Liz Cohen remembers the exact moment she gave in to heroin. Sitting in a rundown motel room with her boyfriend and starting to feel the intense pains of withdrawal, she says she begged him to get her more drugs. But when he told her that all he could give her was heroin, she balked. Up until that point she’d stuck to prescription painkillers like Vicodin and Oxycontin, uppers like cocaine and speed, and drinking—heroin, she says, was the line she wouldn’t cross.

“In my mind, I wasn’t really a drug addict, I was just a girl who liked to party. But heroin was serious, heroin was for junkies on the street,” she says. “So I told my boyfriend, ‘No, anything but that. We promised we’d never do that.’”

His reply shocked her. “You’ve already been doing heroin for months,” he said bluntly, explaining that while she’d thought the powder she was snorting was crushed-up painkillers it turns out he’d been giving her the cheaper narcotic heroin, instead. And, he added, he knew a faster, easier way to get the high she so desperately craved. He handed her a needle.

“I was devastated, I’d become what I’d always said I wouldn’t be,” she says. But that feeling disappeared quickly. “The second I stuck the needle in my arm, the whole game changed. I was in love. Heroin became my life, my love, my everything.”

A popular, pretty, former high school basketball star, Liz was the last person you’d expect to end up a homeless drug addict. Yet it was her beloved sport that first introduced her to the opiates that would consume her life.

Her freshman year, she was goofing around and turned her ankle, tearing all of the ligaments. At the ER, the doctor prescribed her Percocet, an opioid painkiller. At first she says it made her nauseous, but it didn’t take long before she realized the powerful pills killed not just the physical pain but also the emotional pain. And facing a year of surgery and recovery instead of playing ball with her team, the teen had a lot of emotional pain.

“They made me feel so euphoric and invincible that I used up my one-month prescription in one week,” she says. After that, she lied to her doctor about her pain levels to keep the prescriptions coming.

Liz is not alone. According to the Centers for Disease Control and Prevention, “past misuse of prescription opioids is the strongest risk factor for starting heroin use,” and three out of four new heroin users report having abused opioids before using heroin.

Eventually, Liz moved on from her opioids to harder drugs, and she forgot all about the basketball team, academics, and her dream of getting a sports scholarship. By her senior year of high school, she flunked out and ran away from home to move in with her dealer boyfriend—the one who would get the teen hooked on heroin.

Not long after she embraced shooting up, Liz, who’d always known she was adopted, found her birth parents and made plans to meet them.