It's a fight Carroll knows all too well, a struggle against a typically white or brown powdered substance that presents itself as a euphoric high and a warm sensation throughout the body.
Fifteen years ago, a group of residents banded together in an attempt to decrease heroin usage in the county. They made a 35-minute film titled "Heroin Kills." They grabbed national attention as grieving parents appeared on ABC's "20/20" news program and "The Oprah Winfrey Show," sharing the story of how their children became addicted to heroin, some of whom overdosed and died. And they watched as it seemed their campaign worked.
But now that Carroll's heroin-related overdose deaths jumped from two in 2011 to 13 last year, it appears the drug is back.
Officials are worried that the substance they worked so hard to combat has risen again due to a crackdown on prescription pill abuse. It's a trend local and state health and law enforcement officials have seen, as well as those who operate treatment centers and sober homes within the county.
"When I get a call from treatment centers or the hospital for guys coming in, if they say they're 18 to 25, I literally say, `Heroin, right?"' said Tim Weber, who owns two local sober homes. "That's what they say, almost every time. It's always heroin or (oxycodone) pills."
About half of the clients at The Shoemaker Center -- a detox and inpatient rehabilitation program in Sykesville -- have a primary diagnosis of opiate dependence, according to program coordinator Meghan Graves. This statistic includes both heroin and prescription pills, and health officials said there's a reason why these two are interconnected.
Both are opioids. They have a similar high and a dose of either satisfies the same craving. This fact has led to the newest trend in drug usage: As painkillers become harder to find, users are moving to the next available product, which is heroin, said Kathleen Rebbert-Franklin, Maryland Alcohol and Drug Abuse Administration acting director.
This rise of heroin deaths in the county is on par with state trends, as heroin-related deaths saw a 54 percent increase, a jump from 245 in 2011 to 378 last year, according to the latest available Maryland Department of Health and Mental Hygiene data, as DHMH officials said statistics are released on an annual basis only.