People living in Chicago’s suburbs are prescribed up to four times as many pain pills per person as those who live in the city, a Chicago Sun-Times analysis shows.

In the southern tip of Illinois, it’s up to seven times as much, according to the analysis of federal Drug Enforcement Administration records of the numbers of prescriptions written for the two most popular prescription pain drugs — oxycodone and hydrocodone.

Oxycodone, the more powerful of the two, is the key ingredient in the brand-name prescription painkillers OxyContin, Percocet and Percodan. Hydrocodone, which like oxycodone is an opiate-based drug, is the main ingredient in Vicodin, Norco and Lortab.

The north and northwest suburbs — areas that have ZIP codes that begin with 600 — had the highest per-person consumption of prescription oxycodone in the Chicago area, the DEA data shows. These ZIP codes include some of the Chicago area’s wealthiest municipalities.

Suburbs to the west and south — with ZIPs beginning with 601, 603, 604, 605 and 609 — had the second-highest oxycodone consumption in the metroplitan area.

And Chicago, along with close-in suburbs in the 602, 607 and 608 ZIP codes, had the lowest consumption of prescription oxycodone per person in the area, as well in all of Illinois.

The patterns for hydrocodone were similar.

It’s not that suburbanites suffer more pain, experts say. Instead, they say the prescription pattern reflects that suburbanites tend to have more money, better insurance and more connections to doctors who can prescribe the potent painkillers.

And that sometimes lead to more problems with abuse and addiction, says Jeanette Wiener, a registered nurse and addiction counselor at New Hope Recovery in Chicago. Wiener says she’s been seeing more people from the suburbs seeking help for pill addictions.

“My experience has been that you’re going to see more pills being used in the suburbs — both by people who have legitimate pain and people who use it for addictive purposes — because they have access to physicians, and they have money,” says Wiener.

Dr. Sandeep Amin, an anesthesiogist at Rush University Medical Center in Chicago, says that in recent years more clinics dispensing powerful painkillers have opened in the suburbs.

“You’re seeing now the proliferation of some of these clinics that are willing to dispense narcotics to patients,” Amin says. “It’s a matter of patients getting easier access to some of these medications in the suburban locations, whereas, in the past, you had a fixed number of clinics that were comfortable or willing to give out medication.”

Amin says a state-run system that tracks painkiller prescriptions helps prevent abuse but doesn’t work as well along Illinois’ borders, where people can just cross into Wisconsin or Missouri to fill prescriptions more than once. He says that could explain the some of the higher consumption in the north suburbs and in Southern Illinois. Amin believes a federal prescription monitoring system would prevent this.

An analysis of the DEA data by The Associated Press found that the total amount of oxycodone prescribed nationwide increased by 275 percent from 2000 to 2010, while prescribed hydrocodone increased 148 percent. The national data showed that much of this growth occurred in suburbs.

Dr. Ileana Arias, principal deputy director at the U.S. Centers for Disease Control and Prevention, joined other health officials from around the nation earlier this month at a conference in Orlando to publicize the escalation in prescription use and abuse.

“This is an epidemic. And at CDC, we do not use the word epidemic very lightly,” Arias said. “The problem is, unfortunately, a wicked problem.”

October 30, 2011 (CHICAGO) (WLS) -- A 2010 study by Roosevelt University researchers found the Chicago area had the most heroin-related hospital visits in the nation.

The drug is cheap, and it's attracting users everywhere including some who are very young.

Today's heroin can be snorted or smoked -- not just injected -- and that's led to a change in the typical user. Increasingly, today's addict is young, female and from the suburbs. And the roots of their addiction can be found in their family's medicine cabinet.

For many, the road to dependence begins at independence --one of a handful of West Side exits off the Eisenhower serve as the gateway to the nation's busiest heroin corridor.

"The ride there you're just anxiety, just, 'Oh I can't wait to get there. I can't wait to get it. I can't wait to feel better,'" said a 19-year-old female heroin addict whose scar are more than skin deep.

She grew up far from the west side's rough and tumble streets, amidst the manicured lawns of the far west suburbs which seems an unlikely breeding ground for a new crop of heroin users.

"I always thought of them as homeless and not caring about what they look like and real skinny and everything," the 19-year-old addict said.

Heroin has never been cheaper and more pure. Just $100 can buy a two day supply.

"I knew. The first time I did it I was like, 'This is bad. I like this way too much. And this is going to be bad," said the 19-year-old addict, whose identity ABC7 has hidden.

DEA Agent Jack Riley says powerful Mexican drug cartels have partnered with Chicago street gangs to make heroin easily available.

"If I had to liken anything to a weapon of mass destruction, it would be heroin," Riley said.

After smuggling the drugs here, Riley says the cartels often operate in Spanish-speaking areas near Midway Airport.

"They can assimilate into these hard working neighborhoods. They can appear to be great citizens, take care of their lawn, put Christmas lights up," Riley said.

The cartels need the gangs to distribute the drugs but officials say fights between the two groups are increasingly to blame for the near-daily violence plaguing some neighborhoods.

"What we consider to be senseless violent acts, many of them may be actually connected to the cartel's operations in Chicago," Riley said.

It seems the danger is of little deterrent to users.

"Within two weeks I was getting sick physically without it, and I needed it," the 19-year-old addict said.

It wasn't until an overdose nearly killed her that she began treatment a few weeks ago at New Hope Recovery Center in Geneva. In four years, the facility has seen a seven-fold increase in heroin cases and many involve teens first hooked on prescription painkillers.

"They'll run out, and someone will say 'Well, snort some heroin. It'll help you, so you won't go through withdrawals,'" said Jake Epperly, New Hope Recovery Center.

That may have been how Billy Roberts began using. The Homer Glen 19-year-old died of an overdose two years ago and his father now warns of heroin's dangers.

"I do it for him," said the victim's father John Roberts. "And I'll continue doing it as long as I'm alive. To give my son's life meaning.

A former Chicago cop, Roberts says it's time for new solutions.

"We need help. The police cannot do this alone. We need a comprehensive, strategic approach to this problem if we're ever going to see these numbers turn downward," Roberts said.

To put in perspective how big the problem is here, the Chicago DEA has secured funding for a 90-person strike force to combat the operation run by the cartels and gangs in the city. Officials say it's the only such strike force outside of the U.S.-Mexico border.

The 19-year-old woman interviewed by ABC7, who is currently in treatment, says she knows at least 20 other kids her age, from her community, who are current or former users.

(Copyright ©2011 WLS-TV/DT. All Rights Reserved.)

Hurt in a car crash, a Geneva woman got hooked on the painkiller Vicodin. When one doctor stopped prescribing it, she got it from others and was sneaking around so much that her husband thought she was cheating, said her counselor, Jake Epperly.

The face of drug addiction, experts say, is increasingly white, suburban and upper-middle class. New users include older adults seeking relief from pain and teens looking for a high.

The resulting abuse of prescription medications represents the greatest epidemic in drug abuse since crack cocaine ravaged cities in the 1980s and 1990s, said Epperly, owner of New Hope Recovery Center in Chicago and Geneva.

Statistics tend to back him up. Deaths from prescription drugs tripled nationwide from 2000 to 2008 and exceeded deaths from heroin and cocaine combined, according to the U.S. Centers for Disease Control and Prevention. Drug deaths reached an all-time high of almost 37,500 in 2009, the tipping point in an ongoing trend reported by the Los Angeles Times: For the first time, drugs killed more people in this country than car crashes.

In Illinois, drug deaths first outnumbered traffic fatalities in 2006, when 1,410 drug-related cases were reported, according to the CDC.

As drug abuse has increased in the Chicago area, none of the traditional street drugs has gone away. Instead, heroin use has spread from the city to the surrounding counties, according to a 1998-2008 Roosevelt University study last year.

In Lake County, for example, researchers found that heroin deaths rose 130 percent from 2000 to 2009. In McHenry County, such deaths increased by 150 percent over one three-year period.

In Cook County, the number of deaths actually decreased during the decade leading up to 2008 with one notable exception, which underscores the spread of the drug: Heroin-related deaths increased 40 percent among white women, Roosevelt researchers reported.

Heroin and prescription painkiller abuse is intertwined, experts say. The two are similar enough that addicts who run out of one may take the other as a substitute.

Users often start on prescription meds because they are easily available and considered safe. Once hooked, they may move on to heroin, which is now easier to try because it's pure enough to snort or smoke rather than inject, Epperly said.

Both types of drugs have something else in common: They are depressants that kill by suppressing breathing, particularly when mixed with alcohol or other downers.

And the most common way teens get started on prescription pills, according to the U.S. Drug Enforcement Administration, is through the medicine cabinet at home.

Though the war on illegal drugs has been hotly debated in recent months, prescription drug abuse involves a product that is legal but controlled — and deadly when misused.

The DEA estimates that 1 in 6 people younger than 20 has tried prescription drugs to get high.

Jack Riley, special agent in charge of the DEA's Chicago division, said he's alarmed that drug cartels are starting to supply street gangs with prescription drugs. And the gangs are sending members to doctors to fake ailments and get prescriptions.

"It'll take educators, parents and law enforcement to go after people involved in prescription drug abuse — just like we're going after the Mexican drug cartels — because they're doing that much damage," Riley said.

Special delivery

A drug dealer is no longer someone standing on a street corner, law enforcement officials say. Instead, he or she may be, intentionally or unwittingly, a doctor or pharmacist, even a package delivery driver.

In June, an Aurora man pleaded guilty to conspiracy to illegally deliver drugs through a package delivery company. Prosecutors said Steven Immergluck, 35, a sales representative, and others recruited a pharmacy and doctors to write and fill prescriptions for an Internet drug provider. They then delivered the goods nationwide to customers' homes.

Through just one of multiple schemes, prosecutors alleged, the defendants delivered 35,000 packages and made almost $500,000.

Similarly, a Calumet Park man was charged this month with illegally diverting the painkiller hydrocodone from the Skokie pharmacy where he worked, the DEA reported. Earl Newsome, 57, is accused of selling some 700,000 pills with an estimated street value of up to $7 million.

Among users, Bill Stelcher, a retail salesman from Hoffman Estates, knows firsthand how prescription drugs can ruin a life.

Wracked with pain from a bad back, Stelcher, 44, had surgery in 2000. For three years, he lived with excruciating pain and took a succession of painkillers, including Vicodin and Oxycontin.

He was taking 30 to 40 pills a day and stayed in bed most of the time, but a pain management clinic kept renewing his prescription, he said. Follow-up surgery finally fixed his back, but by that time he was hooked, he said.

Five or six times he tried to quit on his own, going through painful withdrawal, but he ended up back on the painkillers, he said.

"The drugs completely take over," Stelcher said. "It was killing me. If I'd had it my way, I would have been dead."

His wife got him into rehab, and he has been clean for almost seven years, he said.

"There are places you can get help," he said. "It will bring life back. You can smell and taste and see things again differently."

Heroin in the cornfields

In Will County, the recent focus is on the troubling rise of an old scourge: heroin. A decade ago, the county had five or six heroin deaths a year, with most of the victims men in their 40s.

In recent years, the number of deaths has nearly quadrupled, to more than two dozen annually. More victims are in their teens and 20s, as John Roberts learned.

Roberts, a retired Chicago police officer, had moved his family to what he thought was a safe community in southwest suburban Homer Glen.

Two years ago, his son Billy, 19, tried heroin, Roberts said. The teen was put into rehab, then monitored closely to keep him away from other users, he said. His son went to meetings but didn't think he needed them because he wasn't an addict, Roberts said.

The teen turned up dead at a friend's house, he said.

"I thought I'd seen a lot and knew how not to become a victim," Roberts said. "It's like, 'How is this happening?'"

In response to such tragedies, Will County officials have started HELPS — Heroin Education Leads to Preventive Solutions. The program, launched in the summer, will use TV commercials and public speakers at schools and churches to warn about drug abuse.

Signs of opiate drug use include pinpoint pupils, too much sleep, too little motivation, unexplained absences and worsening school grades, counselors say.

Parents need to keep their prescription drugs away from children and throw them out when they're done with them.

More generally, the Roosevelt University researchers recommend drug education for young people, increased funding for treatment and overdose prevention.

They also recommend limited protections for those who call 911.

Overdose victims die needlessly, health advocates say, because their friends are afraid they'll get arrested if they call for help.

In memory of his son, Roberts is pushing for a new law to give drug users immunity from prosecution if they call for emergency help.

Springfield, Ill. - The Illinois State Senate gave the green light to legislation that would save lives from drug overdose.

Lawmakers said friends are watching friends die from drug overdose. They fear if they call for help they will face prosecution.

The goal of the bill is to save lives of drug addicts. It passed unanimously and could become law by the end of next month.

State Senator Ira Silverstein said more people reportedly die from a drug overdose in the state of Illinois than from car accidents.

“Today, Senate Bill 1701 was passed in the Senate,” Silverstein said. “It gives immunity to individuals who call 911 when they discover an individual that has overdosed.”

Silverstein describes his bill as life-saving legislation.

“I think it's very important that an individual who finds someone overdose and calls 911 that he or she should not be liable or arrested for any type of drug related offenses,” Silverstein explained.

The bill will make Illinois one of three states that provides immunity from prosecution for drug possession when a person seeks aid for a friend's overdose.

New Hope Recovery Center's Intake Director Jim Butler said time and time again friends watch friends die, instead of calling for help.

“We've been involved in instances like this where at our program in the Western suburbs where folks have died under these exact circumstances that we're talking about right now, needlessly,” Butler said.

The immunity is only granted for those without a prior criminal offense.

Butler said that safeguard could interfere with saving lives.

“If someone is going to try and save a life,” Butler said, “Whether they have a previous arrest record or not, I don't think should come into play.”

Critics fear the bill lets the bad guys go and provides a loophole for drug dealers.

There are safeguards in place to prevent abuse of the law including a limit on the amount of drugs in someone's possession.

Illinois joins the states of Washington and New Mexico which already have similar laws.

David and Gail Katz thought their 25-year-old son Daniel had finally turned the corner on his addiction to prescription painkillers after a year and a half of sobriety.

Then, over a two-week period in 2007, Daniel's drug use suddenly "spiraled out of control," his parents said.

On June 15, 2007, Daniel, a well-liked former hockey player, died at his best friend's house after overdosing on OxyContin and cocaine.

"We heard that he had told his girlfriend that he wanted to start again and turn his life around and that night, he overdosed," Gail Katz said.

Some think it's harmless

The Katzes think Daniel started abusing painkillers in college after experimenting with marijuana and alcohol in high school. Though they sought treatment for him several times, Daniel "just couldn't stay sober," Gail Katz said.

The Highland Park couple has since made a full-time job of educating teens and their parents about prescription drug abuse, the fastest-growing drug problem in the United States.

Deaths from unintentional drug overdoses in the United States have increased five-fold over the last two decades, claiming more lives than any other type of accidental injury except car accidents, the federal Centers for Disease Control and Prevention reported earlier this year.

Largely driving the trend is rampant misuse of prescription drugs, particularly painkillers such as OxyContin (oxycodone), Vicodin (hydrocodone) and fentanyl.

Abuse of prescription painkillers was responsible for more overdose deaths in 2007 than heroin and cocaine combined, the CDC says.

Rates of treatment admissions for abuse of painkillers and other non-heroin opiates also rose 345 percent nationwide between 1998 and 2008, according to the Substance Abuse and Mental Health Services Administration.

"Five years ago, 70 percent of the people we saw here were heroin addicts. Today, 70 percent of the people we see are prescription drug users," said Jake Epperly, president of New Hope Recovery Center in Lincoln Park.

Prescription painkillers, known as opioids, are synthetic versions of opium used to relieve moderate to severe chronic pain.

But in excess quantities, these drugs can suppress a person's ability to breathe. They're especially dangerous when mixed with alcohol or other drugs.

Experts say too many people, especially teenagers, mistakenly think that prescription drugs are safer and less addictive than street drugs, even when used improperly.

"People think, 'It comes from the doctor. Mom took it for a toothache or a broken bone. How bad can it be?' " said Sally Thoren, executive director of Gateway Foundation, which provides substance-abuse treatment at locations throughout the state.

The surge in prescription drug abuse followed a shift in doctors' prescribing habits that began in the 1990s. Recognizing that they needed to do a better job of managing chronic pain than they had in the past, doctors started writing more prescriptions for pain drugs. Greater availability opened the door for more widespread abuse, said Kathleen Kane-Willis, director of Roosevelt University's Illinois Consortium on Drug Policy.

"In the 80s and early 90s, there was so little pain medicine prescribed," Kane-Willis said. "Now, the pendulum has kind of swung the other way."

Docs prescribe more

Rather than denying pain medication to people who need it, Kane-Willis said more doctors need to have frank conversations with their patients about the dangers of prescription drug abuse.

Also contributing to the problem are rogue online pharmacies, operating mostly outside the United States, which provide medications to patients who have never seen or talked to a doctor.

Street gangs, too, have become increasingly involved in prescription drug diversion, according to the Chicago field division of the Drug Enforcement Administration.

Dan, a 30-year-old businessman from Chicago who asked that his full name not be used, has struggled with his addiction to Vicodin for the last eight years. He was first prescribed the drug after a motorcycle accident in 2002.

Before long, Dan, whose family has a history of substance abuse, was going from hospital to hospital, pretending to have shoulder pain, kidney stones and other ailments in order to score more painkillers. At one point, he took as many as 60 to 70 pills a day, often with alcohol.

Monitoring program

"It's to the point where you can get pain medication as easily as you can get liquor," he said. "All you have to do is say, 'I'm experiencing pain,' and automatically, they're going to give you pain medication to control that. You can use that doctor for probably a month or two before they catch on."

After several failed attempts to get clean on his own, a near-fatal overdose in August led Dan to seek help for his addiction at New Hope Recovery Center. Now, he's cautiously optimistic that the worst is behind him.

"I can't say I'm going to be clean for the rest of my life, but I can promise that when I lay my head down on my pillow tonight, I'll be clean," he said. "I'm taking it one day at a time."

Since 2000, Illinois has had a prescription drug monitoring program that tracks prescriptions filled at retail pharmacies. But the onus is mostly on health care providers to check the database to see whether there's a pattern of doctor-shopping with their patients.

How to dispose of drugs

Most people who abuse prescription drugs get them from a friend or family member. To dispose of unused or expired medications safely, don't just throw them in the trash or the toilet, said Janet Engle, head of the department of pharmacy practice at the University of Illinois at Chicago. Instead, remove the medication from its original container, mix it with an undesirable substance like kitty litter or coffee grounds and then throw it out in a nondescript container that can be sealed.

Earlier this year, the DEA and Walgreens launched safe drug disposal programs. Disposemymeds.org is also a resource for finding drug take-back programs in your area.

David Katz said prescription drug abuse will continue to be a widespread problem until the public recognizes that misuse of these drugs can have fatal consequences, as it did for his son.

"Nobody wants to think this could happen to them, but it can," Katz said.

She stood on the sidelines amid the blankets and camp chairs, a petite, brown-haired woman in a monogrammed polo shirt, cheering as her 7-year-old son sprinted down the soccer field.

At halftime, she stepped up with a water bottle and pep talk. And after the game ended in a 4-0 loss, she circulated among the pint-size players as the designated "team mom," passing out apple slices, pretzels and peanut butter crackers.

"Good job, guys," she said brightly as she tousled hair, patted shoulders and gave high-fives. "You did really well."

The Saturday soccer game is familiar territory for many middle-class mothers. But for this 39-year-old executive, the autumn afternoon felt like a gift. Last year she missed a lot of games. When she did show up, she was usually drunk. An outgoing woman with a big smile and wry wit, she would stand by herself because, she says, "I was afraid the other parents would smell alcohol on my breath."

Her story -- of a nightly glass of wine that turned into a nightly bottle and eventually four bottles a day -- reflects a growing national trend: Alcoholism, once largely considered a man's disease, has become increasingly common among women.

At her most desperate, Heather -- who asked the Tribune to withhold her last name because of the stigma associated with alcoholism -- was drinking around the clock, waking in the middle of the night to pour herself a glass of white wine and regularly driving her son to school while drunk. A doctor told her that she was killing herself with alcohol. She had gone to that appointment drunk; a blood test confirmed that she was over the legal limit by 8:45 a.m. And for weeks afterward, she kept drinking.

Now, after an intervention by her employer and her pastor, she has remained sober for a year. But staying that way remains a daily, sometimes hourly, struggle.

"I know this disease is waiting for me. It wants to see me dead," she says. "It's like it's outside doing push-ups, getting stronger and stronger and stronger. It's just waiting for me to have a moment of weakness so it can take me back."

Drinking on rise among women

Over the last several decades, women have been drinking more and getting drunk more often. Studies show that the rates of alcoholism have nearly doubled among women born after 1954 when compared to those born earlier. And, over the last decade, excessive drinking among women suggests that rates of alcohol dependence are continuing to increase. The number of binge drinking episodes among women, for example, rose 31 percent between 1993 and 2001, according to the U.S. Centers for Disease Control and Prevention.

Heavier drinking rates, in turn, seem to be resulting in higher rates of drunken-driving arrests; the number of women arrested for driving under the influence increased nearly 30 percent between 1998 and 2007.

And it's not just women who are drinking more. Girls are drinking earlier than ever before, with nearly one-quarter of female high-school students reporting that they began drinking before they turned 13, a particularly disturbing trend because drinking at a young age increases a person's risk of becoming a problem drinker later in life.

Across the country, addiction treatment centers report spikes in the number of women seeking care. Two years ago, the well-known Hazelden rehabilitation center in Minnesota doubled the number of beds available for women in an attempt to meet increasing demand for drug and alcohol treatment. In Chicago, programs including New Hope Recovery Center and Resurrection Health Care's treatment facility have seen similar increases.

"Ten years ago, it used be 65 percent men. Today, we're approaching 50/50," says Dr. Daniel Angres, director of addiction services at Resurrection. As factors driving the trend, he and others point to increased pressure on women to juggle work and motherhood, along with a culture that often makes light of drinking with books such as "The Three-Martini Playdate" and the Facebook group "OMG I so need a glass of wine or I'm gonna sell my kids."

Behind the statistics and theories, however, are the stories of everyday women. Some cases -- such as Diane Schuler's wrong-way, drunken-driving crash that killed her and seven others on a New York expressway in July -- have drawn intense publicity.

But many more women struggle anonymously. Women such as a 45-year-old South Side mother of four who told the Tribune how she hid bottles beneath the towels in her linen closet. Or the 49-year-old executive of a nonprofit whose 10-year-old daughter once found her passed out on the bedroom floor during a family ski trip.

"There's been liberalization of so many different things, many of which have been very good for women -- sports, education, employment," said Dr. Laura Jean Bierut, an alcoholism researcher at Washington University in St. Louis. "But one of the areas of liberalization that may not be good is that girls are drinking more like boys. And drinking more like boys has also resulted in what appears to be an increase in alcoholism in women."

Drinking began at an early age

In many ways, Heather's story reflects these larger trends. Growing up in Lake Forest, she started drinking when she was 10, sneaking a sip from her grandmother's bourbon and Coke. In high school, she binged whenever she could. And in college, she spent so much time partying she failed out of school. She re-enrolled, eventually graduated and, in her 20s, reined in her drinking.

But on maternity leave with her infant son, she sometimes treated herself to a glass of wine in the afternoon. When she went back to work, she began to depend on several nightly cocktails to help her unwind -- a pattern that her physician, Dr. Lisa Oldson Orelind of Northwestern Memorial Hospital, says is "a very common way people get into trouble."

The dual pressure of motherhood and career created a constant knot in her stomach, Heather says. "I felt this need to be perfect -- perfect at my job, a perfect wife and mother."

A family history of alcoholism -- Heather's grandfather, father and brother are all recovering alcoholics -- no doubt made her more vulnerable. Over next few years, her drinking accelerated, fueling the collapse of her marriage. Her then-husband didn't realize how much she was drinking, but now wonders, "if it was willful ignorance on my part, that I didn't want to see what was happening."

After the couple divorced in 2006, Heather began finishing a quart of vodka a day. At work, colleagues covered for her unexplained absences, lost paperwork and missed deadlines. At home, she planted her then 5-year-old son in front of the television so that she could pass out on the couch. Afraid that she would die, she taught her son how to use her BlackBerry so he could call for help.

By 2007, she was struggling to quit. After a family intervention, she managed to stay sober for three weeks. But always, the bottle drew her back.

When tests last year showed she had developed alcoholic hepatitis, an inflammation of the liver, Dr. Daniel Ganger, the director of hepatology at Northwestern Memorial, warned that she was killing herself with alcohol. "Maybe within in year she would have been very ill or possibly dead," he says now. Still, for weeks afterward, Heather kept drinking. She couldn't stop, even to save her life.

"I would say to myself, 'You're not going to drink from 9 a.m. until lunchtime,'" she recalled. "But I could never make it. I'd say, 'OK, just give it an hour.' But there were days when I couldn't give it an hour."

Then, last October, the Rev. David Abrahamson, the pastor at St. Luke Lutheran Church in Lakeview who had known Heather for more than a decade, confronted her in his cluttered church office. At the pastor's side that afternoon was Heather's boss. They explained that her job was safe, but under one condition. "You're going into a rehab program," Abrahamson said.

Heather had arrived at the church drunk, exhausted and expecting to be fired. She had damaged her liver and been told that she was drinking herself to death. Her parents and ex-husband had begun to discuss challenging her fitness as a parent. That afternoon, she said: "OK, I'll go."

For the next several days, she drank heavily. But the following Wednesday, she walked into Harborview Recovery Center at St. Joseph Hospital, a 15-bed facility that overlooks the lakefront.

Sharing lessons about alcoholism

On Thursday, Heather marked one year of sobriety. The last 12 months have been far from easy. Her mind returns again and again to the times she drove drunk with her son in the car. "Just to think that I put my son in that position," she says. "I pray to God that he will not remember any of that. That it is just erased from his memory."

Every Thursday, she returns to St. Joseph Hospital to speak to patients. It helps to see the faces of people still in the throes of addiction, a reminder of the place she doesn't want to return. It helps, too, to share the lessons she's learned: you're not alone, you need help to beat the addiction, there is hope.

On a recent afternoon, she breezed onto the hospital ward. Dressed in a dark suit and a string of silver beads, she waved hello to the nurses, checked in with her counselor, and headed for a small break room. As a group of patients gathered, Heather saw that half of the 10 people around the table were women -- grandmothers, wives and mothers -- a reflection of the growing number of women suffering from the disease.

Michelle, a petite 48-year-old wearing wire-rimmed glasses, had been drinking two bottles of wine a night. Marge, a 63-year-old grandmother, had turned to the bottle after her son died in an accident two years before.

They all took their places around the table.

When everyone was settled, the woman in the dark suit began to speak.

"Hi," she said, "my name is Heather, and I'm an alcoholic."

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Telltale symptoms of alcohol abuse

This questionnaire by the National Institutes of Health is designed to identify symptoms of alcohol abuse and dependence. Answering yes to even one question may indicate someone is abusing alcohol, according to NIH, and three or more positive answers can suggest alcohol dependence or alcoholism, depending upon the severity of symptoms. In the past year, have you:

*Had times when you ended up drinking more than you intended?

*More than once wanted to cut down or stop drinking, but couldn't?

*More than once gotten into situations while or after drinking that increased your chances of getting hurt -- such as driving or having unsafe sex?

*Had to drink much more than you once did to get the effect you want or found that your usual number of drinks had much less effect than before?

*Continued to drink even though it was making you feel depressed or anxious or adding to another health problem, or after having had a memory blackout?

*Spent a lot of time drinking or getting over the aftereffects of drinking?

*Continued to drink even though it was causing trouble with your family or friends?

*Found that drinking -- or being sick from drinking -- often interfered with taking care of your home or family, or caused job troubles or school problems?

*Given up or cut back on activities that were important or interesting to you in order to drink?

*More than once gotten arrested or had other legal problems because of your drinking?

*Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart or a seizure?

Source: National Institutes of Health. Questions are based on symptoms for alcohol use disorders in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) of Mental Disorders, Fourth Edition.

- - -

Resources

*Alcoholics Anonymous, Chicago Service Office. For information or lists of local meetings call 312-346-1475, visit chicagoaa.org or aa.org

*Al-Anon and Alateen offers help for friends and families of problem drinkers. For information or lists of local meetings, call 312-409-4058 or go to niafg.org

*U.S. Department of Health and Human Services, maintains a database of treatment facilities at dasis3.samhsa.gov along with information about how to find help.

*The National Institutes of Health posts tools and resources at rethinkingdrinking.niaaa.nih.gov and www.niaaa.nih.gov

In December, after years of alcohol and cocaine abuse, Jim sat alone in his St. Charles home, afraid to leave the house even to pick up the mail.

"I was feeling despair," said Jim, who asked that his last name not be used. Addiction "had become so normal. I started to accept it [and felt] that nothing was ever going to change."

His family had urged him to seek help many times before, but this time -- when his aunt offered to find a counseling program -- he agreed. His aunt found New Hope Recovery Center, the Chicago-based program that has recently expanded to the western suburbs. Within days, Cole was meeting with a counselor.

New Hope was started in Lincoln Park Hospital in 2003 by Jake Epperly, a counselor who had recovered from alcoholism in the late 1970s. In October 2008 when the hospital closed, New Hope moved to a nearby office space. Today, clients live in apartments around the neighborhood and come to the center for treatment during the day or after work.

The New Hope intervention starts with a 28-day inpatient program. Clients spend most of the day together, beginning with breakfast, and attend group therapy and one-on-one counseling sessions, Alcoholics Anonymous meetings, massage therapy and yoga at the center. After the 28 days, clients move into the Intensive Outpatient Program, working during the day and attending meetings and counseling sessions at night. After four weeks of the outpatient program, clients come for counseling once a week for a year until they think they're ready to leave the center.

The pivotal first step, though, is making a connection with a counselor who will be the point person for recovery and beyond.

In the Geneva office, Jim's counselor was Gretchen Feinholz, a social worker and program director who was trying to persuade him to start the 28-day program. He signed up for counseling three times a week instead, but admits that didn't stop him from drinking and using cocaine after sessions and on weekends. A few weeks later, he was on another binge and disappeared for days. After he sobered up, he returned to the center.

At first, he didn't sleep. He cried all the time and resisted recovery. But after meeting other addicts, spending time in group and individual counseling and letting his body heal, Jim returned home optimistic.

Epperly has worked as a recovery counselor and program director long enough to have seen trends emerge. More people are using pills instead of heroin, he said. And more young people, especially young women, are coming in for help.

Most of the clients find New Hope online; others come through traditional referral routes -- through employee assistance programs and word of mouth, Epperly said.

"I've worked in the field for 20-some years and I know a lot of people," Epperly said, "and they know that if someone's really motivated and runs out of money, we'll work with them."

As the economy falters, Epperly expects to see more people who are out of work. The center already has expanded into Geneva, but as it continues to expand Epperly would like to include services for people struggling with other addictions like gambling, sex and Internet.

Six weeks into his recovery, Jim has started working in health care, is attending meetings three times a week and is excited about the possibility of going back to school to study bioengineering.

Moving forward, he knows he has the center's support.

"If I stay present and keep in touch with them," he said confidently, "they're not going to let me slide. ... We all know where I've been and they're not going to let me go back there."

John David was asleep, coming down from the heroin he'd shot the night before, when his doorbell rang one morning last April in his Humboldt Park apartment.

Waiting on his doorstep were his dad, mom, two sisters and their husbands, and his step-grandfather.

"I wasn't too sure what was going on," David, now 23, remembers. "I was kind of nervous."

What was going on was an intervention into a heroin habit that had led David to drop his longtime dream of cooking school and spend his days prowling Chicago Avenue for drugs he said he paid for by stealing, scamming and begging. Fearing the worst was to come, David's family confronted him that day with letters, tears and pleas that he seek treatment.

It was excruciating, David and his parents told RedEye. And it changed his life.

"I knew I had a problem with drugs, but I didn't have any clue what to do about it," said David, who says he is now drug-free, a chef and living near his parents in Wisconsin. "I don't think I would have done anything if my parents hadn't put their hand out."

Too often, experts say, the families and friends of people on self-destructive paths don't put their hands out soon enough.

There are efforts to change that. The A&E reality show "Intervention," which starts a new season Friday, and HBO's "The Addiction Project," a multimedia campaign that debuts on Thursday, aim to raise awareness of what addiction is and what people can do to help.

Hollywood offers more real-life lessons. The recent downfalls of Britney Spears, who entered rehab two weeks ago after several months of odd behavior, and Anna Nicole Smith, whose death last month shone a spotlight on her troubled life, are very public examples of lives allowed to spin out of control, some say.

"It's really sad when I look at people like Britney Spears or Anna Nicole, to look at all of these supposedly professional handlers who just enabled them by covering up, fixing their problems, keeping their secrets," said Bob Poznanovich, CEO of St. Paul, Minn.-based Addiction Intervention Resources, which the Davids hired to help with their intervention. "People were holding their hands but never gave them help."

Oftentimes, people who think they're helping inadvertently become enablers. They don't know what else to do and fear an intervention will be alienating.

"There's always this sense that they're being disloyal," said Jake Epperly, president of New Hope Recovery Center in Lincoln Park, which has an intervention team.

But by and large, interventions seem to work.

At New Hope, 75 percent of interventions lead to treatment, Epperly said, mostly for alcohol addictions but also for drug addictions, eating disorders and gambling.

At Addiction Intervention Resources, which has an office in Chicago, 90 percent of intervention subjects seek treatment for everything from substance abuse to depression to compulsive behaviors, Poznanovich said. (Meth addicts are an exception, with only 50 percent seeking treatment after an intervention, often because the drugs make them paranoid or psychotic, Poznanovich said.)

People who go into treatment after an intervention tend to fare better than if they go in alone because they have loved ones holding them accountable, experts say. Even if a staged intervention doesn't lead to immediate treatment, it often plants the seed that gets someone to seek help down the road.

The notions that people have to hit bottom before they can get better, or that they have to want help before they can be helped, are misguided and, in some ways, cruel, Poznanovich said.

"Interventions are a way to get people to get help before they are able to get help themselves," he said.

He speaks from experience.

Poznanovich was a successful vice president at Zenith Data Systems in Chicago when he developed a $1,000-a-day cocaine habit that derailed his life. He lost his job, his fiance and half a million dollars, he said. It wasn't until his mother and brother staged an intervention that he started treatment.

"I didn't want to have to ask for help," Poznanovich said. "The beauty of the intervention was that it was done for me."

David, 22 at the time of his intervention, said he at first felt his family members were ganging up on him when they confronted him. But he listened as they read the letters they'd prepared, telling him how his addiction was affecting their lives and that they wouldn't put up with it. He caved after the first letter, read by his older sister.

"It was an eye-opening experience," David said. "I had thought that I was by myself and no one really cared."

David's father, Douglas David, called the intervention experience "the worst thing you could imagine," even though it was successful.

John was a culinary arts student at Kendall College in Evanston (the school later moved to Chicago) when he started doing drugs his freshman year. He said he went from smoking pot to snorting OxyContin, then to snorting and shooting heroin.

"It was about not feeling accepted and wanting to feel accepted," John said.

He got suspended from school because his grades were suffering and never went back.

John said he did "the most despicable things" to support his heroin habit. He said he scammed money from his parents, did errands for dope dealers, panhandled and shoplifted. He was caught stealing $550 worth of DVDs from Best Buy in the fall of 2005 and spent five days in jail. Court records show he pleaded guilty to misdemeanor retail theft and was sentenced to court supervision.

"That was probably when I first knew that I had a problem, when I got caught," John said.

His parents, who were living in Wisconsin while their son's life came undone in Chicago, didn't see the signs at first.

Then, on a visit to Chicago, Douglas said he found a hypodermic needle in his son's bathroom. Later, John's girlfriend's mother told the Davids that she'd seen track marks on John's arms.

"We were scared to death," Douglas said.

Douglas awoke in the middle of the night and told his wife that he feared their son might end up on the streets and disappear. They became proactive, contacting treatment centers to learn what they could do. They hired David Eichhorn, Midwest director of intervention services for Addiction Intervention Resources, to help.

On April 29, 2006, family members flew in from across the country and gathered in a downtown Chicago hotel to write their letters. The next day, they rang John's doorbell.

"It was one of the most powerful [interventions] I'd ever seen," Eichhorn said. "They loved him so much, and he felt it."

John was admitted to Hazelden, a treatment center in Center City, Minn., for its 28-day residential program. Resentment of his family turned to appreciation. In the last week of the program, "it was like seeing miracles," Douglas said of his son's transformation.

After eight months of treatment that involved halfway houses and outpatient programs, John is now the head chef at a bakery and living in Wisconsin with his best friend from childhood. When he gets cravings, he calls his sponsor. He said he is "incredibly happy."

"There's a life afterwards. People should know you can get through it," John said. "People should know that there's always someone who will miss you if you die."

HOW DO YOU INTERVENE?

Intervention experts advise families and friends to approach as a group, armed with letters describing how the addiction has affected them and how their relationship will change if they don't seek help.

"A lot of times, people feel bad about the ultimatums, because it's scary to think that you might have to cut someone off," said Gretchen Feinholz, an addiction therapist with New Hope Recovery Center in Lincoln Park. "But it's important that what they say is what they follow through on."

Some of the most successful interventions take place at work because there's less wiggle room when an employer says to get help or get fired, said Bob Poznanovich of Addiction Intervention Resources. But more often, the heavy lifting falls to family and friends. Poznanovich offers some tips.

- Don't do it alone. Gather together the people who care about the person in crisis so you can confront him or her together, and be unified in your message.

- Don't keep their secrets. Everyone should be open and honest about what they know in order to get a true picture of the problem.

- Make arrangements. Have a treatment center picked out and reserved so that there are no obstacles.

- Write letters. Get your thoughts on paper about how the person's addiction or behavior has affected your life and include facts that prove they have a problem, so that you can read from the letter at the intervention.

- Don't make deals or threats that you can't keep. For example, don't say, "If you don't stop drinking, then I'll leave you"--if you're not really going to do it.

- You can't force them into a treatment center. Illinois law doesn't allow involuntary substance abuse treatment unless the person is mentally unstable and at risk of doing harm tothemselves or others. If they walk away, you still can change your own behavior so that you don't enable their problem.

WHEN DO YOU INTERVENE?

It's often difficult for friends and family members to know when it's time to intervene.

"Usually it's past time, sadly," said Lea Minalga, president of Hearts of Hope, a non-profit substance abuse education and counseling group in Geneva.

Minalga, who has had to stage interventions with her son several times since he started using heroin at 17, said the families themselves often are in denial.

"Usually, families have been living in a hurricane, and they get used to this unbalanced, dysfunctional household, and it becomes normal," Minalga said. "Sometimes it just takes a family member to finally scream, 'This isn't normal!' "

There can be concrete signs of a problem. Some people lose their jobs, let their relationships fall apart or don't do the activities they normally like. Others get into legal troubles or car accidents.

But often you feel in your gut when something's not right. Bob Poznanovich, CEO of Addiction Intervention Resources, said you should focus on your own feelings about the other person's behavior to determine when to intervene.

"When it's gotten so bad for you that you can't take it anymore, that's the jumping off point," he said.

Plush oceanside retreats where well-heeled patients recover from drug use, complete with spa treatments and horseback riding, is a rarity.

That may be the way Kirsten on "The O.C." recovers, but in the real world, drab hospital hallways with bedrooms and meeting areas are more typical.

At New Hope Recovery Center, the 28-day, 14-bed residential program is behind closed doors in a corner of a single floor of Lincoln Park Hospital.

The first step is detox. New Hope runs a rapid detox facility for those addicted to opiates such as heroin and Vicodin. Doctors administer medication to patients under anesthesia that cause them to detox suddenly, experiencing about 90 percent of withdrawal in a matter of hours instead of the six or seven days it can take for opiate addiction.

As at most residential facilities, days at New Hope are structured from wake-up to bedtime with group, individual and family therapy, plus sessions to learn about the disease. Patients must follow a schedule with designated times for when to clean their rooms, when they can socialize and when to rest.

How do patients react at first?

"Some are resentful, but the vast majority are relieved," said Jake Epperly, director of New Hope's Lincoln Park program and president of New Hope centers nationwide. Ultimately, no matter how patients end up in the program, patients must develop an internal drive to recover, Epperly said. "If everyone was motivated, they wouldn't need us. Part of our job is to share reality with them."

Intensive outpatient treatment typically follows--three-hour sessions, five days a week for several weeks, for example. The program includes group and individual therapy, sessions on how to rebuild normal life and education on drug addiction and long-term recovery.

Intensive outpatient is often the beginning step for many addicts. Residential rehab programs are not the go-to recovery option for many because insurance often doesn't cover it and the facilities can be prohibitively expensive, as much as $20,000 for one month of treatment.

New Hope, where about three-quarters of residential patients merit some insurance coverage, costs $13,000 out-of-pocket.

During intensive outpatient and into extended care programs, people can return or continue to work, said Joe Camper, director of VALEO, a behavioral treatment facility for gays and lesbians at Lakeshore Hospital.

"The more they can structure their lives the better. A common relapse problem is having too much time on their hands," Camper said.

Recovering addicts often continue outpatient therapy indefinitely through 12-step meetings and more group and individual therapy.

"It's not something you ever get cured from," said Greg Simpson of the New Hope Recovery Center. Around 80 percent to

90 percent of the time, he said, people are genetically predisposed to addiction.

"People have a real hard time understanding that chemical dependency is a disease, it's not a moral weakness."

Scott Chubb estimates he slept with 1,000 people over seven years of heavy drug use. One-on-one, group sex, multiple encounters a night--"It adds up," he says.

"Even when I was in a relationship I was always cheating and had drug use in the back of my mind. Crystal meth would make me have no control over the fact that I had a boyfriend. The sexual urges are so strong that you don't care at that point," says Chubb, now 31.

Chubb's story is becoming frighteningly common. Meth use has risen steadily in the U.S., making it the fastest-growing segment of drug abuse in the country.

Nearly 5,000 people in Illinois sought treatment for methamphetamine use in 2004, according to the Illinois Department of Human Services, up from just 740 in 2000. And those numbers don't reflect the people who do not seek treatment.

To battle what some call an epidemic, Chicago lawmakers and health officials are renewing their efforts to curb the use of crystal meth. The Health Department and the AIDS Foundation of Chicago are developing an extensive outreach program to educate the public about the dangers of meth. A battery of radio and TV ads, posters and brochures--designed by Chicago advertising agency Leo Burnett--is expected to hit the market by the end of June.

As part of the crystal meth campaign recently announced by Mayor Daley, police will be trained to identify labs where the drug is produced. Last year, 900 meth labs were busted in Illinois, an increase of nearly 70 percent since 2002, according to state police. Officials will also educate business owners on how to keep meth out of their clubs and bars.

That's Ground Zero. That's where Chubb got started.

He moved to Boystown from the suburbs at 23 and started partying at bars and clubs, using any drug he could get his hands on. Eventually he tried crystal meth and quickly ramped up to daily use. Life became a paranoiac blur. He passed out regularly and threatened to kill a friend. He contracted hepatitis, and his whole body swelled up. At the end, too weak and tired to go out, he switched to the online scene, spending hours arranging for both drugs and sex through PNP--"party and play"--chat rooms.

Chubb eventually reached a point when he wanted the obsession to end, but like many addicts, he spent almost all of his money on drugs and didn't have health insurance.

"I was so sick and tired of doing the same thing. I was hungry, tired and sweating all the time," he says. "I did a lot of soul searching."

Checking into a monthlong inpatient rehab program, which can run more than $15,000 for a 28-day program, was out of Chubb's financial reach. He started going to Crystal Meth Anonymous and Alcoholics Anonymous meetings every day, several times a day, to learn how people stay sober.

Former addicts and counseling experts say group therapy settings--whether a free 12-step meeting or a physician-run session--are the best ways to recover from addiction.

"What saved me was walking into a room that was full of people who knew what I was talking about," says Pat, 37, who stopped drinking 10 years ago.

Addicts know the lies you tell yourself, and they call you on it, says Greg Simpson, director of the New Hope Recovery Center's rapid detox program at Lincoln Park Hospital.

Health professionals define addiction as when someone, in spite of negative consequences, continues to engage in abusive behavior.

Pat--who as an AA participant asked that his last name not be used--learned that powerful fact in recovery: "I was always a binge drinker. That was my way of rationalizing it: 'If it's not a party I don't have to drink.' It wasn't an everyday thing," he says. Later, when he lost whatever imagined control he had over drinking, Pat made more excuses. "If I got into trouble with the authorities I rationalized it as, 'Hey, they didn't understand.' "

But Pat realized during his rehab process that reason isn't part of an addict's vocabulary. "At that moment when you want to numb out, you don't think logically at all," he says.

That's how Edward Negron had felt most of his life.

Negron grew up in Humboldt Park and started experimenting at age 9 with pot, alcohol and cocaine. At age 23, when he came out as a gay man, he moved into hard-core use.

"I had a lot to catch up on," Negron said. "I tried every friggin' drug. I think I invented my own."

Negron, now 34, let his life fall apart--alienating friends and quitting his job to party. He bottomed out after a six-month addiction to crystal meth.

"Imagine not ever being sober," he says. "I knew I couldn't stop on my own."

Salvation came by way of an arrest for dealing drugs. "It was a blessing for me. I had a sense of relief when they came out with their guns," he says.

After two weeks in Cook County jail, Negron entered an intensive outpatient recovery program. For hours a day, several days a week, he learned how drugs affect the body and shroud emotions. How users fool themselves and those around them to avoid the truth. How to rebuild his life.

"The most difficult part was to face all the people I screwed over, to go back like a dog with his tail between his legs and ask forgiveness."

Addicts also say they can't hang out with their old party crowd for fear of relapse.

Chubb, who has been sober for a year and a half, says the key is to replace bad behaviors with good behaviors and avoid the triggers that made him crave drugs.

"For some, it's hard to disassociate fun and using," he says. Chubb said he never drank or used drugs until he came out just a month before his 19th birthday. Now he has pulled back from the party scene.

"I don't go to bars; I don't go to the places that caused the most problems. If I walk down Halsted Street, I'm going to a meeting. I'm in bed by 11," he says.

Negron has been sober for more than five years, but like all former addicts, he considers himself a recovering user, not "recovered." Addiction never disappears. "Even today I get urges, using dreams," he says.

Negron now works with community leaders to spread awareness about the growing crystal meth crisis. He's also training to become a substance abuse counselor.

"There's no way anyone can do it on their own," Negron said. "If they say so, they're lying to themselves."