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Within Vermont, where reports of heroin's rise had become fixtures in local papers for more than a year, Shumlin was applauded for turning up the volume on an alarm that had already been sounded; nationally, the attention his address garnered was filtered through a lens of morbid curiosity.

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read the headline on the website Politico, reinforcing the idea that what Shumlin was confronting was an aberration – an urban scourge freakishly resurfacing in the least likely of rural sanctuaries.

Two weeks after Shumlin stepped down from the podium, however, 22 people died in Pennsylvania in a single week from injecting heroin laced with fentanyl, a narcotic that can be 100 times more potent than morphine.

ve Rivait rode her first horse when she was five, too small to get her feet through the stirrups, let alone give the animal a kick that registered.

Yet even then, bouncing in the saddle, she was aware that being on the back of a horse provided relief from the boredom and isolation that, for her, were a more dominant part of growing up in Vermont than the snowcapped mountains and autumn foliage that draw millions of tourists to the state each year.

Not long ago, in Burlington, a 29-year-old former user sits inside a coffee shop on a busy thoroughfare lined with outdoorsy boutiques, yoga studios and craft breweries, telling his own story of addiction and recovery. "The shit is everywhere."Vermont is one of the most forward-thinking states in the nation, with a history of taking pioneering, unorthodox approaches to complex issues.

He stops himself midsentence and nods at the two people next to him who are in the process of conducting a deal. It was the first to create civil unions for same-sex couples, in 2000, and last year, under Shumlin, announced single-payer health insurance and decriminalized marijuana.

Junkies, she thought, were people in places like the Bronx or Baltimore, not the middle of Vermont.

But soon more people she knew were shooting up, and Eve's shock morphed into curiosity, heroin's corrosive reputation diminished by the fact that everyone compared it to a drug she'd already tried: "It's like oxys," she kept hearing, "only cheaper." So one evening, in the fall of 2010, distraught after her boyfriend stormed out in the wake of an argument, Eve took his stash from the bedside table.

By the time Eve's relationship ended, six months later, another opiate was making a comeback.

She had been dating her next boyfriend for only a few weeks when she came home to find him preparing to inject a needle filled with heroin into his arm – a sight so jarring it felt like a hallucination.

By the time she was 18, the same kids who once talked about the thrill of smoking pot were now praising the joys of "oxys," not to mention "vikes" and "perc-30s," the street names for Vicodin and the pale-blue 30-milligram tablets of oxycodone.

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