27-year-old Corey shows where he had needled himself with drugs in Jacob's Ladder Drug Rehahilitation Center in West Virginia, the United States. (Xinhua Photo/Matthew Rusling)

By Matthew Rusling

Ellicott City, Maryland, Aug. 27 (Xinhua) -- Barbara Allen lost a son, a niece and a brother all to the same killer - drug addiction.

Her son James (or Jimmy or Jim, as she calls him) died in 2003 of a heroin overdose at age 35. Her niece Amanda committed suicide in 2010, at age 25, due to issues stemming from heroin addiction. And her brother, when he was 36, was murdered by a woman who was high on meth.

"Previous to Jimmy dying, my brother Bill was murdered. He had the same disease (of drug addiction). A former friend of his came back into his life, she was tweaking out on crystal meth, got my father's shotgun and shot my brother to death," she says.

"In 2010, my gorgeous niece Amanda was struggling with heroin, had gone through a detox program, was struggling three weeks later and died by suicide," she says, describing how the young woman, in the prime of her life, shot herself in the head. Amanda was overwhelmed and isolated, which all stemmed from a heroin addiction.

Allen now runs James' Place Inc., an advocacy organization that aims to help battle addiction, at a time when the United States is seeing the worst drug addiction problem in its history. The problem is affects millions of Americans and their families, and is likely to get worse.

Indeed, researchers, recovering addicts and others with whom Xinhua has spoken said the drug addiction problem has moved up the socio-economic ladder, and is no longer only a problem of inner cities. Rather, it has hit middle class families hard and moved into wealthy suburbs and rural areas nationwide.

The U.N. Office of Drugs and Crime finds that heroin use is at its highest level in the last 20 years. The number of users has doubled since the year 2000, according to government figures.

Over 50,000 Americans died from drug overdoses in 2015, according to a December report from the Centers for Disease Control and Prevention, which contains the most recent available statistics. The number surpassed, for the first time ever, the number of gun deaths in the United States.

Sitting in her living room in front of a piano in an upper-middle-class home in an upper-middle-class suburban neighborhood, Allen tells of the horrors that drugs have inflicted on her family.

"These three, Jim, Bill and Amanda, really are the reason I made the decision to enter into the fray," she says.

"When Jim died in 2003, I just assumed that people were going to die, there's nothing you can do." But once she started researching the laws and history of the U.S. drug problem, "I got really angry. So I entered into the world of advocacy," she says.

She shows this reporter photos of her son, niece and brother. James, her son, looks like any normal young man in the United States, with strawberry blond hair, clear eyes, clear skin and smiling in a photo. Her niece looks like a film star, and this reporter mistakenly thought he was being shown a photo of famed actress Carry Fisher, of the Star Wars series, in her younger years. Allen's brother is wearing a green U.S. army uniform.

None of them appear to fit the stereotype of drug addicts depicted in Hollywood - those living in inner city ghettos, running with organized crime figures and getting in shoot outs and cars chases with cops. And in this reporter's research and talks with recovering drug addicts, none of those he spoke to fit those stereotypes.

"There's no barrier to where drugs show up," Allen says. "Education, socio-economic, spiritual, race, religion, there is no place to hide," she says, explaining that drugs are everywhere in the United States.

"We live in a lovely neighborhood, with really wonderful friends and all that, and yet if you were to take a poll in this neighborhood, you would find it's very rare that there's a family that's not been affected by some substance related loss," she says.

THE PROBLEM IS GETTING WORSE, AND MORE WILL DIE

Allen and others - researchers, recovering drug addicts and medical professionals with whom this reporter spoke - all believe the epidemic is going to get worse.

"Is the epidemic going to get worse? The answer is unequivocally yes," she says.

"More drugs are coming into the country. So the numbers are increasing. A couple of years ago we would talk about 44 thousand people dying a year. Today we're moving into 62, 63 thousand dying a year. And those are the ones who die. That doesn't include the overdoses who survive. That doesn't include the 20 plus million suffering from the disease."

"More will die," she says.

"It's not about a wall (between the U.S. and) Mexico, because the drugs are coming in from so many different ways, and not just from Mexico," she said, referring to U.S. President Donald Trump's plans to build a wall on the border, partially for the purpose of keeping out drugs.

"They come from an airplane from Thailand. They come in the water in submarines. They come inside beef - living cows that come across the border and they've got drugs in them - they come in all kinds of ways," she says.

There's also a new trend among suppliers to market cheaper, synthetic drugs in a bid to make a higher profit margin -- even though those drugs are many times more deadly.

"We are also moving from plant-based drugs like heroine to the synthetics, like fentanyl," she said. "Those are chemically based. They can be made very cheaply (in a lab). They don't have to be harvested and processed and packaged in the same way as heroin or morphine or cocaine," she says.

"And they (the drugs) are getting more deadly. That' s one of the critical issues," she says.

Indeed, fentanyl and other synthetic drugs represent what researchers call the next wave of the drug crisis, and are being sold and used increasingly in the United States. Unlike heroin, which comes from a plant, fentanyl is created solely in a laboratory. It's cheap, highly potent, and deadly if not taken in the right doses.

The drug can be used in heart surgery as anesthesia, and is 50 times more potent than morphine, according to the Centers for Disease Control. There is even one strain of the drug that can kill you if you even touch it, according to the Georgia Bureau of Investigation.

It is prescribed by doctors for patients at the end of their lives, who are in the throes of agony due to diseases such as cancer. But in recent years illicit labs outside the U.S. have been manufacturing the drug, and it has entered the United States and is sold on the street. Illegal drug dealers sometimes lace the drug with heroin and buyers have no knowledge they are purchasing fentanyl, according to a U.S. government report.

On its blog, Harvard Medical School says fentanyl's potency means it is profitable for drug dealers, as only a tiny amount is needed to produce a high. Increasingly, drug dealers sell fentanyl and tell customers it's a more expensive drug, and in this way make a better profit margin. But even minuscule amounts can be deadly, Harvard's Medical School blog reports.

Buying drugs on the street is also a dangerous game because there's no regulation, and often buyers have no idea what exactly they are purchasing.

"You don't know what's in it," Allen says, explaining that drug dealers cut drugs like heroine with a number of products in order to increase their own supply. That could include anything from wall paper to household cleaning products, some of which can be extremely hazardous to consume.

"It's about the stuff that's being filled into it. For example, if I am a dealer and buy an amount (of drugs) that's 100 dollars, and I cut it by 50 percent, now I can make a lot more money because now I have twice as much to sell," she said. "I can take any number of things and fill it. So you as a user don't know...what percent you are getting. It's going to be a powder-like substance (used to cut the drug). It could be scrubber for your sink. There could be any number of things mixed in it. It's often cut with whatever's handy for the person who's dealing," she said.

That also means that legal emergency drugs that are prescribed by doctors to the families of addicts, to be used to reverse an overdose, start to become less effective, she says.

"(The death toll) is going to rise," she says.

Several hours from Allen's home in Maryland, Xinhua reporter meets with John Temple, a professor at West Virginia University. He wrote one of the seminal books on the modern drug epidemic, called American Pain, which traces the origins of the modern heroin addiction drug problem.

"In the short term I think it's getting worse," he says of the nation's drug problem, sitting across from Xinhua reporter on a couch in a new and modern building.

From the upper floors, the building has a broad view of the landscape outside. It's hard to believe, with all of West Virginia's rolling hills and green, natural beauty, that the place is one of the worst-hit states in the country's drug epidemic.

Temple says the problem is "significantly increasing."

"It's by far the deadliest drug epidemic that the U.S. has faced," he says, adding that he himself knows some people whose children are struggling with drug addiction.

"Last year it went up significantly, despite increased awareness, despite efforts to crack down on specific aspects of the drug trade," Temple says.

ROOTS OF THE HEROIN EPIDEMIC

Heroin is the main drug that is driving the overdose rate. The drug - usually injected via needle, although it can also be snorted - comes from the poppy plant.

According to the U.S. Drug Enforcement Agency (DEA), the plant is grown mainly by impoverished farmers on small plots of land in remote parts of the world. It flourishes in warm, dry climates and most of the world' s poppy plants are grown in a narrow, 4,500-mile stretch of mountains extending across Central Asia from Turkey through Pakistan and Myanmar.

The story of how millions of Americans got hooked on heroin in the last decade is complex. In a nutshell, around a decade ago, the U.S. medical establishment made a concerted effort to train doctors to make the treatment of pain a priority, such as pain from a serious car accident or terminal cancer, as well less serious issues.

The U.S. pharmaceutical industry made available a plethora of powerful opioids available by prescription. They often work wonders in terms of alleviating pain, but they are highly addictive - they come from the same plant as heroin-- and are often abused.

Over the years, U.S. drug regulators increased the level of allowed dosages, making opioids stronger and more addictive.

When patients recovered from their illnesses, they developed an addiction. But cut off from the opioids, they turned to a much cheaper alternative - heroin.

Temple explains that the nation's overall addiction problem crept up over time.

But then in the late 90s the overdose rate jumped from hovering around 2 deaths per 100 thousand people per year to around 10 per 100 thousand per year.

"And it's continuing to go up," he says.

Oddly, rather than drug gangs, what started the problem in the first place were large pharmaceutical companies, he argues.

"The epidemic really began with events that happened in the 90s, as drug companies began to market opioids as the solution to what they called America's under-treated pain epidemic," Temple says.

"(Certain pain researchers) believed that pain was undertreated, and that the solution was to use more opioids. And (the drug manufacturers) pushed that in medical schools, in continuing medical education. (Drug manufacturers encouraged) doctors to begin using these drugs for more types of patients and more widely and they promoted the idea that these drugs were not as addictive as we previously thought," Temple says.

"That's proven to be a massive error in judgement. These drugs are incredibly addictive. We began to see that around the year 2000 as the overdose rate just began to creep up and then shoot up," Temple says.

"If you have a predilection toward addiction, you are going to find it very hard to use opioids as prescribed. You are going to find yourself increasing the dose. It' s almost impossible for someone with a tendency toward addiction to use opioids as prescribed," he said.

Temple says opioids and heroin are "chemically and pharmaceutically the same drug. They come from the same plant, they produce the same high, and they lead to the same addiction."

Temple says he's troubled that the U.S. Drug Enforcement Administration (DEA) has over the years allowed companies to manufacture more and more opioids.

"That number has just increased and increased over the years," he says, noting an opioid called oxycodone.

"In 1993 the medical community got by with less than 4000 kilograms of oxycodone, and in 2014 we produced almost 150,000 kilograms, so less than 4,000 to 150,000 kilograms. It's an incredible rise, and the DEA signed off on that," Temple says.

In the last year, that has begun to be curtailed, and last year a sizable cut was announced.

"But it's going to be a long time, if ever, before they can get those numbers down to where they were in the 90s," Temple says.

"And there's a massive pharmaceutical drug lobby in Washington D.C. that is pushing the federal government as hard as they can to do what the drug companies want, and I think that's a big part of it too," Temple says.

HEROIN FLOODING INTO U.S.

The source of drugs like heroin is "constantly changing" Temple says, "because as soon as you clamp down on one source, another one comes about.

At some point around 2010 to 2012 things began to change and a lot of addicts found themselves switching from legal pain killers to heroin, Temple says.

That's when Mexican drug groups extended their reach to places like rural West Virginia, he says.

"And at that point there were various Mexican drug groups that began to systematically target parts of America that had never had a heroin problem before," he said, "including west Virginia, and bringing drugs into those areas, because they knew that there was a prescription drug problem in those areas, and that prescription drugs were becoming more expensive and that there was an opportunity to exploit that by bringing in heroin, heroin being cheaper, and transitioning people from pain killers to heroin," Temple says.

ADDICTION AND AMERICA'S 'I-WANT-EVERYTHING-NOW' CULTURE

Allen believes there's a unique cultural element behind the massive drug addiction problem in the U.S.

"The number one cause of addiction is lack of self-esteem," she says. "That's my personal opinion."

The other issue is what might be referred to as America's drive-through culture, in which Americans are used to getting exactly what they want almost immediately.

That has been re-enforced, culturally, at every level. Credit cards allow people to buy something now without saving money for it; lower-income people can buy luxury cars like BMWs and Mercedes, as long as they buy on credit at a high interest rate. Bad credit? No problem - you can still get a credit card. Cash problems? There are myriad "cash now" services available, in which people can take home a thousand dollars at a pop by using their car as collateral. Globalization has made it possible for even low-income people to buy the latest flat-screen TVs, smart phones and other electronic gadgets. High-end jewelry can be had at heavy discount through online shopping sites.

In America, consumerism rules, and in many cases, consumers get everything they want, right away. Savings rates in the U.S. are low - "why save for tomorrow when you can have everything today?" goes the thinking - and credit card debt is high.

"I want pain relief now, I want money now, I want that car now, I want whatever," Allen says, explaining the nation's mentality of instant gratification.

"So the now-ness," is a major factor, she says.

Another root issue of the drug epidemic is a "lack of consequences," for children, "where parents are like 'oh, I' m sorry you don't feel good. Let's go to the store, let's buy you something," she says.

"We see over and over again, parents not giving children consequences," she says.

Also, some parents work long hours and, out of guilt for not spending enough time with their kids, will give them money or will not punish them when appropriate.

When asked what she would do if her son were alive today, Allen says, "I would get him out of the country. I would take him to Portugal, Italy, Spain, go to a country that has changed its orientation on how they treat this disease. They treat it as a disease. And they have programs that run three to five years, where you live in a community...but their orientation is to help heal the person," she says.

In stark contrast, most drug rehab programs in the United States only last for around 30 days, and often the government still sees the problem as one of law enforcement rather than a health issue.

PARENTS OF DRUG ADDICTS - 'IT'S HELL'

When asked what it's like to be the parent of someone with addiction issues, Allen says, "that's what's going to make me tear up - it' s hell," she says, tears beginning to stream from her eyes and voice shaking.

"There' s no other way to describe it," she says, as this reporter hands her a tissue and she wipes tears from her eyes.

"It's a roller coaster ride," she says, explaining that there was always a lot of unpredictability.

"He's ok, now he's not ok. Oh, he's in jail. Now he' s safe. Oh, he's out of jail, he's ok. Now he's not," she says, adding that her son had lived on the streets for a time when he was a teenager.

Allen said her son started out with drugs at a very young age.

"When he was 13, I discovered he was getting speed tablets from out of state," she says of a popular illegal stimulant.

"Jim was very clever. He and his buddies would go door-to-door getting soda bottles for refunds, and he and his buddies would go outside, find pretty rocks, clean them up and sell rocks door-to-door," she says, explaining her son's entrepreneurial activities at a young age, which allowed him to purchase drugs.

She put him in a treatment program and later learned that he had been participating in what teenagers today call "skittle parties," in which a group of teenagers gather at a home where parents are out. Having raided their parents' medicine cabinets, they throw every pill they can get their hands on in a bowl and swallow them randomly, like candy.

While James had gotten off drugs for a number of years and was doing well, "unfortunately in his late 20s, he was introduced to heroin, though the daughter of a girlfriend," Allen says.

"That was a hellacious time," she says.

"The first time I saw him on it, my first thought was 'he's been taken over by the devil.' And I don' t mean that to sound quite that dramatic, but that wasn't my son," she says.

"For Amanda, she started with heroin," Allen says of her niece, who had lived in the U.S. state of New Hampshire at the time, in the nation's Northeast.

The disease of addiction has a powerful grip on users, especially heroin, as people become violently ill when they try to kick the habit, going through severe withdraw symptoms that Allen describes as "the flu times ten," in which people constantly vomit, have diarrhea and a painful burning sensation on their skin. Another dose of heroin is the only way to stop these intense symptoms, which is why it's so difficult to quit, experts say.

That's something difficult to understand for those who've not experienced it, who say drug users should just stop partying.

"When heroin came into the picture, it was absolute terror," she says of her son' s addiction.

"I became obsessed. I would track him down, I would track down drug dealers," she says.

She had to constantly monitor her son, had to restrict his access to cash in what was a 24-hour, 7-day-a-week job - in addition to working full time as a single mom.

At times things would level out, and her son would get off drugs for a time and be working and be productive, but then something would trigger his addiction and he would start using drugs all over again.

Some of the worst times were holidays such as Christmas.

"I would be just sick," she says, tearing up again. "I would be with (family members) and I wouldn't know where he was."

"I would be doing family things for Christmas or for a wedding or whatever, and my son wasn't there," she says. "And sometimes I knew where he was and sometimes I didn't," she says. "It was horrible."

"Then when he died, one of the first things I said was 'he's finally safe," she says.

Allen says there aren't enough words to describe how angry she was about how her son, her brother and her niece were stigmatized, "because I know these three people. Jim would give you anything he had. My brother Bill who loved to eat, would give you the last morsel of food. My niece, she was funny, she just lit up the room," she says.

After her son died, she says she made a decision.

"I would never be ashamed of talking about him. I would never, ever hide how he died," she says.

U.S. GOVERNMENT ACTION

There's been no real overarching government plan of attack to tackle the problem, although there's been piecemeal legislation over the years. Many mayors and governors are taking the lead in states where the epidemic is particularly bad. President Donald Trump in March launched a commission to combat the opioid crisis, but it remains to be seen how effective that will be.

The city of Huntington, West Virginia has been hit hard by the problem, and Cabell County, where the city is located, is suing drug companies. The plaintiffs say big pharma flooded the state with 40 million doses of prescription opioids from 2007 until 2012. They allege that led to a crisis of addiction and overdose.

But just suing big pharma, or even cutting the supply, is not going to fix the problem, experts say.

"Once you create an addiction, it's not as easy as removing that supply. An untreated addict whose addiction is out of control, will go to almost any length to obtain the drugs," Temple says.