“They were doctor shopping,” he said, adding that at the time he was too naïve to know what was happening.

“They’re traveling outside the county all the time,” he said. “It’s an economy.”

For each couple of prescriptions they get filled, they may sell one and use one, he said.

 “You wouldn’t believe how smart addicts are,” Houck said.

He also doesn’t think doctors are solely at fault for the epidemic.

“There’s always going to be a gateway drug. People will always find a way,” he said.

When it comes to opioid painkillers, most people abusing opioids and surveyed by the Center for Behavioral Health Statistics and Quality said they weren’t getting opioids from their doctors.

In a 2014 study, researchers found that more than 50 percent of opioid abusers reported they got their drugs for free from friends or relatives, 11 percent said they bought them from friends or relatives, and 4.4 percent said they stole them from friends or relatives. Only 4.8 percent said they bought them from a drug dealer or a stranger.

People who have doctor-prescribed opioids don’t tend to use them all. Between 42 percent and 71 percent of prescribed opioids go unused, according to a recent JAMA review of other studies.

Dr. Mike Jordan is executive director of the Marion County Children’s Alliance, which hosts the Marion County Heroin/Opioid, Task Force.

Jordan said that closing the pill mills and urging doctors to write fewer prescriptions will take prescriptions off the street. But there will also be unintended side effects. Closing off the supply of opioids will drive more people to heroin.

“And they want a stronger high and heroin is cheaper as opioids are less available,” he said.

Jordan fears that the opioid, heroin, and fentanyl problem is complex with no easy answers. The problem is rooted in socioeconomic issues.

“Once you start down that trail (of drug use) you reach critical mass ... and you get totally out of control,” he said of drug use.

At least with prescription opioids, drug abusers knew what was in them and their potency, he said.

Society needs to work on getting people to not start using illegal drugs from the start, he said.

“This is a temporary problem. We’re dealing with heroin and opioids today. But there will be a replacement,” Jordan said.

Rather than putting blame on doctors for the opioid epidemic, Jordan thinks society should look at the issues that are really fueling the problem.

While Jordan said he can’t cite specifics as to why Marion County has high incidences of drug use and overdoses, there are social issues to consider.

“When you have low levels of education, high poverty, and high incidences of single (-parent) families, then there’s a disruption to family life and little parental supervision,” he said.

“These are all sociological questions that are hard to answer,” he said.

The answer is for Marion County to educate people about the dangers of opioids and fentanyl and focusing on making treatment available to those who want it.

“At least as a community we’re trying to come together,” he said.

• • •

But many who ask for addiction help will not get it as soon as they want.

Most of Marion County’s addicts go to The Centers for addiction help. The publicly funded facility has 50 rehabilitation beds and six detox units.

Steve Blank is The Centers’ vice president of outpatient services. He notes that The Centers gets state money to provide in-house rehabilitation services for those without health insurance. The Centers also gets state money to keep the insured if they need to stay longer than their insurance will pay for.

Most in-patient rehabilitation clients stay three to six months. The Centers provides group and individual therapy and encourages them to attend 12-step addiction programs.

State funds don’t go far enough to cover everyone who asks for in-patient care, Blank said. In those cases, The Centers offers them space if they can afford to pay. The cost is $6,000 to $8,000 per month, still a fraction of what local private facilities charge. Most of The Centers’ in-patient rehabilitation clients do not have insurance, Blank said.

Outpatient is best suited for drug users who do not use every day, often still have jobs and family support.

Blank said that society shouldn’t expect an easy fix and looks at opioid and cocaine addiction as a disease.

“It’s a little more than just saying no to opioids,” he said.

And for now, it’s still easy to get heroin and it’s cheap, he said. The risk of the heroin being laced with deadly fentanyl will not keep people from using it.

In a written statement to the Star-Banner, Florida Sen. Dennis Baxley warned that there may be consequences as doctors cut back on prescriptions.

Part of the solution is that “we must provide more addiction treatment slots and early on in the addiction process,” he said.

In addition, “we must provide much more graphic warnings of devastating consequences of addiction in public service announcements, much as we have with other hazardous behaviors,” he said.

Blank estimates that about 1 in 3 of his patients will get and remain clean.

As for why Marion County has such high incidences of drug use and overdose, Blank responded, “How many? Why and higher in some counties may not be the right question ... now.”

“This (addiction) problem is here,” he said. “It’s not going away.”

“We can’t arrest our way out of it,” he said. “It’s about education and prevention ... and not ‘just say no.’”