"I'm going to die if I keep going," Alex told InsideEdition.com in the first of a series looking at the epidemic.
Nestled on a quiet road in a hamlet in Nassau County, N.Y., is a stone and brick two-story house with a red door.
The home is picturesque and charming, with a lush green yard that would make the perfect play space and an inviting porch light that seems to never turn off.
It’s across the street from a school, where smiling parents picking up their children on a rainy April morning pay no mind as a tall young man shuffles out of the house and shakily lights a cigarette.
Alex K. is only 21, but his weathered features look like that of an older man. And despite the humid, 50-degree weather, he can't stop shivering. He’s quick to pull at his dog hair-covered sweatshirt to keep warm.
He’s just woken up. He’s also just gotten out of jail, is coming off heroin and is preparing to go to rehab for what will be his 13th 30-day stint.
“I was always worse than my friends, always a step ahead,” Alex said, letting the rain gather on the lenses of his glasses as he takes a quick drag from his cigarette.
He first stole alcohol from his parents’ liquor cabinet when he was about 11 years old and quickly moved on to marijuana, but it was a serious back injury he suffered while playing football three years later that catapulted him into the harder stuff, he said.
“I had three slipped disks,” Alex said. “Doctors said they couldn’t do anything but prescribe pain medicine. Cortisone shots didn’t work. I was getting Vicodin, Percocet, morphine... nothing worked.”
None of those painkillers really killed the pain — not like heroin, he said.
“It started off great, it was fun," Alex said. "It was amazing. Heroin, it helped."
But things quickly went downhill for Alex, who at 21 should be enjoying his first legal alcoholic drink, but he is instead entering the seventh year of a battle against opioid addiction.
He quickly became hooked on the dangerous drug, and that addiction is the root of his countless arrests, fractured relationship with his parents and numerous attempts to come clean.
Alex is not alone.
The United States is in the midst of an epidemic, as Americans grapple with addictions to both prescription and illicit opioids at record levels, according to the Centers for Disease Control and Prevention.
More than 40 Americans die from prescription opioid overdoses every day, and of the more than 52,000 deaths caused by drug overdoses in 2015, 33,091, or about 63 percent, involved a prescription or illicit opioid, the CDC said.
What’s more, the staggering number of deaths tied to the epidemic might be underestimated, experts say.
The CDC presented research last week that found it may be difficult to track the causes of death within surveillance systems based solely on autopsy report codes known as International Classification of Diseases, Tenth Edition, or ICD-10.
“The Minnesota Department of Health in early spring was notified of a middle-aged man found deceased in his home,” Dr. Victoria Hall, a CDC field officer based in Minnesota, told InsideEdition.com.
The man had been on long-term opioid therapy for chronic back pain and his family was worried that he might be abusing his medication, Hall said. Two days before his body had been found, he was slurring his speech and seemed very ill, she continued.
An autopsy found that the man had both pneumonia and a toxic level of opioids in his system when he died.
“But the death certificate only listed the pneumonia,” Hall said.
Hall’s research found that more than half the deaths involving opioids examined in her study had not noted opioids as a contributing factor in the deceased’s death certificates in the state’s total.
“How these death certificates get coded [is] usually a medical examiner... writes down causes of death. What they write gets transformed... it’s all dependent on exactly what’s written by that M.E. or physician,” Hall said. “In a lot of cases, there’s just no mention of opioids.
“It’s quite concerning because we know the opioid epidemic is quite severe already... it’s very scary,” she continued. “As many different angles we can attack the opioid epidemic, the better. This is yet another angle we need to address.”
And heroin is a big part of the problem, officials said.
“Heroin use has increased sharply across the United States among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: Women, the privately insured, and people with higher incomes,” the CDC said.
Between 2000 and 2015, the rate of heroin-related overdose deaths has more than quadrupled; in 2015 alone, more than 12,989 people suffered fatal heroin-related overdoses across the country.
It was the realization that he might one day become such a statistic that left Alex eager to make a change.
“I’m angry and I’m terrified,” he said, shaking his head at the prospect of going through withdrawal for the umpteenth time. “I know I don’t have to go [to rehab], that I’m a man, I could just go to DSS [Nassau County Department of Social Services] and get an apartment in the projects if I wanted, and welfare money and I would get another job and keep going, but I’m tired.
“There are no veins left in my entire body. I shoot up in my toes and I’m 21,” he continued. “I can’t keep going. I’m going to die if I keep going.”
It was a similar realization that led Dustin Patterson, 30, to try to get clean.
“I grew up around lots and lots of drug use, and lots of violence,” said Patterson, of Xenia, Ohio, one of the U.S.’s five states with the highest rates of drug overdose deaths.
Patterson’s life has not been an easy one.
Telling InsideEdition.com that he was exposed to drugs at a very young age, as close relatives grappled with addiction, Patterson said he quickly learned how to fend for himself and turned to a life of crime to get ahead.
“I didn’t understand why they chose drugs over me,” he said of his relatives that had been consumed by drugs. “I was picked on and made fun of because my clothes were dirty and I acted on that. I hurt people in school and got others to laugh at that. I got taken away by Children’s Services and from the sixth grade until I was 18 years old, I was in and out of foster care, treatment centers and group homes.”
He went on to lose numerous loved ones to drug use, and It all became too much for Patterson to bear
“This whole time, I hated drugs, but after high school I did what I knew best; I started living the street life and I started selling drugs and robbing people,” he said. “I was hopeless. I never thought I’d amount to anything. Eventually, I had the bright idea to try heroin.”
Though he had tried his fair share of narcotics before, nothing compared to heroin — and nothing prepared Patterson for what he would go on to experience.
“When I did heroin, it was a high I never felt before,” Patterson said. “It made me think everything would be okay. It started to take the pain away.”
It was only a matter of days before Patterson would go on to become a full-blown addict.
“I started out using once a weekend, then it was once or twice a week, then it was every day... I thought at the time, 'You’re not a drug addict; you’re [just] snorting it.’"
One day, he said he woke up "dope sick," a term describing the symptoms of opioid withdrawal. He felt nauseous, he was sweating profusely and his entire body ached.
"That’s when I realized there was a problem,” he said.
Like Alex K. and Patterson, countless Americans graduate to heroin and the battle is all but lost by the time they realize they have a problem; they’re addicted.
The issue is one that law enforcement and medical officials are trying to push back against while grappling with two other life-threatening dangers infiltrating communities across the country: fentanyl and its deadlier analog, carfentanil.
While pharmaceutical fentanyl is primarily prescribed to manage acute and chronic pain associated with advanced cancer, its illicit, non-pharmaceutical counterpart is now being used to lace heroin and cocaine — both with and without the user’s knowledge — to increase the effect of the drug in question, officials said.
Carfentanil is said to be 100 times deadlier than fentanyl and 10,000 times more potent than morphine. A 10 milligram dose of the tranquilizer is powerful enough to take down a 15,000-pound elephant, and now it’s being linked to deaths across the country.
“A lot of friends that have passed away... they’re not testing positive for heroin. It’s straight fentanyl,” Patterson said. “When I used heroin, I never thought I could die because I was snorting it.
"I would snort anywhere from 10 [to] 18 caps a day. Snort one cap of cocaine laced with fentanyl — and I’m talking about [drug] veterans — $15 will get you killed."
In a series of stories told in the upcoming months, InsideEdition.com will examine the uphill battle officials are facing in combating the many facets of the opioid crisis, while taking a look at the many victims it has claimed and the others it continues to affect — those plagued by addiction, the first responders facing the problem head on and the people left behind.