Girls as young as 15 are starting to experiment with heroin in the midlands, and are using ecstasy to come down from the high, a study into heroin use has found.
Some women from Athlone and Portlaoise are also travelling to work as prostitutes in Dublin to feed their addiction.
Dr Niall McElwee is conducting a study into the use of heroin in Athlone and Portlaoise, and will publish his findings at a national conference in the midlands in December.
His study is co-funded by the Regional Drugs Task Force and the Midlands Health Board, and will shape anti-drugs policy in the region for the next 10 years.
A director of a centre in Athlone for child and youth-care learning, Dr McElwee has found that there are no services for women with heroin addictions in Athlone and Portlaoise, and the methadone clinic in Athlone has a waiting list of over 20 addicts.
"A lot of users we have spoken to say they have taken heroin in the company of young girls. We are trying to talk to these girls. I was a bit surprised at that fact.
"I thought they might have been smoking cannabis or taking ecstasy, but they are taking ecstasy to come down off heroin.
"I was told some years ago there was very little organised prostitution in Athlone; that it was all done in Dublin in the Phoenix Park.
"I have been told lots of times since then that heroin addicts are prostituting themselves on Benburn Street in Dublin, and coming home during the week."
Dr McElwee is concentrating on face-to-face interviews with heroin users in Athlone and Portlaoise, and each of the 25 he has met with so far come from "marginalised, alienated" backgrounds.
"We haven't interviewed anybody who comes from an upper middle-class background. Some people we have interviewed look well, are in stable relationships, and running shops or holding down jobs. But they are from upper working class to lower middle class backgrounds.
"Others have hepatitis C positive, HIV positive, have overdosed, look awful, are in and out of jail, and have done needle-stick robberies.
"We talked to one woman who went into jail and came out addicted to heroin. She served a two-year sentence. She had only experimented with light drugs before going in.
"Athlone has a waiting list of over 20 people for the methadone clinic. A big problem is that addicts are being told there is no point going to the services because of the methadone waiting list. So there is despair among the heroin users.
"We don't know how many people there are who are using heroin who haven't come into contact with the services. When you are trying to come off heroin, and it's costing you €100 a day, a week can be a costly period of time."
Dr McElwee says the "numbers we are being given consistently" are between 80 and 300 users in Athlone, and between 70 and 200 in Portlaoise. They may have more specific figures when the study is completed.
The Marist Rehabilitation Centre, which is phasing out its operation in Athlone, did bring some heroin users into the town, said Dr McElwee.
Although there are "two sides to every story", he was able to outline one scenario which unfolded on a number of occasions.
"Men came to Athlone, and entered into relationships with local girls. The girls ended up pregnant, and became 'mules' for the heroin. That was a major source of hassle," he said.
Getting heroin is no problem in Athlone or Portlaoise.
"It is done through mobile phones. Mules, rather than the dealers, will bring it to somebody else. Everyone said they have no problem getting it, and I wasn't surprised at that."
Dr McElwee's study will investigate questions such as whether there should be needle exchange centres in Athlone and Portlaoise, and whether there should be safe houses where people came inject themselves.
He said a number of people had overdoses, and were barely brought back to life. They might be safer in groups, he suggested, but this was not a recommendation yet.
Dr McElwee is surprised that Mullingar has no heroin despite its proximity, while Birr, a smaller town further away from Dublin, has a considerable heroin problem. "There is no immediate definable reason why this should be. I haven't got to the bottom of that yet."