Pueblo is seen from Interstate 25 in southern Colorado.

(Courtesy Flickr user Prizmatic/Creative Commons)

Heroin abuse in the U.S. has gone up significantly over the past decade. In Colorado, the Pueblo area is the epicenter of the problem. Just 6 percent of the state’s residents live there, but they represent 18 percent of Coloradans being treated for heroin addiction.

From law enforcement, doctors, heroin users, and a person who's gotten treatment, here are a few things to understand about the problem:

Why are more people from southeast Colorado seeking treatment for heroin use?

Most experts seem to think it’s a combination of factors -- economics, ease of access, even that there’s just less to do in southeast Colorado. 

Leroy Lucero, who is the president of a network of treatment centers in the area, says the economic conditions are a big factor. 

“It can be very depressing when you’re sitting in San Luis, or let’s say Antonito, and you can’t find a job, you don’t have a job, you may or may not have any skills, etc.," he said. "And you’re trying to feed your family."

How do people start using heroin?

Many experts in Pueblo noted the connection between pain medication and heroin. For instance, when Dr. Michael Nerenberg was an emergency room doctor, he said it was far more common to see people seeking prescription painkillers. 

Now he works with Access Point Pueblo, which brings clean needles to injection drug users. Every week, he says that the majority of the people he sees are heroin users. 

Do higher treatment numbers mean more people are using? 

Not necessarily. It could be that more people who already use heroin find out that treatment is available, for instance. 

Just how big of a problem are heroin and prescription drug abuse in Colorado now?

Compared to the rest of the county, Colorado ranks 12th for self-reported prescription drug abuse. That's an improvement from 2010 and 2011, when the state ranked second. Heroin use isn’t measured on a state-by-state basis in a statistically significant way, so it’s harder to say where Colorado falls nationally.

Deaths from prescription drug overdoses are still more common than deaths from heroin overdose, according to the most recent data from the state. But heroin overdose deaths have more than tripled since 2008. So Colorado, like the rest of the country, is seeing a shift towards heroin abuse.