SIOUX FALLS, S.D. (AP) — Anna Welter knew something was wrong.

She asked her fiance, Nick Laughlin, repeatedly if he was using drugs and heard his denials. She was suspicious he was on something, certain he was lying.

"When you live with someone for nearly three years, you can tell if they're gacked out," Welter said. "You know if they're high."

She was aware of Laughlin's past heroin use, his taking of prescription pills to deal with sciatic nerve damage and stomach pains from alcohol abuse. But he continually denied being on any drugs.

In the morning, Welter found him on the bathroom floor, overdosed on heroin laced with morphine.

She sprang toward him and frantically tried to perform chest compressions after calling 911. An ambulance arrived and paramedics brought him out of the small bathroom and into the living room. Officers kept her away as EMTs worked on Laughlin for more than half an hour.

He had four holes in him. Three from Narcan and one in his arm where the needle broke off. He was pronounced dead Feb. 10, 2017 at 10:33 a.m. He was 28 years old, one of the many young victims of the growing Sioux Falls opioid epidemic.

"You never think this will happen to you," said Welter. "Until it does."

Local law enforcement is seeing more opioids than ever before, a deadly trend that made its way from the East Coast to the Midwest.

The majority of heroin found in Minnehaha County is laced with fentanyl, a synthetic opioid 100 times more potent than heroin, the Argus Leader reported.

A lethal dose of fentanyl is about 2 mg, the size of Abraham Lincoln's hair on a penny.

Dealers often mix fentanyl with heroin to stretch out their batch. Street dealers may even sell pure fentanyl as heroin, Minnehaha County Sheriff Mike Milstead said. These dealers aren't chemists, and if they're off by a speck, it could mean life or death for their addicted customers.

"They're taking among our most deadly poisons and hoping they have it about right so that you get high and don't die, so they can sell it to you again," Milstead said.

In 2016, 11 people died from an overdose in Minnehaha County.

In 2017, that number doubled. Two-thirds of fatal overdoses last year were caused by heroin and fentanyl or other opioids, such as oxycodone, hydrocodone, oxycontin, Milstead said.

The average age of someone dying from an overdose is 43, but Sioux Falls Police Capt. Blaine Larsen and Milstead have seen people of all ages succumb to the addiction. They've also seen people of all races and economic status.

"Anyone can get roped into this," Larsen said. "It's a lot more lethal than some of our drug problems that we've seen in the past."

In many ways, Nick Laughlin's death underscored the devastating toll of opioid abuse. The former Lincoln High School student was a talented musician, an award-winning cook and a "social butterfly," according to family and friends.

"He cared about everybody," said Welter, who still wears the engagement ring he gave her. "I'll never meet anyone like Nick for the rest of my life."

His struggles with addiction began in his early 20s — a frequent presence that would rear its head before receding into the background, always to return. But though drug abuse led to Laughlin's death, loved ones insist that it didn't define him.

"He always loved cooking," said Shelley Johnson, Nick's mother. "To him, that was the way he made people happy — making delicious food for them."

He worked at restaurants in downtown Sioux Falls, including Icon Lounge, Skelly's Bar and Makenzie River. While at Skelly's he won second place in the 2015 Sioux Falls Taste of Elegance competition for a specialty pork belly dish.

His culinary expertise was matched by his talent for making and keeping close friends. When he passed away, Makenzie River shut down the restaurant the day of his funeral so fellow employees could attend.

Welter recounted how often Nick would perform "random acts of kindness" for strangers and friends. Their couch was always open for anyone who needed a place to stay, and he would go out of his way to help those in need.

Beneath it all, the true extent of his drug use lurked in the shadows.

Heroin users aren't like those strung out on methamphetamine, Milstead said. Heroin addicts aren't out on a robbery spree. They're not in a group, car hopping or flashing stolen guns, as those seeking meth are often found.

They are usually alone, maybe with an addicted friend, when they're found. First responders frequently find victims passed out in the corner of their house, sitting at a table, or on their knees.

One recent case involved 21-year-old Emily Groth, an O'Gorman High School graduate known for her vast creative talent and strong athletic abilities who died of an overdose May 16 in Sioux Falls.

The man who sold her the drugs, Devlin James Tommeraasen, was found unconscious at Hy-Vee on South Minnesota Avenue the same day. Officers gave him Narcan, according to court documents, and he was taken to the hospital.

He sold Groth and another person .20 grams of heroin on May 14. He sold them another .75 gram later that day.

Tommeraasen was indicted by a Minnehaha County grand jury for distributing a controlled substance and possession of a controlled substance.

His alleged supplier, Corrod Phillips, 26, of Chicago, was indicted by a federal grand jury for possession with intent to distribute heroin. If convicted, he faces a maximum of 20 years in federal prison.

Federal law has allowed prosecutors to increase the severity of the punishment for drug dealers if their batch leads to serious injury or death. A state law passed this year allows state prosecutors to do the same. The charge is still an intent to distribute, but the mandatory minimum is increased.

"One of the things that drive cases to go federal are higher mandatory minimums," said Sioux Falls-based U.S. Attorney Ron Parsons. "That's an effective tool prosecution has to try to work up the chain of drug distribution."

Erik Premer, who was Laughlin's best friend, is a former addict who bonded with Nick over shared struggles with drugs. Premer started using opioids after breaking a finger. Unable to afford a doctor, his friend gave him OxyContin.

"When you start using opioids, you think, 'It's not heroin, it's pills. It comes from a doctor, so it must be OK,'" said Premer. "Most people don't even know they're addicted until they try to stop."

The first time he used opioids, it only made him sick.

"But the second time was like meeting God," said Premer, who works as a piercer at Vishnu Bunny Tattoo and Piercing in downtown Sioux Falls. "It was dangerously enjoyable."

The addiction wasn't clear to him until he went to work as a plumber with his father in Chicago. It was then, without any pills, that he started to experience withdrawal.

"It's like the flu times a million," he said. "You have anxiety so bad, you just want to rip your skin off to make the unsettling feeling go away."

Like Premer, Laughlin's descent into drug abuse was fueled by an addictive personality, backed up by family history. On both sides of Laughlin's extended family was a deep history of alcoholism. His father, Kevin Laughlin, is also a recovering heroin and opioid addict.

"The cards were stacked against Nick, genetically," said his mother.

Minnehaha County is one of a select group using a Baltimore-based technology called OD Map. The technology tracks in real time overdose data across the law enforcement's jurisdiction. Milstead's deputies can log overdose data from the scene: Was it fatal? Was Narcan or Naloxone used? How many times?

If a particularly potent batch is causing a flare-up of overdoses, Milstead and his team can use the map to figure out where it came from, and where the next batch could hit.

Minnehaha County is the only department utilizing OD Map in the region. He's hoping cities like Minneapolis, Omaha and Des Moines start using the technology, because trends and issues there often make their way here.

"The statistics of success (for addicts) are discouraging," Milstead said. "That person is addicted. They don't want to quit. If they do want to quit, it is not easy. They have to have it or they're going to be really miserable really soon."

Milstead is looking forward to the opening of the county's Triage Center, a starting point for people with acute mental health or substance abuse crisis. Local hospitals, law enforcement and mental health care providers are all involved in creating the drop site, where people can go to be referred to whatever services they need most.

The goal is to redirect the overutilizers of the jail and emergency rooms to a more suitable place to be treated.

"What is this doing here?" Milstead said of the emerging crisis. "We know it's killing people. We know that there are a lot who have survived that still have a chance."

Kevin Laughlin, Nick's father, hides sharp blue eyes behind thick-framed glasses. His hair reaches down past his shoulders, and wrapped around his forearms are tattoos smudged from age.

The three lines tattooed on each thumb are for his son. Three red lines on the left, three black on the right, just like the markings Nick had on his own hands.

They serve as a sort of memento, a way to honor his memory. Premer has them on his thumbs as well.

Kevin began abusing opiates in the 1990s, after doctors gave him fentanyl nasal spray to deal with headaches. In 2010, he began taking pain pills during recovery from shoulder surgery. After noticing some of his medication was missing, he confronted Nick.

They began sharing pills.

"It's embarrassing, really, that I used with him like that," Kevin said. But as an addict, he only thought of getting high.

"If you're in that frame of mind and they're available, it's terrible," he said. "It's a terrible addiction."

The fallout from that addiction is still felt by Laughlin's mother, whose divorce from Kevin stemmed from his drug use while Nick was in middle school.

On a recent afternoon, she looked through photographs at her house in eastern Sioux Falls, alternating between smiles and tears as Nick's fiancee sat nearby.

"You always hear things like 'they should just shape up,'" Shelley Johnson said.

"If it was that easy, people would do it," Welter added. "If it were that easy, we wouldn't have addicts."

The night before Nick died, Johnson had dropped him off at his apartment.

"He didn't say he loved me that night," she said. "He usually told me he loved me."

Laughlin and Welter went to the grocery store, where he pushed her around in a cart. He had just bought her a gigantic stuffed dog for Valentine's Day, and that night they had a quiet dinner at home. Afterward, when Welter went to bed, Laughlin's addiction reared its head one final time.

"Who would put themselves through that hell?" Johnson said. "When Nick passed away, one thing I thought was, 'At least his demons are gone.' That's what it seemed like, that his demons were always after him."

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Information from: Argus Leader, http://www.argusleader.com