Every five hours, someone overdoses on heroin in Ohio.

One in every nine deaths from heroin overdoses in the U.S. occurs in Ohio, leading the nation. In Lorain County, approximately 140 people died from heroin overdoses in 2016, according to The Chronicle-Telegram.

On the other hand, according to The Columbus Dispatch, Ohio has lower rates of oxycodone and hydrocodone overdoses than many other states. Oxycodone and hydrocodone are prescription opioids, usually distributed in pill form. These painkillers are closely linked to heroin and can have similar effects on users when abused.

While the relatively low rates of oxycodone and hydrocodone overdoses in Ohio are seemingly positive statistics, these low rates could be related to the high heroin-overdose rate. Four of five heroin users began their addiction through abusing oxycodone or hydrocodone. In 2011, Ohio Governor John Kasich attempted to combat the prescription opioid epidemic by busting “pill mills” — rings of corrupt doctors who illegally prescribe prescription opioids — and limiting the prescription of opioids to a three-day supply, among other policies. These initiatives make it difficult for patients who need painkillers to get their medicine, and caused the price of opioids on the black market to skyrocket.

While Kasich succeeded in reducing the overdose rate for prescription opioids, many individuals have switched from using prescription opioids to heroin due to the increased difficulty of purchasing prescription drugs and price hike. Heroin is much cheaper than prescription drugs; according to Novus Detox Center, one dose of oxycodone typically costs around $80, while 20 doses of heroin typically cost $100.

Unfortunately, while the effects of prescription opioids and heroin are comparable in many ways, users are more likely to overdose on heroin than on prescriptions, according to Novus Detox Center. Because they are pharmaceuticals, prescription opioids are laboratory pure and measured. Heroin is often cut or laced with other dangerous substances, causing inconsistencies in strength. This inconsistency is what makes heroin so dangerous, especially for inexperienced users. Furthermore, according to Medical Daily, heroin has a 1 to 5 ratio, meaning that it only takes five times a single dose of heroin to cause an overdose. In comparison, cocaine has a rate of 1 to 10 and marijuana has a ratio of 1 to 1,000.

While it is no doubt a positive that prescription opioid abuse is down in Ohio, the increase in heroin abuse now must be addressed. Heroin is one of the most addictive drugs, with one in four people becoming addicted after just one hit. The withdrawal symptoms are also some of the most brutal of all drugs, making it excruciatingly difficult for users to recover. Although recovery is different for everyone, a solution for many people is extensive rehabilitation. Often, rehab centers only require one or two months of stay. While many rehab centers would argue that the drugs are completely out of users’ bodies after a month or two, a couple of months is not enough to ensure individuals a foundation for rebuilding their lives without substance abuse.

Another option to rehab is medication-assisted treatment. MAT is a hybrid of mental health therapy and medication-assisted detox. Certain medicines like methadone can be instrumental in decreasing withdrawal symptoms and dependency on heroin and prescription opioids. Making MAT readily accessible to addicts would help many fully recover.

While rehab works for many users, recovery options should be individualized, especially when these cases are brought to a courtroom. From my experience working with courtrooms in Houston over Winter Term, court-ordered rehab is typically one-size-fits-all; this is unrealistic for the complicated nature of these addictions. The more personalized treatment individuals can get, the better their chances at recovery are both physically and emotionally.