The Palm Beach Post unleashed an investigation last week connecting a cutoff in Oxycontin prescriptions to a rise in heroin overdoses in 20 states East of the Mississippi River.

In 2010, South Florida had some of the most notorious cases of pill mills around – the area was considered a significant trafficking area for oxycodone. Drugs prescribed illegally in Florida made their way throughout the northeast US – making their way through the Mid-Atlantic, Great Lakes and other areas east of the Mississippi. Florida was becoming notorious for its clamor of addiction as well as illegal drug sales.

Law enforcement and state officials mostly considered their operations a success. Pill mills were shuttering, and drug dealers were being taken off the streets. Doctors abusing the system were losing their law licenses and even serving jail time. Deaths from opioid overdoses were declining. As Florida finally began shutting down pill mills, pills became hard to find. So many opioid pill abusers turned to heroin to stave off withdrawal symptoms. In states like West Virginia, Connecticut, and Delaware, where go-betweens delivered many pills before the pill mills were shut down, heroin quickly became a drug of choice for people with substance abuse disorders. And overdose deaths for street heroin increased significantly.

According to the report from the Post, a nine-state region (including Florida) had a 107 percent increase in deaths from heroin when pill mill crackdowns in Florida began in 2011. As Oxycontin deaths began to decline, a sharp increase in heroin deaths coincided.

Doctors in Florida were also influenced heavily by Perdue Pharma, according to the report. Before the pill mills broke up, doctors were marketed to directly, and laws were re-written to help Perdue flourish with one of the most addictive drugs in recent history.

By cutting off the pill supplies, people addicted to them were often left to their own devices. There was no mass scheduled detox for them to turn to, and there is not a massive budget in most states to provide drug treatment to every person who needs them. Opioid detox can be physically painful and sometimes even dangerous – people have been known to suffer from seizures and heart palpitations while they’re detoxing. Medication-assisted treatment can help defeat the pain, but it wasn’t readily available in 2011 when the pill mills broke up. By leaving addicted people without the drug they were addicted to, a large percentage of them turned to new sources of a similar high.