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Heroin is so prevalent in Ohio it is "falling out of the sky," according to new state data that finds children as young as 13 now are starting on the drug, considered a cheap substitute for prescription painkillers.

Regions across the state saw increases in heroin abuse during the past six months, with availability in Cleveland considered at epidemic levels, according to a report released this month by the Ohio Department of Alcohol and Drug Addiction Services.

Participants in the bi-annual survey, including addicts and drug abuse counselors, say the top reason for the increase comes as people addicted to painkillers "realize that heroin is cheaper and easier to obtain," the report said.

Ohio has struggled with soaring rates of addiction to prescription painkillers, with a record number of fatal overdoses in 2010.

The report also says recent changes to the painkiller OxyContin meant to reduce its abuse also has turned painkiller addicts to heroin.

"Heroin remains highly available in all regions," according to the report. "The general sentiment among participants was that heroin is 'falling out of the sky."'

A separate report released this month by the Ohio Department of Health cited 338 heroin-involved deaths in 2010, or one in every five drug overdose deaths in the state.

"They say, 'I never thought I'd switch from taking a pill to putting a needle in my arm,"' Saunders said Tuesday.

In Toledo, the age of first-time heroin use "reportedly occurs in users as young as 13-14 years," according to the report.

That corresponds with a "frightening" drop in the age of heroin addicts at Maryhaven in Columbus, one of Ohio's biggest treatment centers, said president and CEO Paul Coleman. Maryhaven treats 132 patients younger than age 18, many addicted to painkillers but some also to heroin, Coleman said.

Heroin addictions will go down as the state continues to reduce the availability of prescription painkillers, although much work remains, said Orman Hall, Alcohol and Drug Addiction Services department director.

"Virtually nobody starts out on heroin," Hall said.

The latest Justice Department report on drug abuse finds heroin availability and abuse increasing as Mexican drug traffickers increase production.

The 2011 National Drug Threat Assessment also finds that some of the new heroin users are prescription drug addicts "switching to heroin because it is cheaper."

Another government report finds heroin abuse on the rise nationally.