Its hard to believe that a trend might actually move from rural to urban areas. This story about oxycontin implies that oxycontin abuse is a recent phenomenon in the Boston area. If so Maine and other rural states have been dealing with these pills for years. I would go out on a limb and anecdotally say that the majority of federal cases in Maine in the past several years have been pills and primarily oxycontin. They don't call it "hillbilly heroin" for nothing.
From the Boston Globe:
BROCKTON, Mass. --A growing number of young adults experimenting with the powerful painkiller OxyContin are getting hooked on heroin, triggering a spike in drug overdoses, broken lives and pressure on emergency services south of Boston.
"It is alarming," Abington Police Chief David Majenski told The Enterprise newspaper. "We have made a tremendous amount of heroin arrests and it is not slowing down at all."
The link between OxyContin abuse by teens and addiction to heroin is tenacious. Several recovering addicts said they got "high" on OxyContin while in high school, got hooked, then turned to heroin when buying the painkiller on the street got too expensive, the newspaper reported Sunday.
At least 2,682 people were treated in emergency rooms for opioid-related abuse, dependency or poisoning between 2003 and 2005 in the region, according to the Massachusetts Division of Health Care Finance and Policy.
An examination of death certificates filed in 28 communities shows that 74 people have died of opiate-related overdoses, including heroin, between Jan. 1, 2004 and Aug. 31, 2006, the newspaper said, citing its examination of death certificates filed in 28 local communities.

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