicago.
Matt Kirk first started sneaking cigarettes as a pre-teen, then moved to marijuana and prescription pills.
As for heroin, Brian Kirk admits missing the warning signs.
Matt, who played hockey since he was 5, gave up the sport midway through his sophomore year of high school. Brian Kirk dismissed carpet stains in the family's $300,000 home as simply careless spills by his son. Only after the teen died did he learn that the marks were actually from heroin-induced vomiting.
In the months before the death, the older Kirk recalled, his son was "always telling me he's sick," enough to routinely miss a day of school a week.
"I never put it all together," Brian Kirk said.
In April 2009, Kirk found his son dead on the basement floor at 18. Under his body was a drug needle.
"To this day, I still can't believe it," Kirk said.