Behavior & Development • Nov 15, 2011

From Percocet to Heroin, the changing face of adolescent drug use

I never learned about heroin in my pediatric residency.  I didn’t need to—I never treated a patient with heroin dependency.   But this ugly drug has invaded St. Louis and St. Charles County high schools and our community emergency rooms.  The new face of heroin is a suburban adolescent, in the prime of life, not breathing.

Heroin causes breathing to slow, and heroin overdose causes death by respiratory depression.  These patients arrive in the emergency room blue and non-responsive.  They are usually brought in by nervous friends, also abusers, who do not want their own drug use to be revealed.  These are the lucky ones— most heroin addicts die before anyone realizes they are not just sleeping.

“It never ceases to amaze me how frequently they come in almost dead and then they come back again, the same way, a week later,” said my colleague Dr. Robert Yeager, an Emergency Medicine physician at Progress West HealthCare Center in O’Fallon, Missouri.   Dr. Joseph Karre, also an Emergency Medicine physician at Progress West, just shook his head, “I can’t believe how many high school kids are willing to try it.”

Jarring Statistics

Heroin use in the greater St. Louis area has dramatically risen in 2010-2011.  The epidemic has moved west, from St. Louis City into St. Louis county, and now St. Charles County.  And, heroin users are getting younger.  Increasingly, heroin use starts in high school.

  • 210 people died from heroin overdose in St. Louis city and counties in 2010, according to the medical examiner.  More than 300 deaths are predicted for 2011.
  • The St. Charles County Regional Drug Task Force has seized more than 2,000 doses of heroin in 2011.

Today’s heroin is usually snorted, rather than injected.  It has become a “soft drug,” in the eyes of many teens, not much different than marijuana, ecstasy, and other party drugs.  Many teens start by using prescription pain killers such as Percocet, often legitimately after a sports injury or surgery.  This leads to prescription drug abuse, and heroin is often the next step.

At, you can see the hauntingly beautiful pictures and read the stories of countless St. Louis area teens and young adults who have died of heroin overdose.  These stories are written by parents, parents who themselves are still young, still working, still living in St. Louis suburbia.  They raised these children to the brink of adulthood, only to watch them die from a pathetic addiction.  I can’t help but wonder if I’ll ever have to write my own child’s story.


  1. I was wondering where you got your numbers for the overdose deaths for St. Charles and St. Louis Counties for 2010. I was at a Heroin Town Hall meeting put on by NCADA and St. Louis County Police and the numbers were not the same as yours, so I was just curious. Thank you!

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