Sarah Wolfson is back on her horse.

Wolfson rode and trained horses throughout high school, but five years ago as an SIU student, Wolfson had an accident while riding, severely hurting both of her knees. To relieve her pain, she was prescribed Vicodin. Her doctor took her off the pain medication after a few months, leaving her in withdrawal.

Wolfson then took to the streets to find a new source of Vicodin, and after a while found it to be too expensive. She dropped out of SIU and became one of 4.2 million Americans who have used heroin at least once, according to the National Institute of Drug Abuse.

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Heroin, an opiate synthesized from morphine, is a naturally occurring substance found in the poppy plant. As of 2011, 23 percent of users in the United States are dependent on the drug, according to the NIDA.

According to a presentation Thursday at John A. Logan College, 90 percent of heroin consumed in the U.S. is from South America and Mexico.

No matter where it starts, there is an increasing amount of the opiate ending up in southern Illinois. Because of this, Centerstone, a behavioral treatment facility, decided to sponsor the event, according to Kathryn Sime, development and communications manager.

Centerstone, in Carterville, provides behavioral healthcare and addiction recovery programs. Wolfson receives treatment from Centerstone as part of her treatment.

Sime said she asked her colleagues what topic the conference should discuss and was surprised so many people said heroin and opiate addiction.

U.S. Attorney Stephen R. Wigginton, the event’s keynote speaker, said most users are similar to Wolfson by starting out using prescription drugs.

Wigginton, who serves the 38 southernmost counties in Illinois, has spoken to thousands of students as part of an anti-heroin initiative he started in 2011.

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He said there were 279 million prescriptions written in 2010 for opiate-based medications for 308 million citizens, according to that year’s census. From 1997 to 2007, there was a 402 percent increase in use of prescription opioids per person—from 74 milligrams to 369 milligrams.

“Nearly one [prescription] for every man, woman and child in America,” Wigginton said. “You tell me we don’t have a problem.”

Seventy percent of prescription painkiller abusers obtained the pills from friends or relatives, according to the National Survey on Drug Use and Health.

Since a cocaine shortage in 2008, Wigginton said heroin has become America’s most popular drug. Heroin was much cheaper than prescription pills, Wolfson said.

Wigginton said prescription drugs sell for about $1 per milligram, while heroin cost $100 to $150 per gram, meaning one gram of Vicodin can cost about $1,000.

“It takes a lot more pills to get the same high, so you can spend $300 a day on pills or spend $100 a day on heroin,” he said.

As part of preventing the drug from spreading, the Drug Enforcement Administration buys heroin to find how it is moving around. The DEA buys heroin 640 times annually in St. Louis, Wigginton said.

One thing the DEA has found is the purity of heroin has increased. In 2001, heroin had an average purity of 13 percent, which in 2013 increased to 43 percent, Wigginton said. The higher the purity, the higher the risk of addiction and overdose.

There were 310 heroin overdose deaths in St. Louis in 2011, compared to 65 heroin deaths in 2007.

“If you have 401 deaths from the flu, that’s a national crisis,” Wigginton said. “You would see the city shut down and the CDC come in.”

St. Clair County, just east of St. Louis, had 26 overdose deaths in 2013. Men made up 69 percent of those deaths, 77 percent of them were white and the average age was 42.

Even though a middle-aged man was the average heroin user in St. Clair County, one in five teenagers has abused prescription drugs, Wigginton said.

Heroin is moving its way east from St. Louis, which is why Centerstone hosted the event, Wigginton said.

Wolfson said she thought she had hit her rock bottom several times before she actually did. She woke up one day in a complete stranger’s home, with people shooting up around her. As she went to grab her purse and leave, she discovered it had been stolen, and with it the last bit of money she had.

“I just looked around and couldn’t believe this is my life,” she said. “This is not what I wanted. This is not what I had planned.”

The next day she was arrested for possession of a controlled substance and her lawyer helped her get into a rehabilitation program. Wolfson said she has been sober for three months, though she has had a few relapses in between.

She said horse riding is an escape and therapeutic for her. She rides two or three times a week, but the winter has decreased that.

At the time of her accident, Wolfson was just starting her senior year at SIU, aiming for a degree in business management. One of her goals is go back to school and get her degree in counseling, so she can use her experience to help others.

For people in similar situations, she offered one starting piece of advice.

“Just don’t let one slip mess up everything you’ve worked for,” she said.

Austin Miller can be reached at [email protected]