Sacramento Magazine Discusses Heroin: The Pleasure and the Pain
2016 edition on newstands
Heroin, the drug that ravaged inner cities in the 1970s, has made a come- back of epidemic proportions—only this time it’s become the scourge of the suburbs, where teenagers can score a hit for about the same price as a bottle of good craft beer. What’s driving heroin’s resurgence? In many cases, her- oin has been linked to skyrocketing abuse of prescription opioid painkillers such as OxyContin, a crisis unto itself. A Granite Bay family chronicles with brutal frankness their son’s trek through the dark tunnel of addiction.
By CATHERINE WARMERDAM
Photography by MARK THOMAS KALLWEIT
Illustrations by TONY WIN
In July 2013, Mike* was a 24-year-old heroin addict with no place to sleep, no possessions except the clothes he was wearing, and little will to live. His par- ents, Larry and Debbie, having tried for years to help Mike get clean, were done. Emotionally exhausted by many un-successful attempts to rescue their son from drugs, they gave him a choice: Call a drug counselor who could get him into rehab or face the lethal consequences of his addiction without them.
Mike, reckoning that heroin would kill him eventually, made a hasty plan to commit suicide. “I had a paycheck waiting for me in Roseville, but it wasn’t going to get me a place to live or get me into rehab. It wasn’t going to get me anything that I needed,” recalls Mike. “So I called my dealer and was planning to buy enough heroin to overdose. I had nothing left and nowhere to go. That was my one chance to end it.”
Mike scraped together enough change to catch a bus to Roseville, where he collected the paycheck from his restaurant job. With the money, he bought a sweatshirt and book four of Christopher Paolini’s “Eragon” series. Using borrowed cell phones, he left messages for his parents, begging them to pick up. They didn’t. Suicidal thoughts drifted through his mind, but the desire to live still tugged at him.
Nighttime fell. Lonely, desperate and wanting to get clean, he ﬁnally called Ricki Townsend, the professional intervention- ist that his parents had referred him to. “She told me, ‘If you stay sober for a week, you will have a place to go.’” Townsend wanted Mike, who had just been kicked out of a detox program, to prove that he was committed to getting clean. Mike, insist- ing he was ready, called off the meeting with his dealer.
That night, Mike slept behind the Walmart near the Roseville Galleria, unsure how he would stay clean for the next seven days but grateful for the lifeline he’d been thrown. The next morning, aching from the early stages of withdrawal, Mike wandered over to a coffee shop and contemplated his next steps. “I’m sitting in front of Starbuck’s, obviously looking like hell, and this guy comes up and says, ‘Hey, man, you OK?’ and I just blurted out my story. So he sat down with me and said, ‘I’ve been there. I’m two years sober.’” The stranger (Mike doesn’t know his name and hasn’t seen him since that day) bought him breakfast, talked with him for a half hour, then dropped him off at an Alcoholics Anonymous meeting in Rocklin. (It’s not uncommon for drug addicts to seek help through AA.)
At the meeting, Mike met a girl and told her his story. She suggested he call someone who could take him in. But who? All of his friends were serious users in as bad a shape as he or worse. And his parents had issued their ultimatum. (“They gave me a great gift,” he says in retrospect.) The only phone number he could remember belonged to an old friend from years back, someone he had smoked pot with as a teenager but who had written Mike off when his drug use escalated. Mike borrowed the girl’s phone and left a message: “I know you don’t want to talk to me, but I’m trying to ﬁgure out what to do.”
Within a minute, the friend called back. “Where are you? I’m on my way.”
Unraveling an individual’s spiral into drug addiction is anything but straightforward. The telling of it is fraught with faulty memories, tinges of denial and divergent perspectives on a single event. Plus, the addiction path isn’t linear; there are stops and starts, setbacks and strides forward, long blocks of time unaccounted for. Yet some predictable turns and common pat- terns invariably emerge. In these respects, the story of Mike’s freefall into heroin is hardly unique. And he and his parents tell it with unﬂinching candor.
Mike was raised an only child in a middle-class, two-parent home. His father, Larry, now retired, was a corporate executive whose career allowed the family to live for short periods in Seattle, England and Boston before settling back in Granite Bay in 2001. Debbie was a stay-at-home mom who operated a secretarial business for a time.
“Mike was our world,” recalls Debbie. “He loved trying new things. He was always good at any sport he tried. He was very outgoing as a kid. He was always good in sales, just like his dad.”
Although Larry traveled a lot for work, the family was active together when Mike was young, enjoying rock climbing, horse- back riding, music, traveling. “Breakfast and dinner were important,” says Larry. “At the end of the day, Mike had a nor- mal childhood. Probably a little more affluent than most. Debbie and I came from very humble roots.”
Mike’s parents also remember him as a sensitive child who cried a lot when he was young. “He got injured easily, physi- cally and emotionally,” recalls Larry.
When Mike relocated from Boston and started junior high in Granite Bay, Larry and Debbie detected a negative shift in their son. He became “difficult, angry, hurtful,” according to Larry.
Mike recalls junior high being a bumpy transition for him. “It would be easy to say that it was because I wasn’t able to ﬁt in, but that wouldn’t be the truth. I found a good group of friends pretty quickly.” Still, something was awry.
“There was just something missing. I didn’t know what it was,” says Mike. “It’s something I was born with: this innate feeling that enough isn’t enough. Where most people get a feel- ing of being content, I never had that.” He loved classic rock and idolized the rock-star lifestyle, and he was fascinated by drugs. “I always had this curiosity. It wasn’t about peer pres- sure; it was my decision, 100 percent.”
He smoked pot for the ﬁrst time in eighth grade—“We stole it from my buddy’s parents”—and continued to smoke “on weekends here and there” through the ninth grade. By his sophomore year, Mike had started dealing drugs to kids at school—ﬁrst pot, then pills, hallucinogens and more. He was good at it. By the time he graduated from high school in 2007, he was raking in upward of $5,000 a week as a dealer. He had also become a serious user, trying virtually every illicit substance except meth and crack.
Mike’s parents became aware of his drug use when he was 15 or 16, believing at the time that it was limited to pot. He had grown “introverted and very angry,” recalls Larry. “We thought at ﬁrst that it was just typical teen behavior. But he was having trouble launching. He was getting ﬁred from menial jobs.”
Larry says he and Debbie eventually “knew something was terribly wrong.” But addressing the problem wasn’t easy. They tested him for drugs at home, only to have him beat the tests with a synthetic urine device.
The family sought help from two different therapists while Mike was in high school, but neither made any inroads with him. Instead, something else emerged from the sessions: Larry and Debbie were struggling with their own addiction to alcohol, a disease that runs in both of their families. “We looked like a good, happy family,” says Debbie, “but we both drank in excess at night.”
Debbie admits now to having sabotaged Mike’s early inter- ventions by refusing to attend family counseling sessions because of fears of confronting her own drinking. (She and Larry are now sober.) But Mike says it wouldn’t have made a difference anyway. He had no desire to get clean then, and no amount of prodding from parents or counselors was going to change his mind.
When Mike was 19, he moved out of his parents’ house and immersed himself in a life of dealing and using—everything from weed to party drugs like Ecstasy to cocaine. He relished the “secure feeling” that came from having a safe full of drug money, sometimes as much as a quarter million dollars in cash. He purchased a $10,000 television, ﬂashy guitars and “an unbelievably expensive sound system.” The spending, as he puts it, “was ﬁlling the same gap that led me to use.”
Debbie tells a story of helping Mike move out of an apartment he had been evicted from during this period. “We moved a big, heavy safe out of his apartment and we didn’t even ask him what it was for.” As Larry explains, “We were terriﬁed of our son. That’s pathetic to say, but that’s how sick the family becomes. We had nobody to talk to. We were completely alone.”
Over the next couple of years, much of Mike’s drug income would come from dealing OxyContin, the highly addictive opioid painkiller. By that time, Oxy abuse across the country was rampant. According to government ﬁgures, 2.1 million Americans suffered from substance abuse disorders related to prescription opioid pain relievers in 2012. That same year, health care providers in the United States wrote 259 million prescriptions for painkillers in 2012, enough for a bottle for every American, according to the Centers for Disease Control. Thousands of Americans whose dentist or physician had written prescriptions for Oxy were blindsided by its potency; people who had never before abused drugs became unwitting addicts. Meanwhile, Purdue Pharma, the pharmaceutical com- pany that manufactures OxyContin, spent millions of dollars advertising Oxy to physicians in an aggressive campaign to beef up sales. In 2007, executives at the company pleaded guilty to engaging in fraudulent marketing that asserted OxyContin was less prone to abuse than other painkillers, despite scientiﬁc evidence to the contrary.
Like many dealers, Mike originally got his Oxy supply from someone with a prescription. The father of one of his mari- juana customers approached him one day offering to sell him his leftover pills.
“He got 260 OxyContin 80s [80 mg pills] twice a month, but only needed ﬁve of them,” as Mike tells it. “At that time I was selling them for $50 or $55 each, and he was willing to sell them to me for $8. He was an older guy and wasn’t in touch with prices. Already I’m seeing dollar signs. Right there on the spot, I bought every single one he had.”
During this same period, Mike was nursing an old back in- jury and started using Oxy for pain relief. “I started off taking them here and there. Because I had plenty of them around and I wasn’t spending $55 on them, I just started doing them more and more and more.” He quickly became hooked.
“When I tried to stop, I got sick and didn’t know why. It was nothing like the other drugs I had done up to that point,” says Mike. “Before, I could just sleep it off. With Oxy, it was a com- pletely different ballgame. But I didn’t make the connection until it was way too late.”
As Mike’s Oxy addiction engulfed him, his drug dealing fell by the wayside. “My so-called business withered away because my focus wasn’t there. Before using Oxy, I never had less than
$250,000 cash in my safe. I ended up spending all that money buying pills.”
With opioid addiction swirling out of control across the country, Purdue Pharma was forced by the Food and Drug Administration to reformulate the drug to make it more dif- ﬁcult for users to smoke, snort or inject. The reformulated pills hit the market in 2010. But what initially seemed like a prudent action ended up having dire unintended consequences.
Almost overnight, the street price for the original formula of OxyContin doubled. Meanwhile, the new formulation was virtually useless to addicts because the physical and chemical properties of the tablets made them very difficult for abusers to crush, break or dissolve.
“When they reformulated it, the pills were completely differ- ent. I couldn’t give those things away, let alone make $55 off of them,” says Mike. “That just rocked my world. It changed things for a lot of people, not just income but a sense of wellness.”
Opioid addicts like Mike—facing painful withdrawal symp- toms and overpowering cravings—were desperate to ﬁnd a replacement for Oxy. For most users, heroin was the logical next step. Oxy and heroin share similar chemical properties and, as far as the addict is concerned, give the same high. Plus, users could go from paying, say, $100 for one Oxy pill to $10 or $20 for a bag of heroin, thanks in part to a glut in the inter- national heroin supply. (It is believed that the move to legalize marijuana in the United States has resulted in Mexican drug cartels’ ramping up heroin production to make up for pot sales lost to American growers.)
Mike, who had been smoking or snorting as many as 15 or 25 Oxy pills a day, eventually tried getting clean. With the ﬁ- nancial and emotional support of his parents, he sought treatment from an outpatient methadone clinic. There he met a girl who suggested they use heroin to stave off the with- drawal symptoms of being weaned off methadone.
“I got right into it with her,” says Mike. “She was an ex-heroin addict so she knew how to use the needles. But it would have happened with or without her; I needed something to make it through the withdrawals, and it would have been heroin.”
His ﬁrst heroin high “didn’t live up to all the stories. I already had a major opiate addiction and had been on methadone for so long that I was very scared to overdose,” recalls Mike. “Look- ing back, she gave me a shot that would kill any other person three times over, but I was already so addicted to opiates that I barely felt it and had to do more.” Eventually he was spending between $80 and $200 a day to get high on heroin. Between his day job and selling a small amount of heroin on the side, he was able to earn just enough money to get high.
Mike had both perpetuated and become ensnared by the Oxy-fueled heroin crisis. According to the federal government, the vast majority of heroin users also abuse opioid painkillers. Heroin use in the United States rose 63 percent between 2002 and 2013. During that same period, the number of heroin-re- lated overdose deaths nearly quadrupled. In 2013 alone, more than 8,200 Americans died from a heroin overdose.
Once considered an urban street drug whose users were typically low-income males in their 40s or older, heroin has besieged small towns and middle-class suburbs, where it’s being abused by teens and young adults who typically started with Oxy or other opiates like Vicodin or Norco.
“It’s hit all the rich neighborhoods and all the poor neighbor- hoods,” says Jon Daily,LCSW, CADC II founder and clinical director of Recovery Happens Counseling Services, which offers outpatient addiction treatment services in Fair Oaks, Davis and Roseville. “It can happen in families with alcoholism or trauma histories, or in families that are enabling and not setting boundaries. But it can also happen in families that have everything in place.”
Daily, like many others who work in drug treatment, says it was “easy to predict” that the surge in opioid painkiller addic- tion would explode into a national heroin epidemic. “OxyContin made its way [to the Sacramento region] maybe seven years ago,” says Daily. “Suddenly overnight half of our clients became opiate addicts. Then when Oxy became harder and harder to use, it became about easy access to heroin.”
Sadly, the crisis shows little sign of stopping. “We are just in the infancy stages,” says Daily. “It’s probably got another 10 or 15 years to run.”
Even for Mike, who was no stranger to the drug scene, Oxy took him by surprise. “Everybody knows heroin is addictive,” says Mike. “But nobody at that time knew that OxyContin was like the same thing as heroin, just in a different form. It was just a pretty little green pill.” Mike, who has heard “hundreds of people’s stories” from his time in treatment, has yet to meet anyone who went straight to heroin. “It always started with Oxy.”
It is easy to look at drug addiction from the outside and arrive at some snap judgments about the user: It’s the family’s fault; they are dysfunctional. Of course he’s an addict; he’s never had any self-control. But addiction experts say that the science behind addiction—from what causes it to how to treat it—is an extremely complex subject that researchers still don’t fully understand.
“There are a lot of factors inﬂuencing addiction,” according to Curtis Buzanski, a licensed therapist and addiction coun- selor based in Fair Oaks. The latest thinking about addiction is that it is a brain disease involving intertwined biological and behavioral components. Genetics plays a role, as does the way in which a person learns to regulate his or her emotions. Familial relationships and histories of addiction are also factors, and yet there is no clear-cut explanation for why some family members become addicts and others don’t.
“I believe in the disease concept, but it is not the whole story by any stretch,” says Daily. “I think there are so many variables that go into the layers of complexity of addiction that nobody has modeled it out yet.”
Buzanski, who specializes in dual diagnosis (that is, treating addicts with underlying mental health conditions), has observed that many of his opiate-addicted patients have suffered some sort of trauma, either what he calls shock trauma, like from abuse or a near-death experience, or relational trauma.
With relational trauma, “maybe the person grew up in a world where they had a hard time connecting or having close, intimate relationships or feeling understood,” he says. “The opiate system in our brain gets activated in instances of bonding. To have an absence of bonding, it’s believed that maybe that opiate system gets pruned, because the brain prunes what it doesn’t use.” That’s why, Buzanski theorizes, many people report ﬁnally feeling “normal” upon ﬁrst using opiates.
Authentic personal connections are essential to mental well- being, but they can be hard to come by for some individuals. “It goes back to that myth that actually keeps a lot of families sick: that if it looks good on the outside, it must be good on the inside,” says Buzanski. “A lot of families look well—they have nice homes, nice cars, the kids are dressed and fed, the parents go to the soccer games, the kids go to nice schools—but on the inside that’s not always the case.”
In his work, Buzanski has encountered “wealthy families who are shocked that their kid is using heroin, but the child doesn’t necessarily have a sense of belonging, even if they were showered with love. If they don’t feel like they belong, they don’t absorb the love.”
It’s that disconnection that Buzanski believes can make an individual vulnerable to drug use. “It may not even be that people are drawn to the drugs out of an emotional state, but that they are ﬁrst drawn to the drug culture,” he explains. “Socially, the drug culture is all-accepting, all-inclusive. The person feels like someone ﬁnally gets me.”
That is one of the reasons why early recovery for an addict is “very challenging,” says Buzanski. “Just getting someone sober doesn’t mean they’re all better. We have to repair that feeling of love and belonging, that sense of self.”
If a sense of disconnectedness is what prompts some indi- viduals to start using, it’s biology that traps them in addiction. “The part that’s so gripping about heroin is that it hijacks your biology in a really big way,” explains Daily. “In a very short period of time, you’re using it just to feel normal, because in the absence of being intoxicated you’re actually sick: ﬂulike symptoms, diarrhea, vomiting, sweating, achy bones, achy muscles, can’t sleep. It’s horrible. That part is the biological drive for a lot of heroin users to keep using. They just want to get out of that state.”
Mike, who after a week on his friend’s couch spent two months in rehab at Clean & Sober Recovery Services, a private residen- tial treatment facility in Orangevale, knows well the hellish experience that withdrawal is: “I felt like I was dying. I was nauseous. I was starving but there was no way I was going to be able to keep down food. Every joint, every muscle, every bone hurt. It’s like a pain you can’t get to. There’s nothing you can massage to make it better.”
For Mike, rehab was a chance not only to get help detoxing but also to disrupt the destructive patterns he had developed over the years. Days were typically spent doing chores, exercis- ing and attending several hours of recovery meetings. It was also a time to build a community of sober friends, to really connect.
Paradoxically, the deep desire for human connection that drives many people to addiction ends up ravaging their relationships with family and friends. Mike has worked hard at rebuilding those relationships since beginning his recovery two and a half years ago. Years of addiction nearly destroyed his relationship with the two people who love him most.
“I was mean to my parents,” he says. “I was manipulative. I would go to their house, my face was sunken in and my skin was gray, and I made my dad feel like an asshole for thinking I was on drugs.
“Today we’re really close, but we’re still working on building a level of normality,” says Mike. “You can’t snap your ﬁngers and be where you should have been by this point.” Getting healthy has meant working through the shame he felt for “com- pletely mistreating people that loved me.” He is quick to acknowledge that nothing his parents did or didn’t do is to blame for his addiction, although he does believe that biology and environment “work together” in addicted individuals
Debbie, for her part, is overjoyed at having her son back. “It’s greater than I ever dreamed. I went 10 years without a happy birthday or a happy Mother’s Day. He gives me a lot of love now, a lot of caring. We can talk about anything now.”
Mike’s father, Larry, feels “a huge sense of loss” for what drug addiction stole from his family: “All those years that were lost that I could have had with him. I had a wonderful time with my father. I went backpacking with him, scuba diving, hiking. Mike and I had none of that.” Still, he is grateful that heroin did not kill Mike. “Most families don’t come out on the other side like we have.”
Larry and Debbie have made it their mission to help abolish the stigma that surrounds heroin addiction and prevents fam- ilies from seeking help. They regularly attend recovery meetings and speak to families of addicts. “Friends don’t say it, but sometimes there’s the feeling that I must have done something wrong to have a son on heroin,” says Larry. “But an addict is an addict, regardless of what parents they had or what school they went to.” Surviving addiction, he adds, is “all about rigorous honesty. The secrets are part of the disease.”
The relapse rate for heroin addicts is high, but Mike is optimis- tic about his recovery. Emotionally, he is a long way from the despair he felt the night he slept behind Walmart. “I don’t have any fears of relapse. I’ll always be an addict. I know I can never do heroin; I know where it takes me. But I just keep doing the things I need to do for myself: Staying around sober people. Going to recovery meetings when I can. Being honest. Having a relationship with my family. Showing up on time. Being ac- countable.”
Mike is not religious, per se, but he is prayerful. “The biggest part of prayer for me is that I don’t ask for anything. Instead, I give thanks for what I have. My spirituality is staying positive.” In that vein, Mike will be forever grateful to the friend who took him in when he hit bottom. To his parents, for letting go so that he could get well. To interventionist Ricki Townsend, for lighting the path to recovery. And to the dozens of fellow addicts he has met at recovery meetings, for making him feel less alone and less ashamed. Getting clean, it turns out, takes a village.
Drug addiction stole a lot from Mike. At 27, he’s not where he expected to be in life, but he seems content. He ﬁlls his weekdays with construction work. On the weekends, he’s a server in a restaurant. He lives in an apartment in Carmichael and has few wants, just “a job that I enjoy and that pays the bills. I don’t need to be rich.” Still, he has dreams for himself. He plans to go to college soon to earn a business degree and eventually get into sales. “I’m pretty dead set on it.”
The tattoos that adorn Mike’s arm and shoulder hint at the dark days he has battled and the recovery he ﬁghts for daily. The Langston Hughes poem “Harlem” speaks to dreams unre- alized. A raven symbolizes death; swallows, rebirth. A constellation of stars—Orion’s Belt—symbolizes his place in the world. He decided to get the tattoo after witnessing a meteor shower with one of his counselors. “I realized how small I am, that the world doesn’t revolve around me. It was a very humbling moment. I ﬁnally realized that my story is not unique.”