Ms. Ivy’s death certificate, recently released, revealed that a mix of drugs was to blame; the police declined to specify the drugs since her death remains under investigation. But “Alysa was a heroin abuser, and her addiction to drugs killed her,” said Patty Schachtner, the St. Croix County medical examiner.

“It’s a tightknit community, and these kids all knew each other,” Ms. Schachtner said of those who overdosed. “They were not what you might expect. They were not the faces of heroin addiction we see on television.”

Nationally, those faces are getting younger and whiter. The most recent federal data show 19,154 opioid drug deaths in 2010, with 3,094 involving heroin and the rest painkillers. Eighty-eight percent of those who died from heroin were white, half were younger than 34, and almost a fifth were ages 15 to 24. Heroin deaths of teenagers and young adults tripled in the first decade of this century.


And those statistics lag behind heroin’s resurgence over the last few years, as crackdowns on pill mills have made painkillers harder to get and new formulations have made them harder to abuse. Painkillers remain a far larger problem, but a federal study last year showed that four of five recent heroin initiates had previously abused painkillers, and the amount of heroin seized on the Southwestern border rose 232 percent from 2008 to 2012 as Mexican traffickers moved their product deep into the United States.