It all comes down to money. As authorities have cracked down on prescription pills, they've gotten more expensive and harder to get. But heroin gives uses an even stronger high, and it's relatively cheap; you can get high with $5 or $10.
It just takes one time to get hooked.
"Very euphoric, unlike anything else," Omid Samadany said.
Samadany never imagined he'd shoot up heroin. But he got addicted to pain pills after a knee surgery about 15 years ago.
"One day I couldn't find pills, or what have you, and you get sick off opiates, you have withdrawal symptoms, and I had a friend who was using heroin," he said. "I was very nervous. I couldn't even do it myself. I had my friend do it for me and I closed my eyes."
He was spending $80 on each prescription pill, but just $10 worth of heroin give him a better high.
"The high lasts longer, it's more instantaneous, and it's a stronger high also. And it's more easily accessible," Samadany said.
Before he knew it, Samadany was shooting up several times a day. He lost his job, had to sell his car, and stopped talking to his family.
"If you use heroin, you either do or you don't. If you're using heroin, you need it because you will be very sick with withdrawal symptoms so you need it on a daily basis," he said.
Samadany is now two months sober on his second try at rehab. He lives and works as a cook here at Cenikor in Deer Park. Of the 160 residents there, about 30 are fighting heroin addiction.
"About a year ago it used to be fifth predominant dependence diagnosis, and now over the last six months, we're seeing it jump up to the third place," Cenikor clinical manager Amy Hansen said.
And heroin's cheap high is attracting a younger generation. After years of seeing addicts in their 30s and 40s, teens and those in their 20s are now walking through the doors.
"They were just experimenting, they never intended for this thing to take over," Hansen said.
And government studies show 40 to 60 percent of recovering addicts will relapse.
"You're only one poor decision away, when you're in sobriety, of being an addict again," Samadany said.
According to the US Dept of Health and Human Services, heroin abuse among first-time users has increased by nearly 60 percent in the last decade.
That translates to an increase from 90,000 to 156,000 new users a year. At the same time, prescription pill abuse has slowly decreased.
In 2012, the number of new users was 1.9 million, which is down from 2.2 million in 2002.
Take ABC13 with you!
Download our free apps for iPhone, iPad and Android devices