It starts out innocently enough. An old weightlifting injury, a minor surgery, a swatch of chronic pain in your back. A prescription from your doctor with a name full of consonance: Percocet, Vicodin, OxyContin. You shell out the copay, pick up the meds, and take them, because you trust your doctor and his degrees. You trust the pharmaceutical industry, and the government agencies tasked with keeping the companies in check. And most importantly, you want to feel better, to live without pain.

For thousands of Americans these are the first steps down a slippery slope, a path upon which innocent lives suddenly descend into narcotic abuse. The transition from pills to powder to needles might seem extreme from the heights of our ivory tower, but for those trapped in the iron grip of opiate addiction, the progression is all too real.

A 2016 report from the American Society of Addiction Medicine (ASAM) found that four in five new heroin users started out by misusing prescription painkillers. The same report stated that between 1999 and 2010, sales of prescription painkillers quadrupled. So did the overdose death rate between 1999 and 2008. ASAM also reported that there were 18,893 overdose deaths related to prescription pain relievers in 2014. A study from the Centers for Disease Control (CDC) found that one person dies from prescription drug abuse every 19 minutes. That is almost three deaths in the amount of time it takes you to sit through your shortest class.

This is a nationwide epidemic, and Pennsylvania is no exception. In Pennsylvania during 2014, overdose deaths were occurring at 14 times the rate they did in 1979. As of Aug. 30, Northumberland County, Pa. suffered has suffered 20 overdose deaths this year, right in our own backyard. On a single Wednesday night in Harrisburg, Pa. this summer, police reported 15 hospitalizations for heroin overdoses. The issue has reached such a critical point that the Pennsylvania Department of Health has provided grants for public schools to obtain overdose reversal medication, fearing for the safety of the student body. Ten of the 15 public school districts in Beaver County, Pa. are now stocking their nurse’s offices with naloxone, the live-saving anti-overdose opioid blocker. This problem is not going away anytime soon.

It is easy to think of heroin as a dirty street drug, found only in alleyways and dive bars.  Most people cower at the mere thought of willfully injecting anything but a vaccine into their bloodstream. So how do so many average consumers become addicts? The answer is simpler than you would imagine.

Medication is expensive, and an honest doctor will only write you so many prescriptions.  A single 40mg capsule of OxyContin costs $4 when purchased legally, and the street value is much higher. While the price varies depending on location, and questionable purity is always a factor, heroin is generally much cheaper. The short-lived opiate high only becomes more desirable, until it stops being a want and evolves into a need.

In some cases, addicts actively seek strains of heroin known to cause overdoses, because that speaks to the purity and strength of the product. Where you once used opiates to feel good, you now must use them to feel normal and to function, to avoid the same chronic pain that put you in this situation. The problem with chasing euphoria is that it is difficult to know when to stop.

What do you think? It is true that drug addicts make a conscious decision to use drugs.  The blame rests on their shoulders, among other factors like the environment, socioeconomic status, and the media. How many mistakes are we allowed to make before we stop deserving forgiveness and assistance? Should your tax dollars fund state rehabilitation programs, or should addicts sort out their own issues?

Before you answer, consider this: what if it was someone you loved?