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As the battle between drug cartels and law enforcement rages in Mexico, traffickers are gaining footholds in America's Heartland. Ohio saw heroin-related deaths spread into 18 new counties between 2004 and 2007, just one indication that dealers aren't limited to big cities. "It's like going to pick up beer," a former user tells the New York Times.

Despite a crackdown in Mexico, the export of potent black-tar heroin has grown. Some pushers are illegal immigrants frustrated at the difficulties in finding a job; others are hand-picked by Mexican cartels and smuggled into the country. The constant stream of new dispatchers and runners makes clearing up local cells "like sweeping sunshine off the roof," says a DEA employee.
(Read more heroin stories.)