The United States is in the grips of a heroin epidemic centered on the Midwest  especially Chicago – where emergency room visits related to the drug have hit 24,627 per year, more than double the number in larger New York, according to The Economist

You may remember a story earlier this year about the arrest of an alleged Chicago drug dealer who literally had customers lined up around the block waiting for product. That was back in June, though it's believed that the city is still home to the nation's largest open-air drug market.

There are other signs as well, like the town in Scott County, Indiana, where close to five percent of the entire population contracted HIV from sharing needles to shoot drugs. Overall, heroin overdose deaths shot from about .5 to about 4.25 for every 100,000 people between 2000 and 2013, according to the CDC.

It's not exactly clear what's causing the spike, though it appears that the widespread crackdown on "pill mills," doctor's offices set up to make fast money by prescribing pain killers like Oxycodone (sometimes known as "hillbilly heroin") to anyone with cash, has contributed. 

As soon as Florida, once the pill mill capital, shut down its mills for good, heroin deaths spiked there as well, according to the Tampa Tribune. As pills became harder to get, and thus more expensive, it seems that some addicts have turned to cheaper, easier heroin.

The demographics have shifted, too. According to an NPR report citing the CDC:

The biggest surge is among groups that have historically lower rates of heroin abuse: women and white (non-Hispanic) Americans. They tend to be 18-25 years old, with household incomes below $20,000.

There was some good news this week concerning the epidemic, though, as the Obama administration made a huge announcement concerning its policy on medication-assisted treatment for addicts, with plans to change the way those treatments are regulated and get help to more people. 

A major investigation by The Huffington Post earlier this year shined light on the seemingly arbitrary limits on which doctors can treat patients with methadone and Suboxone – opiates used to slowly wean heroin addicts off illegal drugs. Those limits were there despite evidence that drug-assisted treatment actually works, whereas only 10 percent of addicts will ever get off heroin by going cold turkey.