By James Queally and Dan Goldberg/The Star-Ledger

On April 11, a 21-year-old woman returned to Toms River after her fifth rehab stint in Florida.

Five days later, police found her dead in a motel room, a potent strain of heroin inside her veins.

Hers was one of two fatal overdoses that day in Ocean County, one of five that week and one of 10 in April, records show. Ocean County would lose another six lives in May to overdoses from heroin, prescription pills or a combination of both. There have already been five more deaths in June, and yesterday, Ocean County recorded its 52nd fatal overdose of the year from heroin or prescription pills, one fewer than all fatal overdoses the county recorded in 2012.

"I don’t have enough fingers and toes to count the number of people I know who have passed because of an overdose," said Chanelle Beardsley, a 23-year old recovering addict who lives in Toms River.

In Ocean County, she said, "(heroin) is easier to get than alcohol, it’s easier to get than marijuana."

But it’s not just Ocean County. Officials say heroin use is increasing across the state.

Cape May County’s 2013 fatal overdose total is about to surpass 2012’s, according to Kenneth Super, chief of county detectives. Hunterdon County had two overdose deaths in 2012, and has already had two in 2013.

Neighboring Atlantic and Monmouth counties are seeing roughly the same numbers as they did last year — not as bad as Ocean, but by no means a cause for celebration, said acting Monmouth Prosecutor Christopher Gramiccioni.

Statewide, records show the number of people between the ages of 18 and 25 seeking treatment for opiate addiction jumped by 12 percent between 2010 and 2011, the last year for which data is available.

There were 368 deaths related to heroin in the state’s 21 counties in 2011, up from 287 in 2010, according to Roger Mitchell, the assistant state medical examiner.

The state does not track drug overdoses for the current year, and most counties only record overdoses when they result in death. The number of close calls — of teens and 20-somethings, brought back to life after slipping into unconsciousness — is far greater, police said.

Heroin and pills are not new to Ocean County, but the recent rash of deaths has unnerved law enforcement and drug experts, who blame everything from an increase in the purity of heroin, to a decrease in the availability of prescription pills. Some believe the lingering effects of Hurricane Sandy led to stress-driven drug abuse. No one can provide an exact reason. Maybe it’s a little of everything, but there is a growing consensus that what was already considered a crisis of opiate abuse has become even more critical.

"What I think we are seeing is epidemic proportions," said Rebecca Alfaro, director of prevention and training on the Governor’s Council on Alcoholism and Drug Abuse. "This is a problem that is getting worse."

NEW STRATEGY

Ocean County Prosecutor Joseph Coronato has been in office only 60 days and has a new strategy for what he calls "a crisis." He plans to use the "Strict Liability in Drug-Induced Deaths" law, passed in the 1980s to combat the "crack" cocaine boom, which allows a prosecutor to charge a dealer with murder if police can prove they sold drugs that caused the fatal overdose.

Coronato believes part of the problem is younger drug addicts who think they’re invincible. Sixty percent of fatal overdose victims in Ocean County this year were 20 to 26 years old, according to county records. Many overdose victims, Coronato said, died from a cocktail of substances including heroin, painkillers, alcohol and others.

"They’re taking heroin and then they’re also going down to the bars and drinking, and they overdose," he said. "When you’re 26, you believe you can jump off the George Washington Bridge or the Empire State Building, and you think you can survive. Death is not an option for you."

Steven Marcus, head of the state’s poison control center, said naïveté may be a factor. Heroin used to be the last in a long line of abused substances. Now, even high school students are abusing prescription pills, dropping the relative age of heroin addicts from the late 20s to the teens and early 20s, Marcus said.

"You now have a population that hasn’t used heroin a lot and is now switching to heroin because they can’t get their other drugs," Marcus said.

CHANGING MARKET

Over the past few years, the state attorney general and county prosecutors have made a concerted effort to remove prescription pills from the streets. With parents encouraged to throw away unused medicines and doctors warned against overprescribing, it is much harder to find pills in New Jersey. In Ocean County, Beardsley said, OxyContin used to cost $25 for a 30mg pill a few years back. Now, it’s $35.

As the pill supply was cut, the demand for heroin, a cheaper alternative, may have grown, some say. It’s a problem taking place across the country where heroin overdoses are on the rise this year, while prescription pill overdoses are declining, Marcus said.

In Cape May County, the lower supply of pills has led to an increase in heroin use, Super said.

"Unfortunately, this tends to be the result," he said, but the detective believes eliminating the pills combined with education in schools can stop teens from ever beginning their opioid habit.

No one starts out wanting to be a heroin addict, Super said, but kids figure pills are okay because they are prescribed by a doctor.

Beardsley remembers a few years back sitting around with friends. She was struggling to get clean. They were getting high on pills. You know, she told them, that’s the same as heroin. Her friends scoffed, saying they would never let their pill habit lead to shooting heroin.

"Sure enough," Beardsley said, "all those people are now doing heroin and some of them are not alive anymore."

EASY TO GET

Heroin is as easy to obtain in Ocean County as it is in cities, officials say, and is often referred to by the brand name stamped on the bag: Kiss of Death, Ferrari and El Capo are just a few that police know about. But the potency varies from bag to bag and the stamps change almost daily, Coronato said.

"It’s like the Italian way of cooking," Beardsley said. "They just throw stuff in the pot."

Because the potency is inconsistent, Coronato said, an addict who uses five bags of lower quality drugs one night might die from the same number of hits the next.

"These kids are playing Russian roulette with that bag," said Mike Pasterchik, the Monmouth prosecutor’s chief of detectives. "You might get a bag of 50 percent, you might get a bag of 90 percent."

Users who buy lower-grade drugs also tend to amplify their high with other substances and often wind up creating a fatal cocktail. "If the kids are buying not-so-good quality, and they’re chasing that rabbit, that’s why they tack on oxycodone and liquor," Coronato said.

Mixing heroin with Xanax is a popular choice, too, which can slow down and sometimes stop the heart.

Ocean County’s heroin surge is most acute in Toms River, according to county records, where one out of every six residents lives and one out of five fatal overdoses this year has occurred.

Police Chief Michael Mastronardy said he has repeatedly seen addicts leave rehab only to relapse and die, while others become dealers to feed their habit. He said he worries that as soon as he locks up one drug dealer, another may be hooked bad enough to take their place.

Toms River is one of two places inside Ocean County that addicts will buy their heroin if they are looking for a small supply, Coronato said. The other is Lakewood. Dealers and users looking to buy in bulk travel to Atlantic City, Camden, Newark or Paterson, he said. Dealers in urban centers are so used to suburban visitors that they actually carry different types of heroin. The pure stuff in one pocket for the out-of-towners, said Ocean County Prosecutor’s spokesman Al Della Fave, diluted drugs for the locals in the other.

HURRICANE SANDY

Hurricane Sandy’s effects on the population may not be fully understood for years. Mental health professionals continue to see higher levels of depression and anxiety, though studies have found virtually no link between new drug abuse and natural disasters, according to the National Center for Post-Traumatic Stress Disorder.

Still, there are some in Ocean County who believe there’s a connection. Seaside Heights Police Chief Thomas Boyd said recovering addicts in his town could have relapsed after watching their lives wash away during the fury of Sandy.

"If you are a heroin addict and you get hit with devastation like that, you’d probably go right back into a desire mode," Boyd said.

EXPANDED POWER

With more addicts come more dealers, so Coronato is also lobbying the state Legislature for a law to give prosecutors more leeway. The bill, which has bipartisan support in the Assembly and Senate, would base the severity of a charge on the number of doses a suspect possesses, not the weight of the drug. Under the current law, heroin possession is often considered a third-degree crime with a presumption of no jail time, leaving prosecutors little leverage to turn addicts into informants.

"Once I have the dosages, I have the leverage to go up the chain and get to the true drug dealers and then I can charge those drug dealers with the deaths that are occurring," he said. "I want to be ruthless with this."

State Sen. Robert Singer, a Republican whose district includes parts of Ocean County, supports the legislation. He also authored a separate bill, which would require doctors and pharmacies to enter their patient’s name and prescriptions into a national registry so that addicts could not easily hop from one doctor or pharmacy to the next.

"If five kids died of a measles outbreak, we’d have parents attacking the schools," he said. "We had five deaths in one week and nobody is outraged. I’m mind-boggled that we did not see a surge of people asking ‘What are we going to do about it?’ "