When Salisbury Police Chief Barbara Duncan walked into a local restaurant to use the restroom, she was surprised to find an occupant with a needle in his arm, the victim of an overdose.

As Wicomico County Sheriff Mike Lewis related that incident to a rapt audience at the recent local summit to discuss heroin, it was shocking. After all, Salisbury is a hometown.

But the drug is prevalent here, a $140 billion annual industry.

“Every day drug dealers are traveling by car and cops are out there. Every day,” Lewis stressed, sharing a personal concern.

Several  weeks ago, his niece was arrested for heroin possession.

He offered aid but she refused, telling him, “Uncle Mike, I love you, but I don’t want your help.”

Part of the reason Wicomico County has a high percentage of heroin is that the county is the crossroads of Delmarva, with a high intensity of drug trafficking, Lewis said, adding the heroin problem began several years ago after a tiny percentage of doctors “lost their way” and overprescribed.

The bulk of heroin coming into Wicomico County is from Philadelphia, New York and Wilmington, he said.  Also, the economy is lagging, evident in the fact that 75 percent of school children receive free or reduced lunches.

Recently, police stopped a car that had traveled from New Jersey, carrying enough heroin for 42,000 people, Lewis said. “We must hold those accountable who are determined to make frequent trips … to bring this poison down to our county,” the sheriff said.

“These people who are addicted to heroin, they all started with marijuana. That was their gateway drug. We have the duty to protect children. We will fight with each and every one of you to solve this issue,” he said.

A member of the state heroin task force, led by Lt. Gov. Boyd Rutherford and in Salisbury for the summit, called drug entrepreneurs “slick and shifty.” He talked about interstate transport of heroin and asked for recommendations for halting it to be sent to the lieutenant governor’s office

In the 1990s, interdiction was successful, Lewis said, but there were allegations of racial profiling. “We need a government that will stand behind those in the trenches,” Lewis said, drawing applause from the audience.

Talbot County Sheriff Joe Gamble said he was surprised to learn how many young people are addicted to prescription pain pills.

He found parents are unfamiliar with the path the leads to heroin. The earlier a child starts drinking and using marijuana the sooner  he will start using prescription pills. Then, some continue to heroin, Gamble said.

“I need help educating parents,” he said, and reversing what many of them believe, that drinking and smoking marijuana is a rite of passage.

“It’s not anymore,” he said.

“This room should be packed to the hallways with parents, for the amount of kids dying,” he said, and the audience applauded him.

Lewis recently received national media attention when he three Maryland police chiefs went to South America with an NBC News crew to see with their own eyes the starting point for most of the heroin on their streets. To them, the poppy field represents an ominous threat.

"Those beautiful flowers of Colombia absolutely wreak havoc on Maryland's Eastern Shore," said Lewis, of Wicomico County. "They've destroyed and decimated families all up and down the East Coast."

Lewis flew with federal DEA officials to a mountainous area where poppy plants are grown and converted into heroin. He and the other law enforcement officers hiked into the fields to see the source of their commuties’ woes upclose.

While the heroin used in most of the United States is processed in Mexico, the historical source for heroin along the U.S. East Coast has been Colombia, where Lewis visited.

In and around Baltimore, heroin is so prevalent now that purity levels for the illegal drug have skyrocketed and prices have fallen by more than half.

“Fifteen years ago, purity levels were between 3 and 5 percent, with 5 percent on the high side," said Gary Tuggle, assistant special agent in charge of the DEA's Baltimore district office. "(Now) we're seeing purity levels about 80 percent, and that's scary."

The price for a kilogram of heroin, he said, has dropped from about $160,000 to $65,000 during the same time period, and the average street dosage costs $10 to $15.