Smaller cities and towns throughout New England are seeing an alarming rise in heroin use and deaths, The New York Times reports.

“It’s easier to get heroin in some of these places than it is to get a UPS delivery,” Dr. Mark Publicker, an addiction specialist in Portland, Maine, told the newspaper.

Portland is experiencing an inordinate number of heroin overdoses, according to Vern Malloch, Assistant Chief of the Portland Police Department. “We’ve got overdose deaths in the bathrooms of fast-food restaurants. This is an increase like we haven’t seen in many years,” he said. Captain Scott Tucker of the Rutland, Vermont police department, called heroin “our biggest problem right now.”

Heroin’s rise around the country can be attributed in large part to people who have switched to the drug from prescription painkillers, which have become more difficult to obtain and abuse.

Heroin is also popular because it is cheap, officials say. While an 80-milligram OxyContin costs between $60 to $100 a pill on the black market, heroin costs $45 to $60 for a multiple-dose supply. OxyContin abuse has been declining because the drug has been reformulated so it is more difficult to crush and snort. According to the 2011 National Survey on Drug Use and Health, the number of people who were past-year heroin users in 2011 (620,000) was higher than the number in 2007 (373,000).

Dr. Publicker, President of the Northern New England Society of Addiction Medicine, said some physicians in the region had been prescribing too many painkillers. “We had a bad epidemic, and now we have a worse epidemic,” he noted. “I’m treating 21-, 22-year-old pregnant women with intravenous heroin addiction.”