ANCHORAGE—For many heroin addicts, addiction begins with pain, then a prescription.

By many accounts, Oxycontin is often the gateway drug.

Because prescription painkillers are more expensive in Alaska, anyone who travels can be a dealer and cash in.

“I know people, when I lived in Wisconsin, you could get [Oxycontin] for cheap, dirt cheap, there,” said a 28-year-old mother of three who’s getting treated for her addiction to prescription medication and heroin. “And you could come up here and sell it and basically triple your money here.”

Then comes the transition to something harder and cheaper.

“They would basically sell their prescriptions in order to buy heroin, the people I knew,” said a 33-year-old woman, another mother who’s being treated for heroin abuse.

“That's how people are becoming addicted to heroin,” said Ron Greene, clinical director at the Center for Drug Problems on East Fourth Avenue in Downtown Anchorage, where both women are being treated.

Heroin is costing the state more than a billion dollars every year in arrests, jail time and lost wages, according to 2005 research compiled for the state.

That price tag is expected to get bigger as more Alaskans get hooked.

“The availability of [heroin] on the streets of Anchorage now, it's insane,” said an undercover detective with the Anchorage Police Department’s vice unit.

Seven years ago, researchers reported more than 15,000 Alaskans were addicted to opiates—painkillers and heroin.

“And that was in 2005, so I would imagine we're well up over 20,000,” Greene said.

An avalanche of local addicts is overwhelming the health care system.

“I truly didn't know the epidemic until I came to work here,” said Debra Laflen, the lead dispensing nurse at the Center for Drug Problems. “I've been a nurse forever. I've even worked with addictions.”

In Alaska, there are few options for heroin addicts who want help.

“We are the largest methadone clinic in the state,” Greene said. “There's only two of them. There's another in Fairbanks.”

The Center for Drug Problems is already full.

”We currently have 104, even though we're funded for 100,” Greene said.

It costs about a million dollars a year—most of it state money—to keep the center running.

Waiting for a treatment spot can start its own downward spiral.

“I've met some of the people on the waiting list,” Laflen said. “I know how badly some of them need to be in here. I see their lives disintegrating around them.”

There’s also Suboxone, which is used to treat heroin addiction. Seventy-nine doctors in the state are authorized to treat heroin addicts with Suboxone, according to state health officials.

But those who have tried to get Suboxone say it’s difficult.

Greene says lobbying in Juneau has convinced some lawmakers to support more funding for substance abuse treatment, but not all.

“I'm very upset with the state, and it's not the division of behavioral health,” Greene said. “I'm talking about the state of Alaska as a whole, that has anywhere between $14- and $20-billion surplus budget out there that they won't give up money to help people, fellow Alaskans.”